ExercisingRightWhile Living With HIV

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R egular exercise is part of a healthy lifestyle, even for people living with HIV. People diagnosed with HIV infection can

live long, healthy lives if they get medical care and take care of their bodies. This includes getting regular exercise. Studies have shown that exercise actually helps many people with HIV feel better. By exercising, you might be able to strengthen your immune system. While exercise can’t control or fight HIV, it may help you fight many of the side effects of HIV and the drugs you take for it.

There are many ways to include physical activity in your day. You don’t have to run marathons to get the health benefits of exer-cise. In fact, even moderate physical activity can help your immune function. It can also delay or prevent wasting and improve your strength and endurance. This brochure will tell you why it’s important to exercise, things to think about before starting an exercise program, and how to keep exercising so you can live life to the fullest.

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Why Exercise?Everyone can benefit from some form of exer-cise. People who exercise often feel that their overall health gets better. Regular, moderate exercise has many of the same benefits for people with HIV as it does for people who do not have the infection.

Here are some of the things that exercise can do:

- Improve muscle mass, strength, and endurance.

- Help how your heart and lungs work.

- Give you more energy so you feel less tired.

- Reduce stress.

- Give you a better sense of well-being.

Besides these benefits, exercise can also stabilize or prevent drops in CD4 cell counts. It can increase bone strength, help you sleep

better, and even help your appetite. There are also good heart-related effects

that can happen when you exercise regularly. You can help get your cholesterol and triglycerides levels to a healthy level by exercising. You can also lose some of the fat around your stomach. Exercise

has been shown to improve the way the body uses and

controls blood sugar (glucose). This can

be very important if you have diabetes.

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Before You StartWhile exercise can lead to many health benefits for people living with HIV, there are some things to think about before starting any exercise program. Be sure to talk to your doctor to see how hard you can exercise so that you do it safely. There are other risks to think about too. For example, you can get dehydrated—meaning you lose too much water—if you don’t drink enough liquids to keep up your fluid levels. If an injury occurs when you’re working out, it may take more time to heal. You can also injure your-self if you use the wrong “form” in exercises.

If you exercise too much, you can lose lean body mass. In serious cases, that can lead to wasting. Wasting occurs when you have lost more than 10% of your body weight and when you’ve had to deal with more than 30 days of either diarrhea or weakness and fever. Wasting is a dangerous problem for people with HIV because it can mean the disease is progressing. It has also been linked to death. In addition, losing just 5% of body weight can lead to some of these same effects.

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People with HIV may find it harder to stay with an exercise program because of fatigue. Fatigue is tiredness that does not go away when you rest. It can be physical or psychological. Fatigue is one of two main ways the body warns you about a problem. The other warning is pain. Most people pay attention to pain and stop whatever is causing it. But, fatigue often doesn’t get as much attention as it should in people living with HIV. Fatigue can be a big problem in people with HIV because it can make you sicker faster. Ongoing fatigue can weaken the immune system.

Take Baby StepsBe sure to take it easy at first, and work exercise into your daily routine. Try to start exercising while you are still healthy. This can help you hold off HIV symptoms that make you feel bad.

Also try to keep your exercise fresh. Find new ways to keep motivated. Your goal is to maintain your exercise program. Realize, too, that your fitness level may be different than what it used to be. As you start working out, work your way into an exercise program that helps you avoid injuries.

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People with HIV can improve fitness levels through training. Here are 10 simple things you can do to improve your physical fitness, and hopefully make you feel better:

1) Walk a little extra. Try parking farther away from your work or front door. Or, get off the bus or train a stop early.

Instead of using the elevator or escalator, use the stairs. This can build up some leg muscle strength and burn off a few extra calories.

3) Lead with your heart. Walk with good posture. That means leading with your heart—chest out and head straight. Remind yourself to do this as you walk. It improves your posture and reduces stress on your lower back and joints. It can also change your attitude and spirits for the better.

It’s important that you talk to your doctor to make sure that you are

able to exercise safely.

2) Take the stairs.

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4) Get outdoors. Take some time to get outside even if it’s for a quick walk at lunch or a stroll around the building during a break. It can help you re-energize and give you a brief change of scenery.

5) Stretch for 5 to 10 minutes every day. Stretch all your major muscle groups. Being flexible helps your joints work. It also reduces stress.

6) Get your heart rate up. Go dancing, play a sport, or work out in a gym. The key is to get your heart rate up and start building aerobic conditioning.

7) Do aerobic exercises. Try to do aerobic exercise 3 times a week for at least 30 minutes each time. Regular exercise can help your immune function.

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Source: Adapted from: Ten Simple Things You Can Do (http://thebody.com/content/art31291.html)

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Do mind-body exercises like yoga and tai chi. They can be particularly helpful in relieving stress and anxiety.

9) Do weight resistance training. This type of training should be done 2 to 3 times a week. If you can’t afford a gym or your own weights, you can get elastic resistance bands. You can also do push-ups, pull-ups, or sit-ups. Resistance training increases muscle mass. This can make your metabo-lism better, giving you more energy.

10) Cross-train. A complete fitness program should include aerobic exercise, weight training, and flexibility training. Develop a routine that works best for you, but be sure to use all of these things regularly. It’s a great way to get the best results.

8) Stress Relief

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Stay Hydrated & Eat RightProper nutrition is important, but don’t eat when you exercise. Here are some helpful tips on what to do about eating before and after working out.

Drinking enough liquids, or staying hydrated, is very important when you exercise. Extra water can help you replace the fluids you lose. Drinking tea,

coffee, soda, hot chocolate, or alcohol can actually make you lose body liquid. Water is best.

Before You ExerciseBe sure you’re well hydrated before exercise.

Drink at least 2 cups of water about 2 hours before exercise. Drink another 2 cups of water within 20 minutes of exercise.

Don’t exercise before breakfast. The body doesn’t have enough nutrients in it to help you through your work out. Doing aerobic exercise on an empty stomach or when you’re

hungry doesn’t make you burn more fat.

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To be at your best, eat a healthy, well-balanced diet all through the day. Eat low-fat foods, fruits and vegetables, and whole grains.

Don’t exercise immediately after eating. The best time for doing fitness activities is about:

- 1/2 hour after a light snack.

- 1 hour after a light meal, heavy snack, or meal replacement drink.

- 2 hours after a regular meal.

- 3 hours after a Thanksgiving-type feast.

Don’t eat sweets (honey, candy, or soda) imme-diately before exercise. It doesn’t give you a quick burst of energy. In fact, it can be harmful to eat sweets before working out. It may put your insulin levels on a roller coaster ride. When this happens, you can get tired.

While You Exercise Drink plenty of water during exercise. Drinking water while you exercise helps you avoid upset stomachs and muscle

cramps. Not drinking enough water may cause

dehydration and lower your ability to perform activities. Drink 1/2

cup of water every 10 to 15 minutes, even if you don’t feel thirsty.

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Don’t consume food during exercise. It shifts fluids away from muscles and into the gastro-intestinal tract for digestion.

Don’t eat salt tablets. They can lead to dehydration.

Moderate exercise. If you exercise up to 1 hour in moderate surroundings, drink cool water.

Extreme exercise. If you exercise really hard for more than 1 hour or in an extreme climate—neither of which should be done—you may need a sports drink that has carbo-hydrates and electrolytes in it.

After You ExerciseDrink more water. Drink about 2 cups of water for every pound of body weight you lost during exercise.

Don’t eat a heavy meal in the first hour after exercising.

Enjoy a snack or light meal about 30 minutes after exercise. Try to eat a snack that’s light and healthy.

To get the best results, eat a healthy, well- balanced diet all through the day.

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Enjoy Your Exercise!When deciding on exercises, choose things you like to do that are physically active. There are plenty of choices. Whether it’s yoga, running, biking, or another sport, do something you like. This will encourage you to keep up with your program. Avoid ruts and change your activities if you need to.

Find whatever it is that will keep you motivated.

If you already have a good fitness level, you can compete in competitive sports. You probably won’t run the risk of spreading HIV to other athletes or coaches. If you get hurt and you bleed, the risk of HIV being spread to other people is very small. But, if you bleed during a sport, be sure to get out of the game and cover your injuries before returning to the game.

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The editorial content for this brochure was developed and created solely by the Patient Education Center

TheBody.com thebody.com/index/dietnut/exercise.html

AIDSInfoNet.org www.aidsinfonet.org/fact_sheets/view/802

AIDSMap.com www.aidsmap.com/Exercise/cat/1478

The American Council on Fitness www.acefitness.org/fitfacts/pdfs/fitfacts/itemid_63.pdf

The American Academy of Family Physicians familydoctor.org/ x2066.xml

Learn MoreIf you still have questions, the following resources offer more information about exercise for people living with HIV.

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