by Edwin Krales, MS, CDN
Nutritionist/Outreach Coordinator, The Momentum Project
Adjunct Professor of Nutrition, Hunter College

To start, don't take any medication with wine, beer, liquor, mixed drinks or any other beverage containing alcohol. If your cough medicine has alcohol in it, don't use it to wash down your aspirin. This combination can irritate your stomach and my cause it to bleed. Bleeding stomachs don't help digestion. Don't take your evening vitamins with a glass of wine. Better still, don't drink any alcohol. HIV loves alcohol and flourishes in alcohol preparations in the lab. Generally, you should not take medications with acidic beverages, especially grapefruit juice. Take your medications and vitamin/mineral supplements with an eight-ounce glass of pure water. However, grapefruit juice increases the absorption of saquinavir. (You can drink a glass of grapefruit up to two hours after taking saquinavir.) If you are in doubt, ask your pharmacist.

Pharmacists now have at least 50 different information strips with various instructions that they can attach to prescription bottles. On a recently filled prescription for antibiotics, there were four information strips about how best to use the medication. Two were related to eating. The first instruction was to take the medication on an empty stomach, either one hour before or at least two hours after eating. The second direction was not to take dairy products, antacids or iron preparations within one hour of taking this medication. In other words, don't drink a glass of milk with antibiotics like Tetracycline. The absorption of both the calcium in the milk and the medication may be reduced.

Two other examples among hundreds of possible drug/drug and drug/nutrient interactions should be mentioned. Maintaining your appetite is a challenge when you are ill. In addition, many people lose their appetites completely when they become depressed. Therefore, try not to take an antidepressant that can further decrease your appetite and as a result increase your weight loss. There are antidepressants on the market that can stimulate your appetite, help you eat more and help you gain weight. Ask your doctor about their possible use. Many people of European and African descent are lactose intolerant as adults. For them, drinking milk and using various dairy products can cause bloating, stomach discomfort, and very often diarrhea that can lead to weight loss. People who are lactose intolerant avoid milk and milk products, use an enzyme product called Lactaid or pay a high price for their indulgence. This isn't news. What many people don't know is that lactose may be an ingredient in their medication. The amount of medicine in any pill makes a very small percentage of the pill itself. The rest of the pill is made up of a filler called the excipient, which may be lactose. One of the new protease inhibitors that uses lactose as a filler is saquinavir (Invirase). The most common side effects of saquinavir are nausea, stomach discomfort and diarrhea. There may not be enough lactose in one saquinavir tablet to cause any trouble, but if other medications also contain lactose as the filler and someone is taking ten or twenty or thirty different tablets per day, it is conceivable that this could be a serious problem. It is certainly worth discussing with your doctor or pharmacist.

Cooking foods in various ways affects the nutrient content and how easily they can be absorbed. Different problems exist for animal and plant foods, but there are some basic guidelines that affect both. Cooking with moist heat is usually better than dry heat or frying for ease of absorption. Chicken cooked in a covered pot with rice and vegetable or in a soup is easier to digest than chicken cooked on a barbecue or roasted. Cooking methods are especially important since the chicken and other meats and fish must be thoroughly cooked in order to kill all the dangerous bacteria that may be in them. The problem with roasting and barbecuing is that potentially carcinogenic compounds are produced whenever foods are charred. Cooking to well done when roasting or barbecuing usually produces a charred outer surface. Foods also become hard, difficult to chew and more difficult to break down in your stomach. Chewing is very important for several reasons. It increases your satisfaction while eating, it helps your body to release various digestive enzymes, it strengthens your teeth and gums. It also increases the surface area of the food going into your stomach so that the digestive juices there can do a better job of taking the food apart to make it easier to absorb. Moist cooking usually produces a well-done food that is softer and easier to chew, won't be charred at all and will be more easily digested.

Since we all like variety and don't cook and eat simply for the nutrient content of the meal, there are some tricks you can use when you are barbecuing to get more digestible food. Precook meat in a microwave or par boil it before barbecuing or roasting. This step will shorten the cooking time on the barbecue or roasting rack. Wrap hamburgers in aluminum foil so that they cook in their own juices on the grill.

I don't suggest trying to scrape off charred parts or removing skin from chicken, since that level of self-control eludes most of us, especially if we are at a party. Try it, you may succeed.

The problems with cooking vegetables so that they retain their "goodness" and palatability are different than the problems we have with cooking meats. Many vegetables if cooked too long can lose 50 percent or more of their vitamins and minerals and become mushy. This long cooking time may make vegetables easier to digest, but they are not very appealing to eat this way. If your vegetables (and your fruits) are not wrapped and refrigerated before use, the natural processes that go on in these plants will destroy may of the nutrients even before they are cooked. The best way to cook most vegetables is to use a small amount of water, in a covered pot with a steamer that keeps the vegetables completely above the water. Steam the vegetables until they are a bit softer than when they are raw. This process will make them easier to digest and enable them to retain most of their nutrients.

Can you imagine a Valentine's Day card with a stomach on it instead of a heart? Perhaps both? When I am with people who annoy me, if I am working too hard or if I have unpleasant thoughts my stomach, not my heart, is in a knot. My sense of taste changes. this doesn't mean that I suddenly like red glen-plaid suits, with bell bottom pants and polka dot ties, but that I don't feel like eating. Everything is "off." I may even get diarrhea. The best remedy is to eat in a pleasant, relaxed setting, with people you love, eating food that makes you feel good. Take pleasure in taking care of yourself. You deserve it.