Since testing positive, I’ve lost weight. How can I fatten up without getting pudgy—and exercise without losing more?
    —Slim Pickings


Dear Slim,
HIV often drops your weight—from wasting, fatigue, med-side-effect diarrhea and appetite loss from depression. But you can gain lean muscle and fat through a program that combines exercise and diet. First, visit your doctor to discuss your personal weight, nutrition and endurance guidelines;
they vary per individual.

EXERCISE
Ditch the heavy cardio routines that make you huff, puff and shed pounds. Stick to light or moderate cardio (walking, biking, swimming) for toning and to boost heart and lung strength.

For weight gain, strength training is ideal. To avoid burning excess calories, do fewer reps with heavier weights than you usually would, and rest longer (three to five minutes) between sets. Combine exercises (think squats, shoulder presses, abdominals with weights) to hit the major muscle groups, aiming for three workouts a week. Gaining takes time and patience—don’t expect overnight results. You may start seeing progress after three to four months, but the real payoff will take a year or more in the gym.

DIET
You need to eat more calories than you burn. That may seem obvious, but the formula can be tricky:

  • To maintain your current size, multiply your weight by 15. If you weigh 140 pounds: 140 x 15 = 2,100 calories per day.
  • To gain, multiply your weight between 18 and 20 times. For the 140-pound person, this means 2,520 to 2,800 calories daily.
  • Use the 40-30-30 plan: a daily diet of 40% carbs, 30% protein, 30% fat (sidebar). These nutritional categories team up for optimal food absorption. For instance, that 140-pounder on 2,520 daily calories would need:


CARBS 2,520 x .40 = 1,008 carb calories.

PROTEIN 2,520 x .30 = 756 protein calories.

FAT 2,520 x .30 = 756 fat -calories.

Carbs and protein pack about four calories per gram; fats, nine. You don’t need a calculator; just check a diet book.

Your goals should be health and strength, not getting buff. Finding and maintaining the right weight for you is the best buffer against illness.

+ JEFFREY GROSS IS A CERTIFIED FITNESS TRAINER BASED IN CHICAGO. GOT A QUESTION FOR OUR TRAINER? E-MAIL IT TO TRAINER@POZ.COM.

À LA CARB

Ordering from a 40-30-30 menu

CARBS
Pick complex carbs, like whole-grain breads, pastas and cereals, brown rice, oatmeal, sweet potatoes, veggies and beans; go easier on simple carbs like white bread and white rice.

PROTEIN
Lean meat, fish, chicken, eggs, soy products, yogurt.

FAT
Avoid saturated fats (including trans fats), those like butter that remain solid at room temperature. Go for unsaturated: vegetable, sunflower, soybean, olive and canola oils; almonds, cashews and avocados. Omega-3 oils help your heart; find them in walnuts and oily fish, like salmon, sardines and trout. Fats from vegetables, nuts and fish trump cholesterol-heavy animal fats. For sweetness, add a fruit fix. Let the gain begin.