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It has always been important to eat well in order to stay alive and to keep your body functioning well. This need becomes even more important with the onset of chronic HIV infection. HIV infection, like many other diseases, can add to the everyday cell damage caused by oxidative stress'or the body's inability to keep a balance between pro-oxidants, which help to kill infections, and antioxidants, which limit the damage pro-oxidants can do. When this happens the body is more likely to have problems, such as cardiovascular disease, cancer, and other diseases. Things become complicated when you add in these nutrition-related problems that threaten health in HIV infection. Take, for instance, cardiovascular disease. There are so many factors to think about'medications, family history, age, gender, chronic HIV infection, exercise, and diet'that you can become confused about where to start. Because there is not much you can do about such things as family history and age, it is worth looking at the things you can work on right away. Even a great diet and supplements cannot overcome some obstacles. So before you even look at making your diet healthful, it will be important to remove as many obstacles as possible. First off, it will be important to your success to quit smoking and avoid excessive alcohol or other recreational drug intake. You also need routine physical activity to stay fit. And dietary improvements may include reducing fat intake, improving fiber intake, and emphasizing fruits and vegetables. Yes, including fruits and vegetables'the real things'is important to a balanced diet. There are some added benefits that become even more important to your body functions in chronic HIV infection. 'Antioxidant capacity' is the ability of antioxidant substances to do one of their many jobs in preventing damage to body tissues, including damage to vessels, which can lead to cardiovascular disease. As it appears now, the power of fruits and vegetables is available in fresh, frozen, dried, and juice forms. Nonnutrient components of fruits and vegetables have been investigated in relation to heart disease and with regard to their ability to lower the amount of oxidative stress usually seen after high-fat meals. In one study the powerful antioxidant pigments of grapes were able to minimize this type of oxidative stress. Pomegranate juice flavonoids showed similar effects in protecting against atherosclerosis (hardening of the arteries in cardiovascular disease). Phenolic compounds in red raspberries showed a complementary and enhancing antioxidant effect to the vitamins and other substances they contain. Another study suggested that the substances that give peppers their smell have had significant antioxidant activity. And that is aside from the antioxidant-rich peppers containing the desirable flavonoids, phenolic compounds, carotenoids (such as previtamin beta-carotene and pigment canthoxanthin), and vitamins A, C, and E. These nonnutrient substances act as antioxidants and in some cases have been shown to dramatically enhance the effects of vitamin and mineral antioxidants in foods. As usual, there are many factors that can enhance your body's defenses against the type of cell damage that can lead to cardiovascular and other disease. People who smoke, drink alcohol, experience a lot of psychological stress, and consume very few fruits, vegetables, and fish tend to have more of a problem with oxidative stress. People who include a variety of fruits and vegetables in their diet, have regular physical activity, and don't smoke give their bodies a head start on antioxidant capacity. So in addition to your other healthful lifestyle changes, look for fruits and vegetables that contain good amounts of antioxidant capacity (often with strong colors and strong smell) when you go grocery shopping. Fields-Gardner is the director of services for The Cutting Edge, an HIV nutrition company in the Chicago area. She is a member of the International AIDS Society and the American Dietetic Association's Dietetic Practice Group on HIV and AIDS. She has written a book on HIV medications and a guide to nutritional management of HIV for clinicians.
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