25 February 2003, Geneva/Rome-- A good diet is one of the simplest means of helping people live with HIV/AIDS and may even help delay the progression of the deadly virus, two UN agencies said today.

A new manual published jointly by FAO and the World Health Organization (WHO) recognizes the relationship between infection and nutrition and offers simple and practical dietary suggestions for the estimated 42 million people living with HIV/AIDS.

By bolstering the immune system and boosting energy levels, balanced nutrition can help the body fight back against the ravages of the disease. By maintaining body weight a good diet can support drug treatments and prevent malnutrition.

"The relationship between HIV/AIDS and malnutrition is a particularly extreme example of the vicious cycle of immune dysfunction, infectious disease and malnutrition," said Dr David Nabarro, WHO Executive Director for Sustainable Development and Healthy Environments.

"The nutritional aspect of HIV/AIDS has been ignored for a long time. The attention was always focused on drugs," said Kraisid Tontisirin, Director of FAO's Food and Nutrition Division.

"The message was always: 'Take two tablets after meals'. But they forgot about the meals," he said.

Almost 95 percent of people with HIV/AIDS live in developing countries where healthcare, resources and drugs are scarce. For them a balanced diet is a positive way of responding to the illness.

"Food isn't a magic bullet. It won't stop people dying of AIDS," William Clay of FAO's Food and Nutrition Division said, "But it can help them live longer, more comfortable and more productive lives."

Dr Graeme Clugston, Director of WHO's Department for Nutrition in health and Development, confirmed the need to pay special attention to the role of nutrition on HIV/AIDS and HIV/AIDS on nutrition: "The effect of HIV on nutrition begins early in the course of the disease, even before an individual may be aware that he or she is infected with the virus."

The AIDS Equation

Widespread AIDS often occurs when a whole range of social and economic circumstances - hunger, food insecurity, desperate poverty and social breakdown - collide with the presence of the human immunity suppressing virus (HIV) in the population.

Such circumstances may force people, especially young men and women, into high-risk activities like prostitution in order to feed themselves and their families.

When HIV/AIDS strikes a family member the effect ricochets through the lives of the entire household. With the food-producer ill, the family risks becoming malnourished and therefore more susceptible to infection.
AIDS has a devastating effect on a person's nutritional wellbeing:
  • nutrient absorption is reduced;
  • appetite and metabolism are disrupted;
  • muscles, organs and other tissues waste away;
  • secondary infections and other stresses increase demands for energy and nutrients.

Despite blunt appetites and difficulties in eating, people living with HIV/AIDS should eat considerably more food to fight the illness and make up for weight loss.

As part of a balanced diet someone affected by HIV/AIDS needs more protein to rebuild muscle tissue, more energy-rich foods for weight gain, immune system-boosting vitamins and minerals and water to combat dehydration.

Food to Care

The FAO/WHO manual offers households caring for a family member with AIDS inexpensive, locally available remedies for the symptoms linked to the disease.

Herbs and spices can stimulate a sluggish appetite or digestion and may have other beneficial effects. Cinnamon can be brewed into a tea to calm chesty coughs, for example, and mint leaves can be used as a gargle.

By encouraging good nutritional habits FAO and WHO hope the manual will improve the diet, health and resistance to infection of the entire family.

Designed to be usedby carers, health-workers, community groupsand non-governmental organizations, the manual includes:
  • forms to monitor weight loss and food intake;

  • fact-sheets outlining the principles of a healthy diet;
  • tips on how to ensure good hygiene when preparing food;
  • recipes with immune system-boosting micronutrients like vitamins and minerals.

It focuses on ways of easing the symptoms of HIV/AIDS - lack of appetite, tiredness, soreness of mouth - by suggesting recipes for soups, teas and stews using fruit and vegetables - guava, papaya and baobab for example - that grow in the rural areas of the developing world hardest hit by the AIDS epidemic.

"We hope this guide will be a building block, that it will be adapted by AIDS-affected communities and that it will make people aware of the vital role played by nutrition for someone living with HIV or AIDS," said Clay.

Spreading the word

To ensure that the benefits which can be derived from proper nutrition reach people living with HIV/AIDS, FAO and WHO are also developing training courses and educational materials for health workers and care providers.

This week, the second field testing of this course will take place in South Africa. It is hoped that the course will be published as a complete package including overheads and trainers' and participants' guide in September 2003.

"Nutrition counselling and support is an essential component of care for the HIV-infected person and it is particularly important in resource-constrained settings where malnutrition and food insecurity are endemic," said Randa Saadeh, the WHO Technical Officer responsible for the training and educational programmes.

The relationship between HIV/AIDS and malnutrition presents an extreme example of the vicious cycle of immune dysfunction, infectious disease and malnutrition.

WHO is developing standards for nutritional intake for people living with HIV/AIDS and expanding knowledge on the subject by:
  • organizing an expert consultation to review and provide guidance on nutrient and dietary requirements for people living with HIV/AIDS;

  • research to determine the impact of improved nutrition on HIV prevention and rate of progression from HIV to AIDS;
  • research to determine how improved nutrition can affect the frequency and severity of opportunistic infections;
  • developing and promoting food technologies which can benefit HIV-affected populations.

"We hope that, with this new information, we can assist governments and organizations in drafting guidelines on nutritional care and support for PLWHA and in developing food/nutrition interventions for HIV-affected populations," added Saadeh.

The Manual on Nutritional Care and Support for People Living with HIV/AIDS entitled Living Well with HIV/AIDS is available from FAO.


Contact:

Stephanie Holmes
Information Officer, FAO
(+39) 06 57056350
stephanie.holmes@fao.org

or

Gregory Hartl
Communications Adviser for Sustainable Development and Healthy Environments, WHO
Geneva
hartlg@who.int
(+41) 22 791 4458