alaine mills, dietetic intern hiv & nutrition. why is it important to have a healthy diet? ...
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Alaine Mills, Dietetic Intern
HIV & NUTRITION
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Why is it important to have a healthy diet?What is a healthy diet?Possible co-morbiditiesManaging side eff ectsFood SafetyQuestions
OUTLINE
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Maintaining/Restoring Body Weight
Managing Side Effects
Eating EnoughExercise
WHY IS IT IMPORTANT TO HAVE A HEALTHY DIET?
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Fever Infections
WHY DO I HAVE INCREASED ENERGY NEEDS?
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WHAT IS A HEALTHY DIET?
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ProteinFruits & Vegetables
WHAT FOODS SHOULD I FOCUS ON?
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WHY PROTEIN?
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WHAT FOODS ARE HIGH IN PROTEIN?
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Antioxidants
WHY FRUITS & VEGETABLES?
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Omega-3 Salmon, almonds, walnuts
Vitamin C Citrus fruits
Vitamin A Carrots, sweet potatoes
Vitamin E Spinach, sunflower seeds, almonds
Zinc Protein, legumes, oatmeal
IMMUNE SUPPORTING NUTRIENTS
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HyperglycemiaHypertensionHyperlipidemiaChanges in body
compositionPancreatitis
Kidney & liver diseaseHypothyroidismOsteopeniaMalnutritionWasting
POSSIBLE CO-MORBIDITIES WITH NUTRITIONAL IMPLICATIONS
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What is it? High blood sugar
Symptoms: excessive thirst & hunger, frequent urination, weight loss
Why does it matter? Can lead to vascular diseases affecting the eyes, heart,
kidney, nerves, and limbs
HYPERGLYCEMIA
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Avoid concentrated sweets (candy, soda, baked goods, etc)
Whole Grains Protein with all meals and snacks
NUTRITIONAL MANAGEMENT OF HYPERGLYCEMIA
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Hypertension
What is it? Persistent high blood pressure
What does it matter? It is associated with increased incidence of heart & kidney
disease
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Nutritional Management of Hypertension
Increase fruits, vegetables, and low fat dairyReduce sodium intakeModeration of alcohol consumption
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Hyperlipidemia
What is it? Abnormal amounts of lipids in the blood
Cholesterol & triglycerides
Cannot be identified without a lab test Can result from some drugs What does it matter?
Can lead to serious health problems, such as heart disease Cholesterol can build up in the arteries and form plaque
Pancreatitis Painful inflammation of the pancreas
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Reduced intake of saturated fats Red meats, butter, baked and fried foods
Increase intake of mono- and poly- unsaturated fats Fish & seafood, nuts & seeds, soy, vegetable and canola oil
Increase fiber intake Whole grains, veggies
Limit alcohol <2 glasses per day
Exercise!
NUTRITIONAL MANAGEMENT OF HYPERLIPIDEMIA
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Osteopenia
What is it? Low bone mineral density
What causes it? Inadequate calcium and vitamin D intake or status Low body weight Certain medications Lack of physical activity
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Nutrition for Osteopenia
Adequate Calcium (Milk, cheese, yogurt, pudding, dark green veggies)
Adequate vitamin D intake (fish, milk, supplements, and from the sun)
Balanced diet
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NauseaMouth or throat soresDry mouthLoss of tasteFatigueDiarrheaConstipationNot eating enoughWeight loss
NUTRITION RELATED COMPLICATIONS
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Cause: Medications
Why is it important? May cause you to not eat as much as you should
Management: Small, frequent meals Avoid high-fat, greasy foods Cool or room temperature foods Avoid lying down after eating Take medications after the meal or with food
NAUSEA
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Causes: Bacteria, virus, or fungus
Why is it important? May cause you to not eat as much as you should
Management: Soft, moist food Avoid spicy or acidic foods Cool or room-temperature foods Nutrient and energy dense foods Medicated mouthwash
MOUTH OR THROAT SORES
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Cause: Medications
Why is it important? May cause you to not eat as much as you should
Management: Moist foods Drink lots of fluids Good oral hygiene Use artificial saliva Sour or tart foods Chew gum Suck on hard candy or ice Avoid alcohol (check your mouthwash)
DRY MOUTH (XEROSTOMIA)
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CausesWhy is it important?Management:
Avoid red meat Avoid metal utensils Use marinades/seasonings
LOSS OF TASTE(DYSGUESIA)
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Causes: Medications, anemia
Why is it important? May cause you to not eat as much as you should
Management: Get enough sleep Exercise Make sure you are eating enough Avoid alcohol & tobacco Seek treatment for anxiety or depression Avoid stress Ready to eat foods or foods that require little preparation
FATIGUE
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Causes: Numerous- medications, bacteria, fungi, disease, diet
Why is it important? May cause malabsorption of nutrients and dehydration
Management: Drink plenty of fluids (water) Electrolytes (salt, bananas, potatoes, sports drinks) Limit dairy Avoid gas causing foods and beverages Avoid greasy and spicy foods Take medications after meals Soluble fiber (white bread, bananas) Anti-diarrheal medication
DIARRHEA
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Causes: Medications, diet
Why is it important? May cause you to not eat as much as you should
Management: Drink more fluids Eat more fiber (whole grains, fruits, vegetables, legumes)
CONSTIPATION
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Causes: Medications, increased energy needs
Why is it important? Good nutrition improves the quality of life and may prolong
itManagement:
Nutrient and energy dense foods Small, frequent, meals and snacks Nutrition supplements Appetite stimulants
NOT EATING ENOUGH(INADEQUATE FOOD CONSUMPTION)
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Causes: Not eating enough, increased energy needs, medications,
hormone imbalancesWhy it matters?Management:
Eat more (especially protein) Manage eating associated ‘ symptoms Resistance exercise Steroids
WEIGHT LOSS
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Wash your hands with soap and warm water before you eat or prepare food
Wash all fruits and vegetables with soap and warm water
Make sure your refrigerator is less then 41 degrees FKeep cold foods cold and hot foods hotOnly keep leftovers for 24 hoursCook meats well doneAvoid: sushi, raw eggs, raw oysters, buff ets
FOOD SAFETY
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QUESTIONS?