Cooking AIDS: Nutrition and HIV

By Naomi Mendelsohn

"Some people with HIV are homeless or live in hotels where they have limited access to a stove or refrigerator. You need to show them how to prepare nutritious foods simply."

You are what you eat, right? Let's see, that must mean that my body is an amalgamation of french fries, apples, pizza and the occasional pint of Ben and Jerry's "Chubby Hubby." But I certainly don't speak for everybody.

Nutritionists and physicians agree that there is a direct correlation between eating habits and health. The better you eat, the stronger immune system you have. What this translates into is a heightened ability to recover from illness and infection.

But what about people who have impaired immune systems, like those living with HIV or AIDS? Well for them, the connection between nutrition and health is all the more vital. So vital, in fact, that there are myriad organizations devoted to helping people with HIV/AIDS get proper nutrition. Non-profits such as God's Love We Deliver in New York City or Project Open Hands in San Francisco deliver nutritious food to homebound people with AIDS.

Other organizations teach people to cook nutritiously for themselves. That's where Mary Jane Detroyer, M.S., R.D, C.D.N, comes in. A nutritionist in private practice in New York, Detroyer specializes in helping HIV/AIDS patients learn and use the tenants of good nutrition in order to fight off disease. Detroyer also spent several years teaching cooking classes at Iris House, a residence and service provider for women living with HIV in Harlem, N.Y.

SavvyHEALTH: How important is good nutrition to HIV patients?

Detroyer: Nutrition is very important. When you're HIV positive, you need to get enough protein. Fruits and vegetables provide enough anti-oxidants, vitamins and minerals. But people with HIV need almost twice as much protein as you or I do because of the virus.

SavvyHEALTH: Are there problems that arise with food and medication?

Detroyer:Certain medications are limiting as to what you eat and when you can eat it because they affect the absorption of medicine. For example, people with HIV need to avoid grapefruit juice, because it affects the absorption of medications. For certain protease inhibitors, you can't have any fat for two hours before taking the medicine. For others, you have to have a high-fat meal. For someone who is on one of these medications and is having a problem with weight and/or wasting, they might tend not to eat anything because they are so concerned.

SavvyHEALTH: What are some food safety issues that people with HIV/AIDS face?

Detroyer: Water safety is important. HIV/AIDS patients should always use bottled water or boiled water to wash off food because of different bacteria and e.coli. If you or I drank it, it would make us sick. But it could put them in the hospital. This is not as important when cooking, because then the water is cooked, but for washing vegetables and drinking it is very important.

Another important thing is: no raw foods, no sushi, no raw eggs. Their immune systems are so weakened, it's not worth the risk. If they are cooking any kind of animal flesh, they need to eat it very well done. No overlightly eggs; hardboiled or scrambled to dry only. This also goes for people with cancer who are having chemotherapy too. Their immune systems are not up to par.

SavvyHEALTH: What about sanitary issues like cleaning counters?

Detroyer: Counters can cause contamination. People with HIV/AIDS have to be very careful when working with cooked foods and raw foods. They need to wash their hands carefully, even after they've handled eggs. Wash everything off after cutting raw meats. There are questions about organic produce too. If they're not sure where it comes from. For example, if an organic compost hasn't been composted long enough, that can be a problem.

SavvyHEALTH: What about spicy foods, do they ever cause problems?

Detroyer: Spicy foods aren't a problem unless they are experiencing thrush or mouth sores. Quite often people find out they are HIV positive when they find an opportunistic infection like thrush. If they have thrush in their mouth it can be very uncomfortable to chew and swallow. Spicy or acidic foods, or hot and cold foods can hurt. Herpes simplex virus sores in the mouth can also be a problem.

SavvyHEALTH:Is this the kind of information you taught in the cooking class?

Detroyer: We had all different kinds of classes. The first dietitian instituted the first class five years ago and we've developed a lot of topics since then.

For example, some people with HIV are homeless or live in hotels where they have limited access to a stove or refrigerator. You need to show them how to prepare nutritious foods simply. If you have limited access to a stove or fridge, you are going to have to learn to eat nutritiously out of cans.

But maybe they have a burner. So the question becomes how do you make a nutritious meal in a pot on top of a stove. You might boil up pasta, mix in some tuna, and throw in some canned vegetables. You might even put in powdered milk, so you'd have a tuna pasta casserole which is much better than going to McDonalds which is often what happens.

SavvyHEALTH:What other things did you teach?

Detroyer: Each class was given recipes, so they had something to take home with them. We would cover a nutrition topic, say fish. So we would talk about food safety and fish. We wold teach them a couple of ways to cook a nutritious fish. We talked about omega-3 fatty acids. A lot of people are starting to develop a problem with cholesterol, and fish is good because it has good fat for your heart.

In another class, we would teach them how to make nutritious high-calorie shakes, instead of buying shakes like Boost. But first of all, you have to have a blender, which we were able to provide sometimes. You just take fruit, yogurt, soymilk, peanut butter — for calories and fat, and you whir it up.

SavvyHEALTH: What other topics did you cover in the classes?

Detroyer: In a lot of the classes we would teach people how to cook vegetables. You'd be surprised but a lot of people don’t know how to cook vegetables, like yellow squash or butternut squash. We taught them how to cook it and how to add protein to it. We showed them how to make oil and vinegar dressing at home, which is cheaper. We show them how to add things like hard boiled eggs, beans and tuna fish to salads, so that could be one meal. Getting one meal with things like spinach instead of lettuce. Very simple things if people don't have time or are tired.

SavvyHEALTH:How soon after diagnosis does someone need to start thinking about nutrition?

Detroyer: Immediately. They need to start thinking about nutrition and exercise. Quite often the diagnosis doesn't happen right away. It usually takes a while before someone's immune system starts to get infections. In the beginning they may like they have the flu and a lot of people don't realize that they have the virus. For some people the diagnosis could come five years later.

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