Although dietary interventions cannot cure AIDS, there are three important facets of this illness which are directly influenced by diet.

These include avoidance of malnutrition to prevent individuals from becoming susceptible to AIDS, treatment of malnutrition which occurs in AIDS to slow down the progression of the disease, and use of vitamins, minerals and fatty acids to boost the immune system.

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Malnutrition and the immune system

Studies show a cyclical interaction between nutrition, immunity, infections and HIV-AIDS. Malnutrition which exists before an individual becomes infected with HIV weakens the immune system and makes the person more susceptible to infections, including HIV. Some authors regard malnutrition as "an important, facilitating co-factor that promotes the acquisition or progression of the disease.

The type of malnutrition that decreases the proper functioning of the immune system represents serious deficiencies of protein, energy, vitamins and minerals.

People who are deprived of an adequate food intake due to poverty, and natural and national disasters such as droughts, floods and wars (all of which are common in Africa), are much more likely to have compromised immune systems. This lack of immunity makes these people susceptible to all kinds of infections, including HIV.

This aspect of combatting AIDS is of such a vast magnitude, that it can only be addressed by governments and international relief agencies.

Malnutrition caused by AIDSAIDS is also called "Slim Disease" because patients suffering from the disease literally tend to waste away. People living with AIDS suffer from anorexia, diarrhoea, nausea, vomiting, fevers, and opportunistic infections, which all put an enormous strain on body reserves of energy, protein and micronutrients.

In addition, many of the anti-AIDS drugs can cause nausea, anorexia and vomiting, which interfere with food intake.

This wasting away is associated with a pronounced loss of lean body mass (muscle tissue) and depletion of body protein reserves. Health workers regard a loss of more than 33% of a patient's normal body weight as associated with decreased chance of survival and even as a predictor of early death.

The most important dietary intervention is firstly to try and combat protein and energy malnutrition. Patients should try and eat high-protein, high-kilojoule diets.

Use of liquid food supplements can boost intakes of protein and energy, particularly when patients cannot eat solid foods because of nausea and vomiting. Discuss this aspect with your doctor, dietitian or pharmacist.

Patients may have to add liquid booster foods to their usual food intake to ensure that they are getting sufficient protein and energy.

Always remember that if patients eat a diet rich in proteins and energy it may help to slow the progressive infection and prolong life.

Dr Ingrid van Heerden, registered dietician

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