Brad Learmonth is a survivor times two. Not only has the 52-year-old New York City arts administrator stayed healthy with HIV since his 1989 diagnosis, but he also recently cleared his liver-busting hepatitis C (tough genotype 1!) with 14 months of interferon and ribavirin. A Sustiva, Ziagen and Viread combo keeps his HIV viral load undetectable and his CD4s solid at around 250.

Meds are the beginning, but hardly the end, of Learmonth’s regimen. Every day, he whips up a smoothie of antioxidant-packed fruits and greens and takes omega-3 fatty acids for heart health, a men’s multivitamin and time-released vitamin C. “Along with getting rest and nourishing my mind and spirit,” he says, “I deeply believe that nutrition is keeping my immune system strong.”

Many positive folks agree that micronutrients—vitamins and other supplements—boost their health. Lark Lands, PhD, and other HIV nutrition specialists back them up. Lands says positive people need supplemental micronutrients “to form immune cells and chemicals and repair ongoing cell damage from the virus.” She adds, “I’ve received countless reports over the years from people who saw their T cells stabilize or rise substantially as a result of comprehensive nutrient supplementation.” Supplements can help when loss of appetite—from meds, depression or the virus itself—makes it hard to eat enough nutrient-rich foods.

Enter the naysayers: Some HIV doctors who call supplements a waste of money, after a spate of recent studies suggesting that in the U.S., where the average diet packs sufficient nutrition, most supplements lack any special benefit. This holds true even for those with HIV, says Cincinnati HIV doc Judith Feinberg, MD. “Most everything you need is in the food you eat,” she says. “I think vitamins are a rip-off.” In a poll of other HIV docs, POZ heard that sentiment repeated a dozen times. The abiding mystery over how many nutrients are needed and exactly what’s in many supplements doesn’t help.

Lands calls the supplement-knocking studies “media-hyped crapola” and points to a small trial of HIV positive Americans on meds, presented in 2004, in which those who took special nutrients saw their CD4s leap 24% compared with 2% in the group on a placebo.

There is one area of agreement for all these opinions: Nutrients from food are more easily absorbed and used by the body than those from pills, and supplements can’t replace dietary nutrition. All advise minimizing sugar, fat and salt and eating lots of the good stuff (fruits, veggies, lean protein like fish and chicken, and whole grains like oatmeal and brown rice). Beyond that, we’ll have to rely on the wisdom of our own bodies—many of which find that supplements seem to ward off fatigue, diarrhea and other facts of HIV life.

Get info on supplemental nutrition at www.larklands.net, www.jonkaiser.com or AIDS Project Los Angeles, 611 S. Kingsley Dr., Los Angeles, CA 90005; 213.201.1556. A few basic guidelines:

Keep it simple.
It’s worth repeating: Food is the best source of nutrition. Without spending a fortune, you can add a quality multivitamin (try GNC or Solgar) with all the micronutrients that matter—at robust but not toxic doses.

Consider adding these.
Omega-3 fish oils have well proven benefits (especially for folks with high triglycerides). Calcium and vitamin D (in a multi is fine) are widely recommended for positive people to prevent bone loss (especially for women in menopause).

Run it all by Doc.
It’s important to know how much is too much or which supplements may interact badly with your HIV meds.

Use your head—and your body.
In the end, common sense and your own experience may be the best guides. That’s what Learmonth does, with his own personal study lasting 17 years—and counting.