Fat
There is no evidence to support HIV-specific recommendations regarding the type or
amount of fat for PLHA (Raiten et al., 2011). Because PLHA may have lipid abnormalities,
a low–saturated fat diet, not a low–total fat diet, may be benefi cial (see “Metabolic
Alterations of Lipodystrophy”). A heart-healthy diet with monounsaturated fats and
omega-3 fatty acids may help reduce the risk of cardiovascular disease.
Vitamins and Minerals
Observational studies suggest that low blood levels and inadequate intakes of some vitamins
and minerals are associated with faster HIV disease progression and mortality (WHO,
2003). Nutrient defi ciencies may occur from poor intake, malabsorption, infections, or
diet–medication interactions. In general, dietary intake of micronutrients at RDA amounts
is a reasonable recommendation for people with clinically stable disease (Forrester and
Sztam, 2011). In some PLHA, short-term, high-dose multiple micronutrient supplementation
may be benefi cial, depending on the patient’s nutritional status and immune status
and the presence of coinfections (Forrester and Sztam, 2011). Evidence suggests potential
harm from higher doses of selected micronutrients, especially of vitamin A and zinc in some
populations (Raiten et al., 2011).