Nutrition for HIV-AIDS best practices workshop 2002
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Teaching Your Client about Eating a Nutritious Diet
Everyone Can Live Longer and Stronger with Good Nutrition!
HIV/AIDS Best Practices Workshop, 2002
By
Stacia M. Nordin
RD, HIV/AIDS Crisis Corps Coordinator
US Peace Corps
PO Box 208
Lilongwe, Malawi
Tel: +265-757-657/157
Fax: +265-751-008
mailto:snordin@mw.peacecorps.gov
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Nutrition & HIV
Because HIV attacks the immune system, an important part of living
healthy with HIV is to provide the immune system with extra strength.
Strengthening our immune systems can help us all prevent diseases; so
what is covered in this paper will benefit us all.
Improving the immune system is done through many parts of one's life-
style such as getting exercise, rest, and finding satisfaction in
one's life, but one of the most important parts of improving the im-
mune system is through eating well. This is because the body uses the
foods we eat to: build the body, provide energy, and prevent dis-
eases. There is a common saying that goes 'You are what you eat', and
this is literally true. If the foods you are eating don't provide the
materials the body needs, then the results are a poorly built (weak)
body, with no energy, and frequent diseases. This is a problem for
people without HIV, but it is lethal for people living with HIV.
The Nutrients Needed for Strengthening the Immune System
The 6 Food Groups in Malawi are put together by the nutrients that
are found in foods, so we have to know something about nutrients be-
fore talking about what foods to eat. Nutrients are the part of the
food that are required for our bodies to work properly. There are
about 45 different nutrients the body needs to complete its jobs. An
easy way to remember the nutrients is to learn the basic groups of
nutrients and to relate them to a village setting and the work they
are doing in our bodies.
* The protein nutrients are like the bricks of a house. Protein is
responsible for building all parts of the body. There are 8 types of
protein.
* The mineral nutrients are like the mud or cement that is used to
hold the bricks together. Minerals join together or connect different
parts of the body. There are 16 types of minerals.
Energy:
* The carbohydrate nutrients are like firewood that is burned for
fuel, carbohydrate is used in the body to provide the first source of
energy.
* The fat nutrients are like paraffin in our homes which is a reserve
fuel and burns strong with a little bit of fuel, fat in our bodies is
reserve fuel and a little fat goes a long ways.
Preventing Disease:
* The vitamin nutrients are like a watchdog which we keep to protect
from thieves, vitamins in our body fight off diseases which try to
enter. There are 14 types of vitamins.
* The water nutrient is like water we use in our homes for cleaning,
water in our bodies cleans away wastes along with fibre. Fibre is
found in plant foods but is not a nutrient, it is like a broom we use
in our homes to gather the wastes so that water can wash it out.
The 6 Food Groups
There are many foods that help the body fight diseases, and Malawi
has a wealth of free foods that are perfect for boosting the immune
system, in addition to building and providing energy to the body. The
main message is to eat a variety of different foods from each of the
6 food groups every day. We use the 6 food groups to help us plan a
variety of foods in our meals and in our gardens.
Planning meals with the Food Groups
The current meal in Malawi consists of a lot of nsima (made with
white maize flour) along with a little bit of ndiwo side dish. This
meal is eaten over and over again every day, every meal. This eating
pattern ('diet') is not helping to boost the immune system because
people are eating too much from the Staple group and not enough of
the other food groups. This diet provides very few nutrients for the
body and leaves the body weak and vulnerable to diseases. In addi-
tion, the way the foods are prepared removes most of the nutrients
through processing or cooking before the food gets inside our bodies.
Another problem in towns is that people tend to eat too much from the
Fats and the Animal Foods groups which is also not a healthy diet.
A better meal consists of foods from each of the 6 food groups and
uses different foods for different meals, while processing ad cooking
the food to retain the most nutrients. Most people in Malawi (and
around the world) need to include more foods from the Vegetables,
Fruits, and Legumes & Nuts Food Groups, which is where we get most of
our vitamins that are responsible for fighting diseases. A better
meal also means eating less maize and instead including a variety of
different Staple foods. This picture shows the proportions of each of
the food groups that should be covering our plates - each person is
different, but something close to this would be sufficient.
Remember, a wide variety is the key!
Getting the Foods for a Better Diet: What Can We Do?
In order to eat a better diet, we have to start thinking about what
we are doing with our environment. The emphasis in Malawi for about
the last 100 years has been on maize, a crop which is not even native
to the culture. Before maize, Malawi's environment and diet revolved
around a wide variety of local fruits, vegetables, nuts, beans, mil-
lets, sorghums, other seeds, roots, and various animal foods. The
landscape has been converted from a healthy variety of trees, plants,
and animals, to one that is merely covered in maize fields. The di-
versity in the environment is gone so the diversity in our diets is
gone, leaving both the environment and the human population unhealthy
and at risk for disease.
Although many of the traditional foods are still available, they are
vanishing quickly because of the push to supply maize year-round ei-
ther by forcing the land to produce it or by bringing in maize aid
when the environment is unable to meet our maize demands. Maize is
not the only culprit, people are becoming more interested in obtain-
ing foreign foods than in giving attention to the abundance of foods
right around them. Expatriates, donors, and aid organizations who
come in to 'help' often never take the time to learn about these
valuable food resources that are already here.
The local foods that are being crowded out by maize and other foreign
foods are often higher in nutrients than foreign foods, can be avail-
able with little work, outside inputs, or money, and are delicious!
There are over 500 foods available in Malawi that are able to meet
all our nutritional needs and many people and organizations are try-
ing to revive the knowledge and use of these plants as part of the
diet. People are collecting and sharing local seeds and intercropping
them in their gardens; focusing on purchasing locally available foods
from vendors; capturing and utilizing excess water to reuse for grow-
ing local foods and medicines; caring for the soil through reuse of
all organic wastes; wisely using all areas around their homes for
food production; preparing foods through methods which retain the
most nutrients; and changing their diets to include a variety of
foods.
Anyone, anywhere around the world can implement these ideas in their
lives and contribute to a more sustainable and healthy world. We all
have a part to play: community members in rural and urban areas, pol-
icy makers, aid organizations, churches, donors, media, etc. Even
food aid and nutrition supplement programs can contribute to sustain-
able living by providing assistance in the form of local resources
instead of focusing on the intake of one or two foods or importing
outside resources. It is feasible to provide all the nutrients we
need in the form of local pumpkins, gourds, roots, beans, nuts,
seeds, insects, fruits, leaves, etc. as part of an aid package when
disaster interferes with the food supply.
By each of us implementing these types of practices, we can create a
healthier world with healthier people and less disease. The following
simplified 'Cycle of Better Living' illustrates the connections be-
tween our environment, our food and water supply, and our immune sys-
tems:
* Including a variety of plants and animals and returning them to the
earth;
* Leads to healthier soil;
* Which provides healthier food and clean drinking water through
natural filtration;
* A variety of healthier foods and clean water gives us better nutri-
tion;
* Better nutrition helps to strengthen our immune systems;
* When our immune systems are strong it helps protect us from disease
and stay healthy.
Food & Nutrition Resources in Malawi
There are many organizations working with food production and nutri-
tion in Malawi. There are training & research institutions, govern-
ment ministries, non-governmental organizations, international or-
ganizations, and volunteer organizations. The groups have different
modes of support such as providing hands-on information, educational
materials, data collection and assessment, and program support. There
are too many organizations to list here, the best way to learn about
who is working in your area is to contact one of the following lead
organizations:
Organization Description
Nutrition Society of Malawi
Secretariat at Bunda College, Nutrition Department
PO Box 219, Lilongwe
Tel: +265-277-222/436
e-mail: (first initial then last name)@bunda.sdnp.org.mw
secretary:
mailto:Nordin@eomw.net
* Started up in 2000, has 55 members with varying backgrounds; clini-
cal, community health, supplementary feeding, agriculture;
* Advocates for nutrition at all levels;
* Mission: To promote the understanding, integration and sharing of
accurate nutrition information in all aspects of life in Malawi.
Permaculture Network in Malawi
June Walker
PO Box 46, Monkey Bay
Tel: +265-587-656
* 200 members practicing, learning and sharing information on sus-
tainable living in Malawi and around the world. Has a list of train-
ers available.
Ministry of Agriculture
Director of Nutrition
PO box 30134, Lilongwe 3
Tel: +265-789-033
Fax: +265-784-650
mailto:agric-planning@sdnp.org.mw
Ministry of Health & Population, Nutrition Unit
Micronutrient Coordinator
Breastfeeding Coordinator
Health Education Unit - Area 1 near NAC
PO Box 30377, Capital City, LL3
Tel: +265-789-400, 724-073/262
Tel: +265-788-201 direct Micronutrient Coordinator
* Primarily clinical nutrition focus - diabetes, malnutrition, nutri-
ent deficiencies and education on nutrition & feeding practices
* Health Surveillance Assistants (HSAs)
* They work though: Central Hospitals, District Hospitals, Rural
Clinics, Nutritional Rehabilitation Units
* Some limited materials available (pictures of food, feeding prac-
tices, etc.) at Health Education Unit (located near NAC)
Ministry of Gender, Youth & Community Services
Private Bag 330, Lilongwe 3
Tel: +265-770-440/736
Fax: +265-770-826, 772-334
Tel: +265-771-275 direct Gender Affairs
* Deputy Director of Gender Affairs covers nutrition
* Community Development Assistants (CDA) / Home Craft Workers do home
economic-type work with nutrition, meal planning, income generation
for women's groups
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