To Fight HIV, Eat Smart

Way back in 1984, I remember covering a meeting at New York's LGBT Center where a dietician was discussing the importance of a macrobiotic diet in fighting AIDS. It was the first of many such stories about many such meetings, and in retrospect, I'm still moved by the desperation of the men in that room at a time when the only approved HIV-fighting drug was AZT.

Today, there is a whole arsenal of meds to keep T cell counts high and viral loads low. But diet still looms as vital for those infected with HIV to stay healthy.

Fad diets come and go, but HIV is a constant. If you hear everyone exclaiming the benefits of the latest craze, ignore them. Nutritionists -- at least the reputable ones -- all agree that people with HIV need to keep their eyes on the prize, well-balanced meals and sensible snacking.

Unfortunately, some people fall for the promises made by proponents of the diet du jour. While most people have the leisure of discovering for themselves how far these diets fall short of their claims, pozzers don't have that luxury.

Eat Smart

Eating sensibly means getting plenty of the right food in healthy portions. It's true that, thanks to meds, wasting no longer presents a direct threat. Today, the problem is overeating: Many pozzers are overweight, but a fad diet won't cure that.

Instead, make fresh fruits and vegetables a center of the plate. Juices, which are processed and won't provide necessary fiber, don't count. Second in importance are whole grains, another great source of natural fiber and nutrients.

Then -- and only then -- comes the protein.

When it comes to protein, the Mediterranean diet, where lean meat and fish are treated almost like side dishes, has it exactly right. Or consider the traditional Chinese meal, where meat is treated like a condiment and sits delicately atop a base of grain and steamed or stir-fried vegetables. Lean protein in sensible portions will suffice; if you choose to go vegan, you'll need to be extra-careful to consume enough protein, especially from beans and tofu.

Don't deny yourself "good" fat, however. Use healthy oil, such as canola or olive oil, and avoid entirely saturated fats, trans fats and hydrogenated oils. If an oil congeals at room temperature, it's a no-no. Remember to look at food labels; hydrogenated and saturated fats are used in all kinds of products, including commercial peanut butter. That's too bad, because by themselves, nuts -- all varieties -- are probably the healthiest fatty food on the planet. Fortunately, grocery stores now stock several brands of pure peanut butter.

If you have a sweet tooth, there's no reason to deny yourself entirely. But indulge sensibly. It's much easier to eat one wrapped miniature candy bar than to try to take a little bit from one of those super-sized monsters. If you want some ice cream, use a small bowl -- and never eat directly from the container! If you must have soda, never buy the 2-liter or liter size. Get small cans (they do exist) -- and never more than two or at most three a week.

Although a macrobiotic diet certainly doesn't "cure" HIV, if it promotes healthy eating, go for it. As far back as the '80s, researchers found that people adhering to a strict macrobiotic diet did have an increase in CD4 numbers, less fatigue. This type of diet can be particularly beneficial if you are susceptible to thrush, since it restricts yeast.

Beware Quack Cures

Over the years, various "experts" have come along with all kinds of remedies for HIV. In 1993, for example, a Minnesota farmer managed to convince several people that they needed to buy one of his cows, which he had supposedly injected with the person's own blood sample. He claimed that the milk that cow produced would produced antibodies to HIV.

Two years later, a man in Arizona was promoting a "cure" that turned out to be a potion made of cranberry juice, saline solution and, believe it or not, bleach. British nutritionist Patrick Holford has long held out mega-doses of vitamin C beats out conventional meds, despite no evidence supporting his theory.

Dr. Robert Atkins' diet has held a longer hold on the public imagination that most of the other diet crazes. Atkins claimed his high-protein, low-carb diet was the best way to treat people with AIDS. Anyone who tells you that you need to eat as much protein as possible is giving you a one-way ticket to liver and kidney damage, severe dehydration, vitamin depletion and the loss of precious muscle mass.

That goes double for the ridiculous paleolithic diet, which supposedly imitates the dietary habits of our most ancient ancestors, before farming made large quantities of grain possible. Civilization, and especially modern advances in agriculture, however, made overeating the culprit, not the types of food eaten. If you eat like a Neanderthal, count on living as long as one.

’Good’ Indulgences

But, you say, you want to pig out on something. Researchers unanimously agree that your best indulgence is water. It may not be sexy or tasty, but super hydration flushes out nearly every part of the body. It's the most effective way to detox, and it promotes healthy digestion. If you're thirsty, that's a bad sign: Drink water before your body needs it.

The most important thing to remember about water is that it is best consumed in its natural state. Anything else just adds a lot of sugar, caffeine or chemicals. Above all, stay away from diet sodas. They retard digestion, actually increase the craving for something sweet, may have a high sodium content or caffeine and can result in irritability, tooth decay, heart disease and even diabetes.

Bacteria has had a bad rap, but did you know that most bacteria are actually beneficial? Several studies have shown that probiotics, as healthy bacteria are called, definitely help preserve immune function, most likely by boosting healthy cells and lowering infection from harmful bacteria. Yogurt, long associated with probiotics, lives up to its reputation and then some, although you can also find probiotics in fermented food like sauerkraut, miso, tempeh and fermented vegetables. Just be aware of the sodium content when you shop for these foods, as too much salt means high blood pressure, among other bad effects.

After all that, it's nice to know that some fun food is especially good for fighting HIV infection.

People with HIV need lots and lots of antioxidants. Traditional Chinese medicine often prescribed tea. It turns out they were onto something. Tea of any kind provides an amazing amount of oxidants. Green tea is especially beneficial in all sorts of ways, not the least in helping prevent certain HIV infections. But if you like the regular stuff, go ahead and indulge yourself.

Here's where it gets fun: Red wine and, yes, dark chocolate are great sources of antioxidants. That doesn't mean a whole bottle during dinner and a giant Hershey bar for dessert. What is does mean is that, in moderate portions, they're not only great tasting and relaxing, but help fight HIV-related neurological complications.

Lastly, researchers have been at odds about whether and how much grapefruit interacts with HIV meds, including certain protease inhibitors. The jury is still out, but be sure always to ask your doctor about the effect of grapefruit when he's writing a scrip.

Even if he or she says it's OK, don't overindulge. In fact, that's the best advice for anything you ingest. Except water.

Steve Weinstein has been a regular correspondent for the International Herald Tribune, the Advocate, the Village Voice and Out. He has been covering the AIDS crisis since the early '80s, when he began his career. He is the author of "The Q Guide to Fire Island" (Alyson, 2007).

This story is part of our special report: "Living Well with HIV". Want to read more? Here's the full list.