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Dietary Guidelines for HIV-positive living
Monica Fairall. The Pursuit of Health SAfm broadcast 24 March 2003
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Two United Nations agencies have come out in support of the beneficial role of diet in the lives of people living with HIV/AIDS. The World Health Organisation as well as the Food and Agriculture Organisation have declared that a good diet is one of the simplest means of helping people living with HIV/AIDS, and may even help delay the deadly progression of the virus.
The organisations have published a manual of dietary guidelines to this end, and I asked Chantal Gegout, a WHO nutritionist based in Zambia, about the importance of diet for people infected with the virus.
CHANTAL: There are special nutritional needs when you are ill. For example, with HIV, because the virus is affecting the immune system, you have people living with HIV who have a muscle mass which is decreasing, and they can lose a lot of weight. So it's really important to increase the quantity they are eating but at the same time to be really careful with the quality and to have a good level of protein.
MONICA: Perhaps you can give us some examples of the sort of quality of food you'd like to see people who are HIV positive eating, Chantal?
CHANTAL: It's really important to vary the food and at the same time to take in cereals, vegetables, meat or fish, dairy, fresh fruits and salads. This is the kind of food that everyone should have. Meat and fish are really important because they are rich in protein and they can help you to recover the muscle mass you have lost. And depending on each case - because HIV has many side-effects such as diarrhoea, and some people have a problem with their appetite, or the taste of the food can change, and you can also have different infections - the nutritional advice can be adapted to one's needs.
MONICA: How easy is it for people to make these changes? Because if one thinks that the people most in need of this kind of dietary support for their immune system are perhaps living under difficult circumstances... They might be poor people, for instance. So it's quite difficult perhaps to afford all those food groups in those meals.
CHANTAL: I completely agree. The meal I suggested to you is the ideal one but it can be adapted depending on your financial position. For example, to have a good level of protein instead of buying fish or meat, which is expensive, and not everyone can afford it, you can take in cereals and pulses, and the amount would be two-thirds cereals and one-third pulses, or you could combine cereals and groundnuts, and this would provide a good amount of complementary protein.
MONICA: Of the people that you deal with, Chantal, how receptive are they to the idea that perhaps by changing their diet they can make themselves healthier? Because I think it's hard enough when you're healthy to change your diet away from the bad habits to the good habits. I'm thinking that for somebody who is not that well, to find the energy and the motivation is even harder.
CHANTAL: That's true, but at the same time you have a good motivation. Sometimes you are so ill that it's really difficult to eat, because you have no appetite, and we are there to give advice on how to eat when you have no appetite, and when you feel better again. I think the role of the nutritionist is to explain the advantage of making an effort in what you are doing to improve your health. But I know it's not easy, because when you have habits it's not easy to change them just like that. But the most important thing is for us to explain the reasons. And, after all, everyone is responsible for what they do.
MONICA: Now, I know that a manual has just become available from FAO and the World Health Organisation. Who is this aimed at? Is it aimed at the public or is it aimed at healthcare professionals?
CHANTAL: The first aim of this manual is for people working in health. At the same time I think it can be used for everyone, depending perhaps on their education level. Maybe some people prefer to receive information orally. But for those who prefer to read I think it can be accessible to everyone.
MONICA: That was Chantal Gegout, a nutritionist with the World Health Organisation, talking about the role that diet can play in fortifying the immune system of people living with the HI Virus. The manual on nutritional care that we spoke about is called Living Well with HIV/AIDS, and more information can be obtained online via the Food & Agriculture Organisation website, www.fao.org.
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