Want to Age Gracefully?

It is often said, 'We aren't getting any younger!' And the effects of chronic HIV infection have been likened to accelerated aging. Some of these changes you experience may be related to aging, directly to HIV and treatment, or to both. However, there are nutritional changes associated with aging, especially for those of us charging into our fifth decade, that we can watch for and in some cases prevent. Organ function changes are quite variable: There is some slowing of renal function, while at the same time there is very little change in heart cell electrical activity. Livers tend to reduce size and blood flow as well as show some loss in drug-metabolizing enzyme function. Because the liver is also responsible for assembling many body proteins, there can be some reduction in body protein stores. Some loss of taste buds and olfactory nerve endings can change the ability to taste and smell foods or other odors, which may change our food preferences and choices. As for the gut, there are many changes that occur. Starting at the top, in the stomach, we produce less acid. This leads to a lower absorption of vitamin B12 and folate. This increases your risk of developing anemias that can leave you feeling fatigued and not wanting to keep up a good routine of physical activity. The whole process of pushing things through the gut slows down, which can decrease the body's absorption of several minerals, vitamins, and proteins. Even intestinal enzyme activity can change. With lower lactase enzyme activity (lactose intolerance), many people may reduce their consumption of dairy products and lower their intake of vitamin D and calcium. This can become a real problem, especially because our absorption of calcium and vitamin D tends to be lower as we age. This among other things can lead to a loss of bone tissues and increase our risk of osteoporosis and bone fractures. Wait, there is more! The total amount of water in the body tends to drop, mostly because of loss of muscle tissues. This usually coincides with a drop in the number of calories your body uses up on a daily basis. However, our ability to absorb calories and fluids doesn't seem to change much, which is one reason we should adjust our activity and eating habits. Changes in your normal sleeping routine can also occur. This can disrupt your motivation for a good diet and activity routine. On top of all of this, immune function tends to decline with age. What to do? Awareness of the potential changes is a good place to start. Begin with making sure that you are getting a balanced diet with a good routine of moderate exercise. Watch for changes over time and work with your health care team to compensate as needed. While nutrient supplementation is an option, it is not always the best choice. You should depend more heavily on diet whenever possible. For instance, you may need to concentrate on making sure that you consume enough foods that contain calcium and vitamin D. If you have dropped some dairy products from your diet, this could mean finding an appropriate milk substitute, such as calcium-fortified soy milk. You may need to make sure that your diet has plentiful sources of other micronutrients, such as vitamin B12 and folate. Keeping a balance with fruits, vegetables, meats, and legumes can be helpful. Like everything beyond survival, aging gracefully requires a bit of work. You may also need to keep an eye on your mental outlook to remember that you have some control over many pieces of aging. Your active and healthy life'as well as the success of your medications'depends on it. 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.