1. Positive Nutrition
Nishanga Bliss, L.Ac.
Assistant Professor, Acupuncture and Integrative
Medicine College
Gastronicity.blogspot.com
2. DIET AND HIV
Since the advent of highly-active antiretroviral
therapy, in areas and populations where there is
widespread access to these drugs, the focus of
nutritional concerns in HIV has shifted from
wasting to lipodystrophy. Lipodystrophy can
include elevated total cholesterol, LDL and
triglycerides and lowered HDL, as well as fat
redistribution syndrome (FRS) in which people
experience fat loss from their extremities and
deposition in the core of the body, especially the
abdomen.
3. Dietary Fat and HIV
In a study comparing HIV+ people with and
without Fat Redistribution Syndrome, no
differences were found in intakes of
carbohydrates, fats, cholesterol or
micronutrients. However, the people without
FRS ate more calories, protein and fiber than
those who had FRS (Batterham, Garsia, &
Greenop, 2000).
4. HIV lowers cholesterol, treatment
tends to raise it.
A 2003 study found that a group of men with
average cholesterol levels for their age had
reduced LDL and HDL after HIV infection
(Riddler, et al., 2007). After three years of
treatment with HAART, total cholesterol levels
had returned to pre-infection levels, however,
LDL, total cholesterol and triglycerides were
higher and HDL was lower than average,
resulting in a lipid profile associated with
higher risk of heart disease and diabetes.
5. What is cholesterol, anyway?
Cholesterol is a waxy substance found in most tissues of
the body and manufactured by the liver and body
tissues. It is used for tissue repair, producing
testosterone, estrogen, DHEA, adrenocorticosteroids
(hormones released by the body under stress), and
vitamin D, creating serotonin receptors, and producing
bile salts. For most people, cholesterol in the diet does
not have an appreciable impact on blood cholesterol
(Hu, et al). When more cholesterol is consumed, less is
produced by the body. In the diet, it is found
exclusively in animal products, especially eggs, butter,
liver and shellfish.
6. The Many Uses of Cholesterol
• ● Cholesterol is produced by almost every cell in the body.
•
•
• ● Cholesterol in cell membranes makes cells waterproof so there can be a different chemistry on the inside and the outside
of the cell.
•
• ● Cholesterol is nature’s repair substance, used to repair wounds, including tears & irritations in the arteries.
•
• ● Many important hormones are made of cholesterol, including hormones that regulate mineral metabolism & blood sugar,
hormones that help us deal with stress, & all the sex hormones, such as testosterone, estrogen & progesterone.
•
• ● Cholesterol is vital to the function of the brain and nervous system.
•
• ● Cholesterol protects us against depression; it plays a role in the utilization of serotonin, the body’s “feel-good” chemical.
•
• ● The bile salts, needed for the digestion of fats, are made from cholesterol.
•
• ● Cholesterol is the precursor of vitamin D, which is formed by the action of ultra-violet (UV-B) light on cholesterol in the
skin.
•
• ● Cholesterol is a powerful antioxidant that protects us against free radicals and therefore against cancer.
•
• ● Cholesterol, especially LDL-cholesterol (the so-called bad cholesterol), helps fight infection.
•
• (adapted from Myths & Truths About Cholesterol - WAPF www.westonaprice.org/moderndiseases)
7. What is cholesterol, anyway?
A large study in Northern California found that
men with a high risk of HIV infection who had low
total cholesterol levels (less than 160 mg/dl) had
a significantly greater rate of HIV infection, AIDS
and AIDS-related death than those who had
normal levels (between 160 and 199 mg/dl)
(Claxton, et al, 1998). Another study found that
low cholesterol was a strong predictor of death
from AIDS (Neaton & Wentworth, 1997). This
research suggests that cholesterol is exerting
some kind of protective effect, at least around
HIV.
8. The Experiment
For over 40 years, Americans have been involved in a vast,
uncontrolled diet experiment. We have been told by the
government, nutritionists, public health experts, the media,
and the food industry to reduce the fat content of our diets,
to substitute vegetable fat for animal fat, and to reduce our
cholesterol intake. This massive experiment was based not
on fact or experience but on a hypothesis, known as the
lipid hypothesis, which states that fat and cholesterol in the
diet raises cholesterol levels in the blood, promoting
atherosclerosis, resulting in a higher incidence of heart
disease. Since fat has more calories per gram than
carbohydrates or protein, it was figured that this diet
change would also help us lose weight and might even
protect us from cancer.
9. What happened? Over the past 40 years…
• Fat, especially saturated fat intake, has gone
down.
• Total calorie intake has gone up.
• Carbohydrate intake has gone up.
• The incidence of heart disease has not
changed
• The incidence of diabetes has skyrocketed—
new diagnoses were up 90% in the past 10
years.
11. “The low-fat campaign has been
based on little scientific evidence
and may have caused unintended
health consequences” (Hu, et al.,
2001, Harvard School of Public
Health).
12. • The data on whether there actually is an
increased rate of heart disease in people with
treated HIV are inconclusive (Calza, Manfredi,
Pocaterra, & Chiodo, 2008; May, et al., 2007).
However, it is clear that there is a higher rate
of diabetes in people living with treated HIV.
For example, a 2003 study showed a threefold
increase in diabetes diagnoses among women
taking protease inhibitors (Justman, et al.,
2003)
13. HIV meds: encouraging pre-diabetes?
An Australian study found “a pro-
inflammatory milieu equivalent to that of
insulin-resistant obesity [which] characterizes
lean men with treated HIV infection,”
concluding “these factors may contribute to
the accelerated diabetogenesis and cardiac
risk in treated HIV infection” (Samaras, 2008).
14. Alternative
Approaches
An study released in July 2008
found that red rice yeast and
fish oil supplements coupled
with dietary, exercise and
stress-management
counseling was more effective
than statin treatment in
lowering LDL, as well
significantly lowering
triglycerides and excess
weight (Becker, et al., 2008).
Fish oil supplements alone
were also found to be
effective in lowering
triglycerides in people with
HIV (Wohl, et al., 2005).
15. Recommendations
• Maintain a healthy weight. If you need to lose weight, research supports
refined carbohydrate, not fat or calorie, restriction as the most effective
way to lose weight and prevent FRS.
• Focus on fat quality, not amount.
• Use stable fats in cooking. Animal fats, such as butter, ghee & lard, &
coconut, palm, olive & expeller-pressed high oleic safflower or sunflower
oil are the least subject to damage by heat.
• Avoid deep-fried foods. If you deep-fry at home, use non-hydrogenated
lard or tallow as a frying medium.
• Increase omega 3 fatty acid levels in your diet by including flax or hemp
seeds & walnuts or their expeller-pressed oils, choosing pasture-fed dairy
& animal foods and sustainably caught wild fatty fish and eating plenty of
leafy greens, and at the same time,
• Reduce omega 6 levels by avoiding corn, soybean, cottonseed & non-oleic
safflower & sunflower oils, and minimizing the use of grain-fed dairy &
animal products
16. Recommendations, pt.2
• Reduce refined carbohydrates (white sugar & most sweeteners &
refined grains such as white flour & white rice).
• Strive to eliminate all industrially produced trans fats from your
diet, found in margarine, vegetable shortening, commercial
pastries, deep-fried & fast food, & most prepared snacks, mixes &
convenience food.
• Exercise regularly.
• Increase fiber & micronutrient intake by eating wide variety of
fruits, vegetables, whole grains & nuts.
• If high cholesterol remains a concern after trying all of the above,
consider natural therapies and supplements before resorting to
lipid-lowering drugs.
• Consider a short cleanse to get you started.
17. Food and the Immune System
Immune Stressors/Supressors Immune Supporters
• High glycemic foods: • Omega 3 fatty acid-rich foods
refined carbohydrates • Anti-oxidant rich foods
• Rancid/inflammatory oils • Probiotic and prebiotic foods
• Pesticides, chemicals in • Mushrooms (except white
food button)
• Excessive alcohol, caffeine, • Pastured/organic/wild animal
drugs foods
• Nutrient-poor foods, fake • Nutrient dense foods in
foods, processed foods in general
general
18. Choose Foods that Fight Inflammation
to Prevent Heart Disease, Cancer and
More are potent antioxidant
• Berries, chocolate, tea, coffee and nuts
sources, and coffee is the largest single source of antioxidants in the
Western diet. Eating a few ounces of dark chocolate a week has
been shown to provide numerous cardiovascular benefits.
• Other foods that are rich antioxidant sources include dried beans,
prunes and plums, onions, and most richly pigmented plant foods.
• Consuming celery, onions and garlic, omega 3 and 9 fatty acids,
seaweed, fiber, dark chocolate, coffee, and full fat dairy products
(Bonthuis, 2010), have all been linked to cardiovascular protection.
• Traditional medicinal and culinary herbs are some of the most
antioxidant rich foods ever measured, and provide important
antioxidant protection in usual dietary and medicinal amounts
(Carlsen, 2010)
