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Article << Previous     |     Next >>   Contents Vol 8(1)

Can a Mediterranean diet reduce the effects of lipodystrophy syndrome in people living with HIV? A pilot randomised controlled trial

Geraldine Wai Bik Ng A D, Una Man Shu Chan A, Patrick Chung Ki Li B, William C. W. Wong C

A Department of Dietetics, Queen Elizabeth Hospital, Kowloon, Hong Kong.
B Department of Medicine, Queen Elizabeth Hospital, Kowloon, Hong Kong.
C Department of Family Medicine and Primary Care, The University of Hong Kong, Ap Lei Chau, Hong Kong.
D Corresponding author. Emails: cnwbg01@ha.org.hk, geraldineng_hk@yahoo.com
 
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Abstract

Background: HIV and highly active antiretroviral therapies have been associated with changes in individuals’ lipid profiles and fat distribution (lipodystrophy). A pilot study was conducted for a randomised controlled trial to evaluate whether lipodystrophy in HIV patients can be controlled by adopting the low-fat and low-cholesterol diet or the modified Mediterranean diet. Methods: Forty-eight HIV patients were randomised into two diet groups. Thirty-six (75%) completed the 1-year pilot study with regular dietetic consultations, during which time lipid levels, weight, body mass index and fat distribution were recorded. Differences between and within groups were determined. Results: Undesirable body fat changes in the low-fat diet group included decreases in tricep skinfold (from 19.9 mm to 15.4 mm (P = 0.03)), hip circumference (from 93.6 cm to 91.7 cm (P = 0.01)) but a significant increase in waist-to-hip ratio (from 0.87 to 0.89 (P = 0.003)). Serum cholesterol increased significantly in the Mediterranean diet group at 9 and 12 months (from 4.6 to 5.06 mmol L-1 (P = 0.03) and 5.12 mmol L-1 (P = 0.01)) with no obvious change in the low-fat diet group. Serum triglyceride levels remained the same in the Mediterranean diet group, whereas it increased from 1.9 to 3.22 mmol L-1 (P = 0.07) in the low-fat diet group. Conclusions: A Mediterranean diet seems to have an advantage over the low-fat diet in maintaining serum triglyceride levels and avoiding lipodystrophy, but this advantage was offset by a rise in cholesterol level. Several procedural and methodological issues were identified which must be rectified before a similar large-scale trial taking place.



Keywords: AIDS, body fat, cholesterol, highly active antiretroviral therapy, low-fat diet.


   
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