Abstract
Antiretroviral therapy (ART) increases the risk of cardiometabolic diseases in people living with HIV/AIDS (PLWHA). However, there is a lack of evidence regarding the effectiveness of a nutritional intervention on several cardiometabolic parameters in this population. Therefore, this study aimed to evaluate the effectiveness of two nutritional interventions on several cardiometabolic parameters in PLWHA treated with ART. A parallel randomized clinical trial was performed with PLWHA treated with ART. The participants (n = 88) were divided into two intervention groups: (1) nutritional counseling (n = 44) and (2) individualized dietary prescription (n = 44). The follow-up period was 30 weeks. A reduction in low-density lipoprotein (LDL) was the primary outcome. Secondary outcome variables were reductions in total cholesterol (TC), triglycerides (TG), fasting plasma glucose (FPG), systolic and diastolic blood pressures (SBP and DBP, respectively), waist circumference (WC), body mass index (BMI), and increases in high-density lipoproteins (HDL). A multiple linear regression was used to analyze the effectiveness of the interventions, adjusted for sociodemographic, lifestyle, and clinical characteristics. Sixty-two PLWHA completed the trial (nutritional counseling, n = 32; individualized dietary prescription, n = 30). At follow-up, we observed in the nutritional counseling group significant reductions in SBP (p = 0.036) and DBP (p = 0.001). Significant reductions in FPG (p = 0.008) and DBP (p = 0.023) were found in the individualized dietary prescription group. In the fully adjusted models, significant reductions in LDL, SBP, DBP, and BMI were found in the individualized dietary prescription group. In conclusion, the two investigated nutritional interventions were effective in reducing some cardiometabolic risk factors in PLWHA. However, after adjustments for covariates, the individualized dietary prescription showed significant reductions in the primary outcome and, also, in more cardiometabolic risk factors than the nutritional counseling.
Highlights
Despite the immense benefits that antiretroviral therapy (ART) use has brought to people living withHIV/AIDS (PLWHA), there are some associated increased risks of dyslipidemia, hyperglycemia/diabetes, gastrointestinal symptoms, obesity, and hypertension, which contribute to a higher cardiometabolic risk in this population [1,2,3,4,5,6,7]
There is little evidence on the effectiveness of nutritional treatment on metabolic abnormalities in people living with HIV/AIDS (PLWHA), specially dyslipidemia, fasting plasma glucose (FPG), blood pressure, body mass index (BMI), and waist circumference (WC) in PLWHA treated with ART [10,15,16,17,18,19,20]
This study aims to investigate the effectiveness of two nutritional treatment approaches on cardiometabolic risk factors reduction in PLWHA treated with ART
Summary
HIV/AIDS (PLWHA), there are some associated increased risks of dyslipidemia, hyperglycemia/diabetes, gastrointestinal symptoms, obesity, and hypertension, which contribute to a higher cardiometabolic risk in this population [1,2,3,4,5,6,7]. Other risk factors corroborate for cardiometabolic diseases in PLWHA, such as smoking, excessive alcohol consumption, and physical inactivity [1,8,9,10,11,12]. Clinical treatment guidelines for PLWHA include prevention and treatment of cardiometabolic risk factors. It is important to explore non-pharmacological treatments. Reducing cardiometabolic risk factors is essential in the treatment of PLWHA in ART, and nutritional interventions have an important role in the management of metabolic abnormalities [14]
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