Reprinted from Everyday Health

High-fiber produce and anti-inflammatory omega-3s can help keep your immune system strong.

By Kelly Mickle

Medically Reviewed by Sanjai Sinha, MD

Good nutrition is important for everyone, but when you’re living with HIV, a well-balanced diet can be especially valuable in helping you ward off other diseases while boosting your physical and mental health. What you eat can also help you maintain your strength, increase your energy, and fortify your immune system.

“There is a battle going on in your body all the time that requires your immune system to work double time to protect you and fight the virus,” says Stephanie Boyd, RD, of Mama’s Kitchen, a San Diego nonprofit organization that provides nutrition education and healthy meals to those living with HIV and AIDS. “Your body needs all the extra help it can get, and a healthy diet gives you the nutrients your body needs to strengthen and repair itself.”

What’s more, HIV treatment and its clinical course can lead to problems like wasting syndrome (significant weight loss from complications of HIV), diarrhea, and changes in the way your body processes or uses fats and insulin — and the right nutrition can help.

Healthy Foods for People With HIV

“Your meals should look like colors of the rainbow,” says Boyd, “full of colorful vegetables, fruits, nuts, beans, whole grains, good fats, and lean proteins.” As with the Mediterranean diet, the goal is to eat fresh foods and minimize processed fare.

Brightly colored fruits and vegetables like berries, leafy greens, bell peppers, and sweet potatoes are packed with antioxidants like beta-carotene and vitamins C and E, which can bolster your immune system and protect against infection.

Fiber-rich foods like apples, whole grains, and beans can give you a long-lasting infusion of energy. “Unlike candy, which gives you a quick shot of energy from the sugar and then causes you to crash,” says Boyd, “fiber takes more time for the body to break it down, which keeps your blood sugar levels stable and makes you feel full and energized longer.” A fiber-rich diet has also been shown to lower cholesterol, promote healthy bowel movements, and reduce the risk for diabetes and heart disease — common health concerns associated with HIV and HIV treatment.

Nuts, olive oil, and fatty fish like salmon and tuna are high in omega-3 fatty acids, which can decrease inflammation. “When you’re HIV positive, you live in a constant inflammatory state because your immune system is working so hard, so it’s good to seek out anti-inflammatory foods,” says Alan Lee, RD, a dietitian at Family Health Center of Harlem and Apicha Community Health Center in New York City, and nutrition counselor for TOUCH, Inc., in Congers, New York. Try topping your morning oatmeal with walnuts and fruit or toss chia or pumpkin seeds (also high in omega-3s) into a smoothie.

Protein is also crucial. “The immune system is using more protein to fight off HIV, which can lead to wasting syndrome, so it’s important to eat enough protein to build and maintain muscle,” says Lee. He recommends lean animal proteins like chicken, fish, and dairy, as well as vegetarian proteins like tofu.

Foods to Limit If You Have HIV

“People are often afraid of losing weight and ‘looking sick’ when they have HIV,” says Lee, “so they can overcompensate by loading up on more fat and sugar than they need. But these foods will just make you feel worse.” Unhealthy fats and sugars can weaken your immune system, cause fatigue, and increase your risk for unhealthy weight gain, diabetes, and heart disease.

“It’s okay to treat yourself every once in a while,” says Boyd, “but watch your portion sizes and eat slowly so you have time to recognize when you’re getting full.”

And go easy on the alcohol. Too much drinking can damage your liver, and that can raise your risk of side effects from some HIV drugs.

When to Take a Supplement

Vitamin D and calcium supplements may be necessary to protect your bone health, but always consult your doctor before you take any nutritional supplements. “Herbal supplements and multivitamins can interact with certain HIV meds,” says Ankita Kadakia, MD, an infectious-diseases physician and AIDS/HIV specialist at UC San Diego Health’s Owen Clinic. “Always discuss with your doctor anything you’re taking over the counter to make sure it isn’t going to have a negative impact on your treatment plan.”

Why Food Safety Is Important for People With HIV

“Because HIV compromises your immune system,” says Boyd, “you’re at an increased risk of food-borne illnesses, which makes it especially important to be vigilant about food safety.” Her advice:

  • Avoid raw meats, eggs, milk, and sushi, as well as unpasteurized dairy, which can all harbor disease-causing bacteria
  • Wash your hands before and after preparing food (and wash them before you eat)
  • Wash all fruits and vegetables thoroughly before eating
  • Use separate cutting boards for raw meats
  • Reheat leftovers until they’re piping hot
  • Use a thermometer to make sure you don’t eat undercooked meats
  • Write dates on your food and clean out your fridge regularly
  • Use a water filter for drinking water

Where to Find Support

Meeting your nutritional needs can do more than just keep you well fed and physically healthy. People with HIV who received healthy food and snacks for six months were more likely to take their medication and less likely to binge drink and feel depressed, according to a study published in January 2017 in the Journal of Urban Health. “Food instability is one of the biggest risk factors [affecting] HIV treatment adherence,” says Dr. Kadakia. “There are great groups and resources that offer food delivery programs and nutrition counseling to those living with HIV, so don’t hesitate to ask your doctor for advice.”

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