HIV/AIDS

H/A: Dietary Intake (2007)

• Intervention
  What amount of dietary intake of protein is appropriate for people with HIV infection?

  • Conclusion

    In people with HIV infection, protein needs are highly individualized. While diets that are higher in protein (at intake levels higher than the RDA) may result in increased body weight and body cell mass, protein requirements were not addressed in these studies. Further research regarding protein needs and implications in people with HIV infection is warranted.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: Dietary intake of protein for people with HIV infection
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Henderson RA, Talusan K, Hutton N, Yolken RH, Caballero B. Serum and plasma markers of nutritional status in children infected with the human immunodeficiency virus. J Am Diet Assoc. 1997; 97: 1,377-1,381.
      • Hendricks KM, Mwamburi DM, Newby PK, Wanke CA. Dietary patterns and health and nutrition outcomes in men living with HIV infection. Am J Clin Nutr. 2008; 88 (6): 1584-1592.
      • Hendricks KM, Dong KR, Tang AM, Ding B, Spiegelman D, Woods MN, Wanke CA. High-fiber diet in HIV-positive men is associated with lower risk of developing fat deposition. Am J Clin Nutr, 2003; 78: 790-795.
      • Isaac R, Jacobson D, Wanke C, Hendricks K, Knox TA, Wilson IB. Declines in dietary macronutrient intake in persons with HIV infection who develop depression. Public Health Nutrition. 2008; 11 (2): 124-131.
      • Samaras K, Wand H, Law M, Emery S, Cooper DA, Carr A. Dietary intake in HIV-infected men with lipodystrophy:  relationships with body composition, visceral fat, lipid, glucose and adipokine metabolism. Current HIV Research. 2009; 7 (4): 454-461.
      • Williams SB, Bartsch G, Muurahainen N, Collins G, Raghavan SS, Wheeler D. Protein intake is positively associated with body cell mass in weight-stable HIV-infected men. J Nutr. 2003; 133: 1,143-1,146.
  • Search Plan and Results: Protein 2006
     
  What amount of dietary intake of carbohydrate is appropriate for people with HIV infection?

  • Conclusion

    Studies report that people with HIV infection generally consume diets that are low in fiber and high in fat. Evidence supports a positive relationship between low-fiber, high-fat diets and fat deposition, insulin resistance and obesity. Further research regarding carbohydrate needs and implications in people with HIV infection is warranted.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: Dietary intake of carbohydrate for people with HIV infection
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Arendt BA, Aghdassi E, Mohammed SS, Fung LY, Jalali P, Salit IE, Allard JP. Dietary intake and physical activity in a Canadian population sample of male patients with HIV infection and metabolic abnormalities. Current HIV Research. 2008; 6 (1): 82-90.
      • Capili B, Anastasi JK. Body mass index and nutritional intake in patients with HIV and chronic diarrhea: A secondary analysis. J Am Acad Nurse Pract. 2008; 20(9): 463-470.
      • Dong KR, Wanke CA, Tang AM, Ding B, Hendricks KM. Dietary glycemic index of human immunodeficiency virus-positive men with and without fat deposition. J Am Diet Assoc. 2006; 106: 728-732.
      • Hendricks KM, Mwamburi DM, Newby PK, Wanke CA. Dietary patterns and health and nutrition outcomes in men living with HIV infection. Am J Clin Nutr. 2008; 88 (6): 1584-1592.
      • Hendricks KM, Dong KR, Tang AM, Ding B, Spiegelman D, Woods MN, Wanke CA. High-fiber diet in HIV-positive men is associated with lower risk of developing fat deposition. Am J Clin Nutr, 2003; 78: 790-795.
      • Isaac R, Jacobson D, Wanke C, Hendricks K, Knox TA, Wilson IB. Declines in dietary macronutrient intake in persons with HIV infection who develop depression. Public Health Nutrition. 2008; 11 (2): 124-131.
      • Samaras K, Wand H, Law M, Emery S, Cooper DA, Carr A. Dietary intake in HIV-infected men with lipodystrophy:  relationships with body composition, visceral fat, lipid, glucose and adipokine metabolism. Current HIV Research. 2009; 7 (4): 454-461.
      • Sharma TS, Kinnamon DD, Duggan C, Weinberg GA, Furuta L, Bechard L, Nicchitta J, Gorbach SL, Miller TL. Changes in macronutrient intake among HIV-infected children between 1995 and 2004. Am J Clin Nutr. 2008; 88: 384-391.
  • Search Plan and Results: Carbohydrate 2006
     
  What is the evidence regarding the consumption of dietary fatty acids for people with HIV infection?

  • Conclusion

    Studies report that people with HIV infection generally consume diets that are high in fat, saturated fat and cholesterol. Evidence supports a relationship between diets that are high in saturated fat and hyperlipidemia, particularly hypertriglyceridemia. Studies indicate that diets low in saturated and total fat and including omega-3 fatty acids resulted in reduced triglyceride levels, increased HDL-cholesterol levels and a lower risk of lipohypertrophy. Further research regarding dosage and duration of specific fatty acid supplementation in people with HIV infection is warranted.

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the evidence regarding the consumption of dietary fatty acids for people with HIV infection?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Agostoni C, Zuccotti  GV, Riva E, Decarlis S, Bernardo L, Bruzzese MG, Giovannini M.  Low levels of linoleic acid in plasma total lipids of HIV-1 seropositive children. J Am Coll Nutr. 1998; 17 (1): 25-29.
      • Arendt BA, Aghdassi E, Mohammed SS, Fung LY, Jalali P, Salit IE, Allard JP. Dietary intake and physical activity in a Canadian population sample of male patients with HIV infection and metabolic abnormalities. Current HIV Research. 2008; 6 (1): 82-90.
      • Capili B, Anastasi JK. Body mass index and nutritional intake in patients with HIV and chronic diarrhea: A secondary analysis. J Am Acad Nurse Pract. 2008; 20(9): 463-470.
      • de Luis Roman DA, Bachiller P, Izaola O, Romero E, Martin J, Arranz M, Eiros Bouza JM, Aller R. Nutritional treatment for acquired immunodeficiency virus infection using an enterotropic peptide-based formula enriched with n-3 fatty acids: a randomized prospective trial. Eur J Clin Nutr. 2001; 55: 1,048-1,052.
      • De Truchis P, Kirstetter M, Perier A, Meunier C, Zucman D, Force G, Doll J, Katlama C, Rozenbaum W, Masson H, Gardette J, Melchior JC, and the Maxepa-HIV Group. Reduction in triglyceride level with N-3 polyunsaturated fatty acids in HIV-infected patients taking potent antiretroviral therapy: A randomized prospective study. J Acquir Immune Defic Syndr. 2007; 44(3): 278-285. 
      • Hellerstein MK, Wu K, McGrath M, Faix D, George D, Shackleton CHL, Horn W, Hoh R, Neese RA. Effects of dietary n-3 fatty acid supplementation in men with weight loss associated with the acquired immune deficiency syndrome: relation to indices of cytokine production. J Acquir Immune Defic Syndr Hum Retrovirol. 1996; 11 (3): 258-270.
      • Hendricks KM, Mwamburi DM, Newby PK, Wanke CA. Dietary patterns and health and nutrition outcomes in men living with HIV infection. Am J Clin Nutr. 2008; 88 (6): 1584-1592.
      • Isaac R, Jacobson D, Wanke C, Hendricks K, Knox TA, Wilson IB. Declines in dietary macronutrient intake in persons with HIV infection who develop depression. Public Health Nutrition. 2008; 11 (2): 124-131.
      • Joy T, Keogh HM, Hadigan C, Lee H, Dolan SE, Fitch K, Liebau J, Lo J, Johnsen S, Hubbard J, Anderson EJ, Grinspoon S. Dietary fat intake and relationship to serum lipid levels in HIV-infected patients with metabolic abnormalities in the HAART era. AIDS 2007; 21: 1,591-1,600. 
      • Oosthuizen W, van Graan A, Kruger A, Vorster HH. Polyunsaturated fatty acid intake is adversely related to liver function in HIV-infected subjects: the THUSA study. Am J Clin Nutr. 2006; 83: 1,193-1,198. 
      • Pichard C, Sudre P, Karsegard V, Yerly S, Slosman DO, Delley V, Perrin L, Hirschel B and the Swiss HIV Cohort Study. A randomized double-blind controlled study of six months of oral nutritional supplementation with arginine and omega-3 fatty acids in HIV-infected patients. AIDS, 1998; 12: 53-63.
      • Samaras K, Wand H, Law M, Emery S, Cooper DA, Carr A. Dietary intake in HIV-infected men with lipodystrophy:  relationships with body composition, visceral fat, lipid, glucose and adipokine metabolism. Current HIV Research. 2009; 7 (4): 454-461.
      • Tsiodras S, Poulia KA, Yannakoulia M, Chimienti SN, Wadhwa S, Karchmer AW, Mantzoros CS. Adherence to Mediterranean diet is favorably associated with metabolic parameters in HIV-positive patients with the highly active anti-retroviral therapy-induced metabolic syndrome and lipodystrophy. Metabolism 2009; 58(6): 854-859.
      • Turcinov D, Stanley C, Rutherford G, Novotny T, Begovac J.  Adherence to the Mediterranean diet is associated with a lower risk of body-shape changes in Croatian patients treated with combination antiretroviral therapy.  Eur J Epidemiol 2009;24(5):267-74.
      • Woods MN, Wanke CA, Ling PR, Hendricks KM, Tang AM, Knox TA, Andersson CE, Dong KR, Skinner SC, Bistrian BR. Effect of a dietary intervention and n-3 fatty acid supplementation on measures of serum lipid and insulin sensitivity in persons with HIV. Am J Clin Nutr. 2009; 90(6): 1,566-1,578.
  • Search Plan and Results: Fat and Fatty Acids 2006