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Q #1: Animal Protein
My 22-year-old son just found out 2 months ago he is HIV positive. He is on Viracept and Combivir. I was wondering, since he doesn't eat any meat or eggs, what kind of nutrients should he take as supplements? (July, 2000)
A: Donna Tinnerello, MS, RD, CD/N responds:
If I were doing an actual consult, I would have a lot of questions to ask the writer. Most importantly, What is your son's current nutritional status? If your son is well nourished and has a good appetite and is willing to substitute other high protein foods, then a supplement is not indicated. However, I will try to answer the question to the best of my ability without this information.
Although it is never a good time to get such a diagnosis, there is reason for optimism in the year 2000 being HIV positive and on Highly Active Anti-Retroviral Therapy (HAART). People living with HIV (PLWHIV) do not necessarily waste away as they used to prior to the medications we have today, and sadly, the way they still do in third world countries where they have nothing at all. Instead most of the PLWHIV that I see here in New York City who are on therapy are gaining a lot of weight, and some of them even have high cholesterol and diabetes as a complication of therapy.
So the fact that your son has chosen to avoid eggs and meat might be a healthy decision on his part. We tell everyone who has high cholesterol to eat these foods in moderation. We are basically telling present day PLWHIV on medications to eat like the rest of us to avoid cardiovascular complications.
However, protein is absolutely essential to a healthy body and a healthy immune system. So I suggest your son consider fish, beans (kidneys, pintos, chickpeas, navy beans), soy protein (tofu, textured vegetable protein, tempeh) and wheat gluten (seitan). If he does drink and eat dairy, another source of good quality protein, I do suggest either non-fat or 1% fat milk, because whole milk products are a source of saturated fat that is known to raise cholesterol levels. Nuts and nut butters are a good protein source with healthy fat - monounsaturated, as in olive oil.
Meat and eggs are not bad food, but they can be easily replaced with the protein alternatives discussed above.
(Administrator's Note: Donna has much more to say on the subject of protein on the web site Always Your Choice. You will also find many other excellent articles that Donna has written on nutritional issues by going to the home page and clicking on "Nutritional Consultation".
Also of interest is Jennifer's article on this web site, Pyramid Power, in which she discusses not only protein but the other food groups as well.)
Q #2: Animal Protein
I am positive and I hear we should lower our animal product intake (meats). Is this true? (April, 2000)
A: Charlie Smigelski, RD responds:
People generally prevent wasting when on a high protein diet. (See the Q&A on Wasting Syndrome.) To quote from Page 22 of my workbook, Eat Up!:
"In simple food terms, you need to be eating at least 12 oz. of protein a day from meats, (fish, poultry, beef), plus some extra cheese, milk, or yogurt. Technical answer: Eat 3/4 to 1 gram of protein for every pound you weigh. If you're active, feeling fine, with no symptoms, eat 3/4 gram. If you have AIDS, eat 1 gram for every pound you weigh. For example, a 140 lb. person needs about 140 grams protein."
It is hard to eat the abount of protein you need on a low-animal product diet. Though this is not impossible, (using soy and whey protein powders would be necessary), animal protein is the easier and more foolproof way to go.
(Administrator's Note: Much of what you've probably hard about animal protein has to do with the saturated fat in red meat. As with non-HIV people, high cholesterol can be a cardiovascular risk for Positive People too. I recommend you read the "Cholesterol" and "Cholesterol & Diet" sections of Jennifer's article Holiday Survival Guide.)
