HIV 101














Healthy Aging With HIV

Different organizations and government agencies seem to set their own standards for who is "Silver" or who is a "Senior." In any case, as you get older, your goal should be to successfully age with HIV. This means you should work toward this goal physically - because so much depends on your health and financially - because you're going to live a long life so you'll need to be secure.

Take Care!
Taking care of your own personal health, diet and nutrition has always been important for anyone who is HIV positive but with HIV therapy helping so many more people with HIV live into old age, it's time to look at aging with HIV from a new perspective. If your viral load is undetectable, it may be time to look beyond HIV to other factors that affect your health. Beyond the age of 50, it is more important than ever to adopt a healthy lifestyle that includes regular physical activity. If you smoke, it is more important than ever to stop.

If you have diabetes, high cholesterol or high blood pressure, it is more important than ever to follow your doctor's orders and bring those conditions under control. They may represent a bigger danger than your HIV!

It's also important to understand about nutrition. Once upon a time, in the bad old days before effective HIV regimens were available, wasting was a huge problem. To combat it, we told people with HIV to eat rich fatty and sugary foods without regard to the quality of the calories. That's not the advice we give now! But, unfortunately, some people with HIV are still following those outdated recommendations. A recent study found that HIV-positive people consume more total fat and saturated fat, and less fiber, than those who are HIV-negative.

So let's be clear: Your best bet is to eat for longevity-just like everyone else. That means a heart-healthy diet low in fats (especially saturated fats), and high in fiber. That means filling your shopping cart with fresh fruit, fresh vegetables, and whole grains. It means cooking with healthy olive oil or canola oil.

Here are some super foods that can help keep your body young and healthy:

- OLIVE OIL (extra virgin)
- PRETZELS (no salt added)
- DARK CHOCOLATE (60% cacao or greater)

If you can't get the food you need because of financial problems, health issues or being home restricted, ask your dietitian, social worker, or other healthcare professionals about local meal programs. There are many great agencies like "Meals On Wheels" as well as HIV-specific programs like "God's Love We Deliver" in New York City.

People over 50 have special requirements to promote optimal health. In addition to your regular balanced diet, you probably need an increased amount of select nutrients like calcium, fiber, vitamin B12, vitamin D, and water, compared to younger adults.

Calcium & Vitamin D.
Both calcium and vitamin D are important in bone health. If you do not have enough of these in your diet, the deficiency can lead to brittle bones (osteoporosis). A recent study showed that people living with HIV are more likely to get osteoporosis compared to those who are HIV-negative. People can have a hard time getting enough vitamin D in their diets since it is not naturally occurring in many foods. You can get vitamin D from the sun, but prolonged sun exposure can also lead to premature wrinkles and skin cancer. So a little fun in the sun is ok, but don't rely on it for your vitamin D needs. Consider drinking 3-4 servings of low-fat dairy products or calcium-fortified orange juice. Many people may want to consider supplements to get consistent amounts of these two nutrients. Recommended daily amount via food and supplements is 1200-1400 mg of calcium and 600-800 IU of vitamin D.

Fiber really is your friend. It can really help lower your risk of getting colon cancer as well as lowering your cholesterol levels. A recent study showed that HIV-positive people who ate more fiber compared to those who ate less fiber, lowered their chances of getting body-shape increases in their belly. Recommended daily amount via food and supplements is 18-25 grams for women and 25-38 grams for men.

Vitamin B12.
Many adults over the age of 50 have a reduced ability to absorb vitamin B12. Eating enough animal products (which are the best source of B12) may not help you. As our bodies age, we may begin to make less intrinsic factor (digestive acids) in our stomachs which in turn reduces our ability to extract vitamin B12 from the protein foods we eat. Try to get vitamin B12 from fortified foods like breakfast cereal that are not bound to protein. Recommended daily amount via food and supplements is at least 2.4 mcg.

We have a reduced sense of thirst as we mature. Be sure to drink plenty of fluids, especially in hot weather. Water is vital for keeping our skin, muscles, and all organs healthy and running normally. Lack of hydration can lead you to produce less saliva, making it difficult for you to chew dry foods, and contribute to poor oral health. Recommended daily amount is at least 3-5 glasses of
pure water per day in addition to other wet foods and fluids you consume.

How Important is Exercise?
Thousands of studies over the years have demonstrated the vital importance of exercise to human health. Now there's a new one that makes the point even more persuasively.

Researchers with the Department of Veterans Affairs put 15,660 men with an average age of 60 on a treadmill to test their physical fitness. Then they ranked them into four categories: least fit, moderately fit, highly fit, and very highly fit.Eight years later, they followed up to see who was still alive.

In the least fit group, 44 percent had died. In the moderately fit group, 30 percent had died. In the highly fit group, 15 percent had died. In the very highly fit group, only 8 percent had died. A dramatic difference!

So when you think about a healthy lifestyle, be sure it includes regular physical activity. "A little bit of exercise goes a long way," said Peter Kokkinos, lead author of the study. "Thirty minutes a day, five days a week of brisk walking is likely to reduce the risk of mortality by 50 percent if not more."

And Prepare
The most productive thing you can do is to prepare as much ahead of time as possible for your 60s and 70s, and definitely a few or more years before you retire or before you turn 65. It’s wise to take as much time as possible to explore your options as well as to educate and advocate for yourself before these changes take place.

Each person’s situation is different, due to individual needs and concerns. Talking to friends and family or support groups can be very helpful, but it’s also worthwhile to explore your options on your own.

Consult a financial planner
One of the first and most important steps you can take is to consult a financial planner. He or she can help you identify your long-term needs, explore your lifestyle options, and identify how much income you will need. A planner can also create financial plans for filling in gaps or managing your life on what you know you will have. Planners can be expensive, so if you can’t afford them then there are other ways to get this type of help. Community colleges often offer courses in retirement planning. Planners sometimes donate time to nonprofits you may know, and some AIDS Service Organizations (ASOs) may have referrals to low-cost or free assistance. There are also books that can help guide your planning.

Change in income
Whether you’ve been working full-time or get SSDI payments or have been getting long-term disability (LTD) checks, your income at 65 or at retirement will change. For some, this means a small change, perhaps because of a decent pension plan or retirement account. For most, who rely on LTD from their former employers, this loss of income can be significant as monthly incomes could actually be cut by half or more. Many people underestimate how much that can affect their daily lives, and sometimes don’t realize the full impact until too late.

Those with long-term disability may also be offered a lump sum payout at some point close to age 65 when their payments would stop. These offers may be reasonable and allow you to invest on your own, but they can also be unreasonable offers. If you’re offered a lump sum payment, it’s important to see a professional to determine if it fits your needs.

Change in residency
A lot of people move either by choice or necessity after their retirement. They may be looking for a different lifestyle or they may be unable to afford living in more costly urban areas. This could mean moving to another state like Florida or even to an assisted-living community in the next town over. There are several things to consider before you take that leap.

One is your doctor or medical provider. Even if you’re not moving out of your home or move just a town away, you may not be able to keep your current doctor because he or she is not in the Medicare plan you choose when you turn 65. Think about what hospitals and other types of services and facilities are available to you.

Another consideration is that while moving may be a necessity, it often means that you’re leaving friends and sometimes family and support networks that you’ve developed over your lifetime. Your support networks and environment are extremely important to maintaining your health.

Before you make any final decisions on a move, identify the factors that help you maintain your health and well being. Then do as much research as possible, including visiting and even staying in the places you are considering.

It is absolutely possible to be happy, healthy and satisfied as you move through your second half-century of life. You can continue to have good quality of life by adopting healthy habits. HIV therapies are continuing to improve, and managing HIV will only get easier in the future. Stay informed, and take good care of yourself now and for all the fantastic years to come!

Alan Lee, RD, CDE, CDN, CFT and Anne Donnelly, MA contributed to this article.



































Copyright 2018, Positive Health Publications, Inc.

This magazine is intended to enhance your relationship with your doctor - not replace it! Medical treatments and products should always be discussed with a licensed physician who has experience treating HIV and AIDS!