HIV, AIDS and high antioxidant diets to maintain health
Good nutrition helps keep your immune system strong, enabling you to better fight disease. A healthy diet improves quality of life. Associated with a weakening if the immune system is increased oxidative stress within the body’s cells. Oxidative stress is defined as a disturbance in the equilibrium status of pro-oxidant/antioxidant systems involving free radicals of intact cells (Tang, 2001).
This condition of oxidative stress can be countered through the selective intake of foods and supplements recognised as antioxidants. Tang (2001) observes that, “In HIV infection, oxidative stress may be caused by both overproduction of reactive oxygen intermediates (ROIs) (free radicals) and a simultaneous deficiency of antioxidant defenses”. He notes that research in this field is ongoing, but the two issues here need to be clearly recognised as factors affecting the decline in health of HIV positive individuals.
Some molecules in the body are in a chemical state termed “oxidized”. These molecules are called free radicals and react very easily with other molecules, and can damage cells. High levels of free radicals seem to cause a lot of the damage associated with aging.
Free radicals are produced as part of normal body chemistry and increase under the effects of disease and pollution. Antioxidants are molecules that can stop free radicals from reacting with other molecules. This limits the damage they do. Several nutrients are antioxidants and can be found in many types of foods.
- The HIV viral infection increases the production of free radicals (ROIs), so leading to oxidative stress.
- A diet lacking high levels of antioxidants contributes to the debilitating effects of the viral infection. Without antioxidants to counter the increased levels of oxidative stress the decline in health can be rapid.
- Aids medications also increase ROI production.
Consequently, antioxidants are important for people with HIV, because HIV infection leads to higher levels of free radicals. Also, free radicals can increase the activity of HIV. Higher levels of antioxidants can slow down the virus and help repair some of the damage done by free radicals.
Powerful dietary antioxidants
HIV disease and many AIDS medications increase the oxidative stress within the body. The Recommended Dietary Allowances (RDAs) set by the US government are the minimum amounts of nutrients needed to prevent shortages in healthy people. People with HIV may need between 6 and 25 times the RDA of some nutrients (AIDS.ORG)!
When it comes to antioxidants, the USDA recommends an intake of 3000 to 5000 ORAC units per day. Research has shown that the average healthy person generates about 5000 ORAC units of free radicals each day, but only obtains about 1250 ORAC units of antioxidants through the diet. For HIV positive people and those with AIDS, the amount of free radicals generated by the body will be higher. It therefore requires a very selective diet to supply the body with enough antioxidants to sustain and maintain health. Dr. Taylor (1999) notes that “Deficiencies of these nutrients can have serious to profound effects on resistance to secondary infections, quality of life, and survival time.”
The ORAC unit has become one accepted industry standard for measuring antioxidants. It was developed by researchers at the USDA-ARS Human Research Center at Tufts University, Medford, Mass. The antioxidant test combines a measure of both the time an antioxidant took to react and also its antioxidant capacity in a given sample. The ORAC unit then combines them into one measure, making it the first in vitro assay method for measuring total antioxidant potential. It is easily expressed as per 100 grams of sample.
In order to counter reduce free radical formation, our bodies need foods high in antioxidants and phytochemicals. The antioxidants beta carotene, vitamins C and E, and selenium and many different phytochemicals are found in fruits, vegetables and whole grains. An important natural antioxidant is an amino acid called glutathione. Glutathione is made by the body and is also found in some foods.
Physiological Conditions that Promote AIDS
Chan et al (1997), observe that HIV thrives in a highly oxidized environment. The body’s CD4 cells shift from a resting state into an active immune response through a process (cascade) of internal oxidative reactions. Once activated, increased transmission of genetic instructions from the cells' genes leads to elevated metabolism and the production of proteins and enzymes. However, this activation of the genetic system also stimulates the HIV genes in infected cells to reproduce. These cells' increased metabolism supplies the cellular factors needed for the virus particles to replicate. Activated, uninfected CD4 cells are are rapidly infected by HIV, providng the molecules that the virus needs to convert its genes from RNA to DNA. In the process, the virus integrates those genes in the cell's chromosomes.
These are specific type of lymphocyte, produced by the thymus gland. They play an important role in cellular immunity. T4 lymphocytes (CD4 cells) are significantly decreased (absolute counts less than 200) in patients with AIDS resulting in compromised immune function.
HIV primarily infects CD4+ T- lymphocytes. HIV-1 replication in vivo is continuous and highly productive, and is associated with a rapid turnover of CD4 lymphocytes (Ho, et al., 1995). Continuous viral replication occurs throughout the course of HIV disease. Up to 10 billion virions are produced and cleared daily.The half-life of an HIV-infected CD4 cell is about 1.3 days.
This metabolic activity initiated as an immune response by the CD4 cells creates electron-deficient free radicals. As highly reactive molecules they damage other molecules by absorbing electrons from them, a reaction referred to as "oxidation." This is where the term “oxidative stress” comes from. Naturally occurring antioxidants come into play by donating their own electrons and neutralising the effect of free radicals on the body. There are a range of natural antioxidants, such as the enzymes superoxide dismutase, catalase, glutathione peroxidase and glutathione reductase; vitamins C and E; and various carotenoids, including vitamin A (Chan et al, 1997).
HIV has evolved to exploit this immune response process. With HIV, an abundance of free radicals are produced while natural antioxidants are progressively depleted. Chan et al (1997) notes that “A state of oxidative stress develops in which immune cells are kept continuously activated and various types of tissue damage occurs.” Cell membranes are made up of easily and rapidly oxidised lipids (polyunsaturated fatty acids). Oxidation of these membranes by free radicals leads to cellular components such as the nucleus unprotected and susceptible to further damage. Finally, the genetic material of the nucleus comes under attack leading to mutations. From this, it appears that AIDS has evolved to increase oxidative stress in the body, so as to perpetuate itself within the body through the exploitation of the CD4 cells’ immune response!
Virus-specific CD4 cells are critical in maintaining an effective host immune response and are present early in HIV infection but are generally lost over time. A person’s immune system copes during the clinical latency period. Eventually, the immune system reaches a "point of exhaustion" at which viral replication exceeds its ability to produce CD4 cells, leading to a decline in immunologic function. Health deteriorates, together with clinical disease manifestations, including opportunistic infections and neoplasms. There is a strong relationship between the viral HIV load (plasma viral levels) and the likelihood of developing AIDS (Libman and Barlam, 2003). The body’s viral load is a sensitive predictor of HIV disease progression independent of CD4 cell count. Antioxidants serve to aid the CD4 cells in removing these virions by reducing the oxidative stress that develops during the fight against the disease. In doing so, they slow the development of AIDS by reducing oxdative stress. Malorni et al (1998) supports this thesis through their findings that, “the redox profile of patients may be considered a predictive marker of AIDS progression and that the acute infection and the asymptomatic phase of the disease may represent a useful period in which the combined use of antiretroviral and antioxidant drugs may be beneficial”. Refer to the section on antioxidants for more details on the antioxidant effect on oxidative stress (the body’s redox potential).
Safe Dosage Levels
Excessive levels of any specific antioxidant needs to be avoided. As such a diversity of antioxidants should be included in the diet. Many, such as Vitamin A, Vitamin D, copper, iron, niacin, selenium, and zinc can cause problems at higher doses (AIDS.ORG). We should never assume that high doses of vitamins or nutrients are safe. They are not safe until clinical studies prove them to be safe, so in all cases, a qualified doctor should be consulted. AIDS.ORG lists a number of antioxidants recognised as important nutrients:
- beta-carotene (the body breaks down beta-carotene to make Vitamin A),
- Vitamin E (Tocopherol),
- Vitamin C, Alpha-lipoic acid,
- Coenzyme Q10, and
- N-Acetyl-Cysteine (an antioxidant that can help maintain body levels of glutathione.
Glutathione is one of the body's main antioxidants). Herbal products contain phytochemicals, plant compounds, many of which act as antioxidants and seem to help prevent heart disease and cancer. Research into the ORAC levels of different herbal foods has shown some natural foods to be vastly more effective than others as antioxidants.
Dr Taylor notes the “ever-expanding knowledge of the role of nutrition (particularly antioxidants and trace minerals) in supporting our natural immunity”. He goes on to identify that a high risk of HIV-related mortality is associated with selenium deficiency, referring to over 20 papers that document Se depletion in HIV/AIDS. To avoid toxicity, Se supplementation at 200 micrograms (mcg) per day for adults is generally considered safe. This elemental antioxidant is excreted by the body, so higher levels may not make a difference.
Effect of oxidative stress on HIV positive cases
Hosein (1997) wrote that research suggests that chronic oxidative stress can affect the immune system's fight against HIV, through the following mechanisms:
- increasing production of HIV
- weakening the immune response
- making T cells (CD4 cells) destroy themselves
- causing cells to make abnormal chemicals
- making the body more sensitive to the toxic effects of certain drugs.
The conclusion of these numerous studies is that any individual with AIDS or HIV can improve their health through the management of their diet so as to maximise the intake of a diversity of antioxidants.
Vitamin A and HIV
This finding that “Vitamin A appeared to reduce the effect of multivitamins and, when given alone, had some negative effects.” (Marsden & De Cock, 2004) is a bit confusing and requires further investigation. Studies in several laboratories have shown that when deprived of vitamin A, two types of immune cells, T and B cells, fail to function properly. Dr Semba (1997) found that pregnant women with the most severe lack of vitamin A had a 32 percent chance of transmitting H.I.V. to their infants, as against a 7 percent chance for women with healthy amounts of vitamin A. Further, his data shows that of the infants born to mothers with the most severe deficiency, 93 percent died in the first year of life, as compared with 14 percent of those born to mothers with healthy levels of vitamin A.
Other’s had similar results. Dr. Barbara L. Greenberg (1997) of the Montefiore Medical Center in the Bronx, New York, and colleagues evaluated serum vitamin-A levels in 133 HIV-positive women during the third trimester of pregnancy. All of the women delivered live infants whose HIV serostatus was known. Of the 44 women who transmitted HIV to their infant, 7 (16%) had severe vitamin A deficiency compared with only 5 out of the 89 nontransmitting women (6%).
However, researchers (Wafaie Fawzi) from the Harvard School of Public Health and the Muhimbili University College of Health Services in Dar es Salaam, Tanzania, found that women taking vitamin A increased the risk of transmission of HIV-1 to their newborn child compared to mothers who did not take vitamin A.
The study results appeared in the Sept. 27, 2002, issue of the journal AIDS (2002;16:1935-1944).
Previous research found that vitamin A may increase the replication of HIV in infected cells, while another study reported that people with low levels of vitamin A in their blood were less likely than others to transmit the virus via heterosexual sex.
Multivitamin supplements slow, but do not stop, the progression of AIDS. Currently, only a combination of AIDS drugs can keep a person with HIV infection from dying of AIDS. Multivitamin supplements can prolong the AIDS-free period. In a six year study of more than 1000 pregnant, HIV-infected women (Dar es Salaam, Tanzania) received multivitamin supplements (vitamins B, C, and E), vitamin A alone, multivitamins plus vitamin A, or placebo. The results were significant. Multivitamins included in the diet reduced the risk of death from AIDS by 27%. It slowed progression to AIDS by 50%. Women who took the multivitamins had far better immune (lower levels of HIV in their bodies) than women who received placebo. Vitamin A was not effective and when added to the multivitamins, it reduced their effect. The researchers, Marston and De Cock (2004) note that HIV and AIDS treatment programs (especially in Africa) must address the need for food supplementation. Dr. Fawzi (2004) stressed that the vitamins are not a substitute for powerful AIDS drugs, that are used once an HIV infection reaches later stages.
Eighteen of the 271 women who took multivitamins, (7%), developed AIDS, compared with 31 of the 267 women, (12%), who took a dummy pill. Nineteen percent in the multivitamin group and 25 percent in the comparison group died, but the difference was not statistically significant.
During the course of the study, 299 of the 1,078 women either died from AIDS-related causes or progressed to WHO stage 4 (equivalent to AIDS): Among the 271 women who received multivitamins, 67 (24.7 percent) progressed to WHO stage 4 or died of AIDS-related causes; among women who received multivitamins with vitamin A, the total was 70 (26.1 (percent) of the 268; for those who received vitamin A alone, it was 79 (29 percent); and of 272 who received the placebo, it was 83 (31.1 percent) who progressed to WHO stage 4 or died from AIDS-related causes.
Women on multivitamins developed fewer typical late-stage complications such as fatigue, diarrhoea and mouth ulcers. Multivitamins also resulted in significantly higher CD4+ and CD8+ cell counts and significantly lower levels of the virus in their blood.
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AIM BarleyLife® also contains more than 7 times the calcium found in an equivalent weight of raw spinach and 15 times the calcium found in an equivalent weight of raw broccoli. Calcium is essential for bone development. In addition, AIM BarleyLife® contains more of other essential vitamins and minerals, more amino acids, more enzymes, including peroxidase, a marker of freshness, and superoxide dismutase, a marker of antioxidant activity and a free-radical fighter, more antioxidants, including at least two powerful ones, lutonarin and saponarin and more chlorophyll.
AIMProancynol 2000 contains some of the most powerful, natural antioxidants ever discovered. A unique blend of green tea, grape seed extract, alpha-lipoic acid, and other powerful antioxidants, helps fight free radicals and maintain a healthy immune system.
Refer to the ORAC page for details on the many foods that are strong, natural antioxidants.