Make no mistake, your body needs a certain amount of fat to maintain itself normally. Many hormones, for instance, are fat-based and require an adequate amount of stored fat in the body to function normally. As with other 'checks and balances' in life, as soon as one piece of the body's puzzle is changed, there can be a cascade of events that change many other parts of the puzzle. Concern for maintaining bone density and preventing osteoporosis can depend on the maintenance and activation of vitamin D stored in fat just under the skin (subcutaneous fat). If you don't have much of this stuff, it will be very difficult to maintain the hormonal balances required to keep bone tissues intact.
The amount of fat stores that you require depends on your gender. The desired amount of fat stores is also dependent on which body composition test you use. Using equations that are developed for HIV disease and other chronic inflammation conditions with bioelectrical impedance analysis, your body fat will include both stored fat and functional fat (an example is the fat around each of your cells). This generally means that your fat weight may look higher than if you were tested by other means. Using this method, if you are a man, you are likely to need approximately 11% to 22% of your body weight as fat in order to function optimally. If you are a woman, you may need between 20% to 32% of your body weight as fat.
How much fat you carry on your body and where it is located depends heavily on your hormonal makeup. If hormonal balances change, then it is likely that the amount and location of your fat stores will change. For instance, if you are diagnosed with hypogonadism, you may be more likely to lose fat under the skin. Testosterone replacement may help you to preserve fat in its intended spaces. Excessive amounts of testosterone may increase the amount of fat in your body.
Because each change in hormones can induce other hormonal changes, it is a good idea to keep things stable as much as possible. Nutritional stability is one of the keys to balancing this equation. Here are some general rules:
' Keep your weight stable as much as possible.
' Eat even when you don't feel like it to keep from changing your weight significantly when you are ill.
' Exercise routinely. This will also help to maintain optimal hormonal balance and function.
' If you need to lose weight, take it seriously'because it is'and see a dietitian about how to accomplish a careful weight loss to help you keep your body composition at optimal levels.
' Keep an eye on your medications, especially if you are taking growth hormone or testosterone-type drugs.
' Be cautious about the use of supplements with hormonal activities, such as the steroid hormone dehydroepiandrosterone; consider the advice of your physician and pharmacist carefully before starting such supplements.
' Keep close tabs on your body composition; bioelectrical impedance analysis can help determine total volume while measures of body circumferences and fat folds can help to keep track of where your body is storing fat and other tissues.
Just like pretty much everything else, keeping a good range of fat in your body can help you to maintain important body functions. Too much and too little can throw off the balance of hormones in your body and make it difficult to stay looking like the person in your driver's license photo. Stability may be somewhat boring, but it can also be a very good thing.
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.
