August #104 : Carb Your Enthusiasm - by Cindra Feuer

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Don't Mess With These Girls

Boiling Point

You Go, Uganda

Miami Vice

Mighty Avengers

Firing Squad for Docs?


Risky Business

Pos & Neg

Blog Rollin’



The Normal Heartache

Film Review: Monkey Business

Carb Your Enthusiasm

Partner Briefs

The Tao of Toe

Read My Lipo

His 'n' Her Hormones

Budding Romance

The Multidrug-Resistance Challenge

Growing Pains

Check, Please

Founder's Letter


With Honors

Most Popular Lessons

The HIV Life Cycle


Herpes Simplex Virus

Syphilis & Neurosyphilis

Treatments for Opportunistic Infections (OIs)

What is AIDS & HIV?

Hepatitis & HIV

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August 2004

Carb Your Enthusiasm

by Cindra Feuer

Should HIVers join the fad-diet frenzy?

Cutting carbs makes your body burn fat—and you lose weight. That’s the nutritional nugget of today’s hot diets. But “the popular diets haven’t been studied over the long-term in people with HIV,” says Sean Hosein, science and medicine editor at the Canadian AIDS Treatment Information Exchange (CATIE). “And they’re not a cure for lipo.” Before tossing the tortellini—or starting any diet—consult your doctor, a nutritionist or a dietitian. Meanwhile, POZ helps you separate fat from fad. (And to digest the definitions of carbs and fats, check out “Diet Dictionary”.)

Atkins Diet

The Skinny
Dr. Atkins’ Diet Revolution, by the late Robert Atkins, MD, cuts carbs to 5 to 10 percent of your daily diet for the first two weeks, then to 20 to 25 percent. Protein and fats satiate faster than carbs do, giving this diet an advantage over low-fat routes. But nutritionists say Atkins can boost lipids and sap the kidneys and liver.

The Menu
ON: Some complex carbs. Heaps of protein. Monounsaturated fats (olives, olive oil, vegetable oil, avocados), omega-3 fatty acids (salmon, herring, tuna), saturated fats (steak, bacon, butter).
OFF: Simple (a.k.a. “empty”) carbs—sugar-loaded foods; white-flour breads, pastas and cereals; starchy veggies; processed or trans (hydrogenated) fats in baked goods and margarine.

Docs Dish
HIV health consultant Lark Lands, PhD, says many HIVers have trouble digesting the Atkins Diet’s fat, causing gas, bloating and diarrhea. But HIV doc Gary Cohan, MD, says, “Insulin resistance, diabetes, blood pressure and lipo accumulation get better on low-carb diets.” Some people claim that Atkins can cut cholesterol, too, but Cohan is wary of its saturated fats.

HIVers Weigh In
DC’s Derek Thomas has lost 30 pounds on Atkins since January. “I love that I can eat three steaks if I want to,” he says. But he started HAART in May, and cholesterol and triglycerides became a concern. His doc will monitor those lipids over the next month or so. If they rise, he agrees he’ll have to lay off the steaks.

South Beach Diet

The Skinny
Cardiologist Arthur Agatston, MD’s The South Beach Diet has a simple recipe: the right carbs and fats. His goal was lowering insulin (the hormone that delivers sugar to the cells for fuel) and cholesterol—goals HAART-takers share. Pounds fell, too.

The Menu
The diet initially banishes all carbs to kick cravings, then reintroduces complex ones.
On: mono- and polyunsaturated fats
Off: most carbs, saturated fats

Docs Dish
Most nutritionists say that of all the trendy diets, South Beach and The Zone (below) are best at getting people off simple carbs and onto complex ones. “You can help improve blood sugar by substituting complex carbs for simple sugar-loaded junk foods,” Lands says. “Booting simple sugars may also help lower triglycerides, but if they are PI-pushed sky-high there’s only so much diet can do.”

HIVers Weigh In
On the diet “I could see my abs, and my cholesterol went from 270 to 170,” says Mike Stone (who lives in South Beach, Florida). “It’s easy for people who don’t have a sweet tooth,” he says, and “it doesn’t involve a lot of cooking.” It also helped Stone’s digestion and blood pressure.

The Zone

The Skinny
This carb-cutter delivers more gradual weight loss than Atkins and South Beach. In The Zone, biochemist Barry Sears recommends a carb-protein-fat ratio of 40-30-30 to control insulin. This can be a plus for HIVers, whose meds can promote insulin resistance and diabetes.

The Menu
“Most favorable”: fish, soy, broccoli, peaches
“Moderate”: low-fat cheese, turkey, squash
“Least favorable”: bacon, hot dogs, cookies, beer

Docs Dish
“The Zone is good,” says Barbara Craven, director of nutrition for the Carl Vogel Center, a DC ASO. “It emphasizes the right meats, fats and vegetables, balanced with foods I recommend, like fish.”

HIVers Weigh In
New Yorker Henry Wein entered The Zone for four months. “My goal was to gain lean body mass and lose abdominal fat while minimizing peripheral fat loss,” he says. “My weight didn’t change, but by losing fat and gaining lean mass, the lipoatrophy was less noticeable” (see “Read My Lipo” ). The diet restored energy, but Wein tired of the special food-delivery options and jumped ship on the Mediterranean.

Mediterranean Diet

The Skinny
The diet of people in the Mediterranean region holds as much as 40 percent monounsaturated fat from olive oil and omega-3 fatty acids from fish, which act as antioxidants and help lower lipids. The high fiber also helps heart health. A physically demanding lifestyle boosts the region’s heartiness, so plan a gym regimen, too.

The Menu
ON: unrefined bread, pasta, grains; fruits, veggies, antioxidant-loaded leafy greens; olive oil; some low-fat dairy; some fish, poultry and red meat; a glass of red wine
OFF: Fatty meats, chicken with the skin, butter, tropical oils

Docs Dish
“Probably the best overall diet on the planet,” Lands says. But CATIE’s Hosein warns HIVers to get enough protein, and Vancouver dietitian Diana Johansen says alcohol may interact with some HIV meds.

HIVers Weigh In
Wichita’s Ben Klein couldn’t keep up with preparing the foods and getting enough calories. “There are no fattening foods on the diet, so if you’re nauseated and don’t feel like eating a lot, it’s hard,” he says.

DIY Diet

Chicago’s Lee Bohen beat HAART’s high cholesterol with a do-it-yourself low-fat diet and daily exercise instead of meds. “I modified my eating habits with common sense,” she says. “I use olive oil. I don’t eat red meat, just chicken and turkey”—and no refined sugar. Her cholesterol fell from 250 to 185.

The Bronx’s Paul Muller built a low-carb/ low-fat diet to attack blood pressure and cholesterol. “I cut down on beef, ham and salt, and ate more fruits and vegetables,” he says. Meds helped drop his cholesterol (340 to 240), his blood pressure went from 140 over 110 to 120 over 78 and he lost 32 pounds. Light weights and aerobic exercise complete the menu.


Protein builds muscles, organs and the immune system. Best: lean meat, eggs, fish, poultry and low-fat dairy.

Carbohydrates are quick energy sources. Complex carbs (legumes and whole-wheat flour, oats, barley, brown rice) are high in nutrients and fibers. Simple carbs (sugar, white bread, pasta, candy, soft drinks, baked goods) lack nutritional value.

Fats are the body’s main energy source. Pick heart-healthy monounsaturated or polyunsaturated fats; avoid saturated or trans fats (sometimes labeled hydrogenated).

Calories measure a food’s energy.

Search: Atkins Diet, South Beach Diet, The Zone, Mediterranean Diet, DIY Diet

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