Healthy Eating for people living with HIV Following a healthy diet and taking regular exercise delivers health benefits for all. Research has shown that people living with HIV are at an increased risk of infections, cardiovascular disease (CVD, heart disease/strokes) and bone disease (osteoporosis). Following a well balanced diet and maintaining a healthy weight can help prevent these problems.

How do I have a healthy diet? Following a varied, balanced diet can support your immune system, promote a healthy heart, protect against some cancers, promote good bone health and help you achieve and maintain a healthy weight. Eating a well-balanced diet is important to achieve and maintain good health. The ‘eatwell plate’ below helps show you how to balance your diet by choosing a variety of foods from each of the five food groups.

Department of Health in association with the Welsh Assembly Government, the Scottish Government and the Food Standards Agency in Northern Ireland

Food Groups A balanced diet includes a variety of foods from the five food groups described below.

Starchy Foods • Eat plenty of these foods and try to include them with each meal. • These foods provide energy as carbohydrate, fibre, B vitamins and iron. • Wholegrain varieties are best as these will increase your fibre intake • Examples include bread, potatoes, sweet potatoes, past, rice, noodles, maize meal, cassava, cereals, yam and millet and can be included in meals such as: - cereal or a bread roll at breakfast - sandwiches/toast as snack/meal - potatoes/cassava/pasta/rice with main meal

Meat, fish, eggs, beans and other non-dairy sources of protein • Eat these foods in moderate amounts • These foods provide protein, iron and B vitamins • Examples include meat, fish, eggs, tofu, Quorn, beans, pulses • Choose lean meat and avoiding frying to help reduce your fat intake. Aim to eat two portions of fish each week, including at least one portion of oily fish such as mackerel, salmon, tuna (not canned) and sardines • These foods can be included in the diet in a variety of ways, for example: - baked potato and tuna - baked beans on toast - lean meat/Quorn with vegetables and potatoes rice/pasta - chicken casserole with maize meal

Milk and dairy foods •

Eat these foods in moderate amounts.

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These foods provide protein, calcium and B vitamins, and are excellent sources of calcium, which is important for bone strength.

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Examples include milk, cheese, yoghurts. Non-dairy alternatives can be used instead such as calcium enriched soya milk and yoghurts.

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Choose low-fat varieties as these usually contain as much calcium as full-fat varieties.

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Try to have 3 portions daily

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1 portion is about ⅓ pint milk, 1 small yoghurt pot, 30g cheese.

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These can easily be included in your diet as milk with cereals, low-fat cheese in sandwiches, low-fat yoghurt with fruit as pudding.

Fruit and vegetables •

Try to have at least five portions every day.

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These foods provide a variety of vitamins, fibre and some iron.

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Vitamins A, C, E and folic acid can protect against heart disease and some cancers.

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Any fresh, frozen, canned or dried fruit or vegetables are all good choices.

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A portion is roughly: - 1 medium fruit such as an apple or banana - 2 small fruits like kiwi or plum - A handful of grapes or strawberries - 1 tablespoon dried fruit - 2-3 tablespoons canned or stewed fruit - 1 small glass (about 150ml) unsweetened fruit juice - 2 tablespoons of vegetables - 1 dessert bowl of salad

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These can easily be included in your diet as a glass of fresh fruit juice with breakfast, salad with sandwich, fruit as snack between meals, vegetables with main meals.

Food and drinks high in fat and/or sugar •

These foods provide energy, fats and some vitamins.

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Try to have only these foods occasionally and in small quantities as they can lead to excessive weight gain and poor heart health.

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Examples include cakes, biscuits, pastries, crisps, sweets, chocolate, sugary drinks.

It is also important to be aware of your salt intake •

Only use small amount in cooking and avoid adding it at the table.

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Use garlic, pepper, herbs and spices as alternative to flavour food.

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Try to limit processed foods like canned soups and ready meals as they often contain more salt.

Links for healthy eating www.nhs.uk/Livewell/healthy-eating : general healthy eating advice for everyone www.nam.org.uk : has a resource on nutrition for people with HIV www.bhf.org.uk/heart-health/prevention/healthy-eating : very helpful for specific advice on preventing heart disease www.milk.co.uk : The dairy council website – useful information on bone health

Alcohol Try to keep to the recommended limits for alcohol consumption: •

Men: a maximum of 21 units per week (3-4 units per day)

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Women: a maximum of 14 units per week (2-3 units per day)

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Aim for at least 2 alcohol free days per week

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Avoid binge drinking

The table below provides examples of the units and calories in a variety of alcoholic drinks:

Drink

Unit

Calories

125ml glass of 12% wine

1.5

104

175ml glass of 12% wine

2.1

145

250ml glass of 12% wine

3

208

1 pint (568ml) of low strength (3.6%) lager/ale/cider

2

176

1 pint (568ml) of high strength (5.2%) lager/ale/cider

3

238

1 can (440ml) of medium strength (5.0%) lager/ale/cider

2

180

1 small single shot (25ml) of spirit (40%) – gin, vodka, whisky

1

58

1.4

81

1 standard single shot (35ml) of spirit (40%) – gin, vodka, whisky

What is a healthy weight? Body mass Index (BMI) is a measure used to indicate how healthy your weight is. To calculate your BMI di‐ vide your weight (kg) by your height (m) squared BMI = weight (kg) ÷ (height (m) x height (m)) BMI can be categorised into ranges that indicate how healthy your weight is for your height. BMI Categories:

Adults (general)

Underweight

Healthy weight

Overweight

Obese

Very obese

less than 19.9

20-24.9

25-29.9

30-40

More than 40

This chart will help you to find your BMI and see how healthy your weight is. If your weight is higher or lower than outlined in the chart, talk to your doctor, dietician or nurse specialist who may be able to help make specific suggestions and give you advice and support.

Source: http://www.nhs.uk/Livewell/healthy-living/Pages/height-weight-chart.aspx

www.nhs.uk/Livewell/healthy-living/Pages/height-weight-chart.aspx for further information about healthy weight