Good Health From the Start

HIV affects nutrition, fitness, and other aspects of health early on. So it is a good idea to keep that process in check from the very start. If you haven't thought about fitness before now, you may find it a bit overwhelming at first. Take one step at a time to make it work best for you. To help yourself, write a list of things you can do to move in the healthy direction. Something along these lines: Things to Do for Me (1) Ask my doctor for a referral to a dietitian for a full nutritional status evaluation. (a) Get information on nutrition and HIV. (b) Work with a dietitian to plan diet for health and to support medication therapies (if there are any). (2) Get a referral to a physical therapist or other qualified fitness specialist for a full fitness evaluation. (a) Get information on fitness and HIV. (b) Work with an exercise specialist to plan activities. (3) Keep routine appointments with both nutrition and fitness specialists to stay on track. Work with your dietitian to find a healthier way to approach eating. Work with your fitness specialist to plan activities that you can live with. Any change in the direction of a healthier lifestyle is a good move. So make changes you can commit to and build on. Physical fitness is supported by both exercise and good nutrition. Here is some advice adapted from certified personal trainer Tim Brewi's Web site, HIV Fitness Guidelines at www.tbrewi.com/hivfitness: Before you start, get the clearance of your physician and note any limitations that should be included in your exercise planning. Include the three types of exercise in your fitness program. These are aerobic, resistance, and flexibility exercise. Each of these has something important to offer. For instance, aerobic exercise can improve endurance conditioning and the ability to further exercise. Resistance exercise supports the maintenance and building of muscle and bone tissues and also boosts endurance. Flexibility exercise can support and improve the safety of your exercise experience. In finding an exercise trainer, look for well-trained and certified professionals. It may even be worthwhile to check out the credentials and credentialing agency before you make a commitment. If you have any physical limitations or particular goals for your fitness program, make sure that your chosen trainer has some expertise in that area'for example, reducing abdominal fat from lipodystrophy. To support your exercise, you will need to consume a healthy diet, which includes getting plenty of fluids and an adequate amount of nutrients, such as calories, protein, and micronutrients. In addition to having a generally healthy diet, it is useful to get an evaluation of where you are and where you can improve. For this you can ask your physician for a referral to a dietitian with HIV-related expertise. Often, dietitians are associated with community-based organizations. It will be helpful to share your fitness goals with your dietitian so that you can plan to support the amount and types of exercise you plan to pursue. Fitness can carry your good health far. Going forth without considering nutrition and exercise is like having a mouse in place of a horse to pull a carriage. The marriage of nutrition with exercise should be undertaken as seriously as you consider your medication regimens. Get good, sound advice from qualified professionals, and make sure the program is tailored specifically to your personal needs and goals. Be sure to add in a follow-up of routine visits to stay on track. Then go forth in good health! On a personal note, this column is dedicated to Tim Brewi, who was instrumental in communicating the importance of nutrition and fitness to people infected with HIV and their health care professionals. Tim's recent death will leave a gap in our work and in our lives. We celebrate his life and honor his professional accomplishments, which have affected so many of us. Fields-Gardner is the director of services for The Cutting Edge, an HIV nutrition company in the Chicago area.