Dietary patterns and health and nutrition outcomes in men living with HIV infection

• Published in: The American journal of clinical nutrition Vol. 88; no. 6; pp. 1584 - 1592
• Main Authors: Hendricks, Kristy M, Mwamburi, D. Mkaya, Newby, PK, Wanke, Christine A
• Format: Journal Article
• Language: English
• Published: Bethesda, MD American Society for Clinical Nutrition 01.12.2008; American Society for Nutrition; American Society for Clinical Nutrition, Inc
• Subjects: acquired immunodeficiency syndrome; administration & dosage; Adult; Antiretroviral Therapy, Highly Active; Biological and medical sciences; body composition; Body Mass Index; body weight changes; carbonated beverages; CD4 Lymphocyte Count; Clinical outcomes; Cluster Analysis; Cohort Studies; Dairy Products; Diet; Diet - psychology; Diet - statistics & numerical data; Diet - trends; dietary energy sources; Dietary Fats; Dietary Fats - administration & dosage; dietary fiber; dietary protein; drug therapy; eating habits; energy intake; Fast food; fast foods; Feeding. Feeding behavior; Food; food choices; Food groups; food records; Fruit; fruit drinks; fruit juices; Fruits; fruits (food); Fundamental and applied biological sciences. Psychology; health status; HIV; HIV Infections; HIV Infections - drug therapy; HIV Infections - immunology; HIV Infections - mortality; HIV Infections - pathology; Human immunodeficiency virus; Humans; immunology; Longitudinal Studies; low fat dairy products; low income households; lymphocyte count; Male; Men; Micronutrients; Middle Aged; mortality; Multivariate Analysis; nutrient intake; Nutrition; nutrition risk assessment; nutritional adequacy; Nutritional Status; pathology; Prognosis; psychology; sociodemographic characteristics; soft drinks; statistics & numerical data; trends; Vegetables; Vertebrates: anatomy and physiology, studies on body, several organs or systems; viral antigens; Viral Load; Infection; Human; Immunopathology; Prognosis; Nutrition; Health; Viral disease; AIDS; Immune deficiency; Feeding
• ISSN: 0002-9165; 1938-3207; 1938-3207
• DOI: 10.3945/ajcn.2008.26098

BACKGROUND: Nutritional status is an important determinant of HIV outcomes. OBJECTIVE: We assessed the association between dietary patterns identified by cluster analysis and change in body mass index (BMI; in kg/m²), CD4 count, and viral load (VL). DESIGN: HIV-positive adult male subjects (n = 348) with a BMI greater-than-or-equal 20.5 were evaluated by biochemical, body composition, and dietary data. Cluster analysis was performed on 41 designated food groups derived from 3-d food records. Dietary clusters were compared for sociodemographic, nutrient intake, and clinical outcomes. Multivariate linear regression assessed associations between dietary clusters and change in BMI, CD4 count, and VL. RESULTS: We observed 3 dietary patterns: juice and soda; fast food and fruit drinks; and fruit, vegetable, and low-fat dairy. Subjects in the fast food and fruit drinks pattern had the lowest fiber intake, highest VL, and lowest CD4 count and had a lower income than did subjects in the other 2 clusters. Subjects in the fruit, vegetable, and low-fat dairy diet pattern had higher intakes of protein, fiber, and micronutrients and the highest BMI and CD4 count. Subjects in the juice and soda pattern had higher energy intakes and lowest BMI. On average, the fast food and fruit drinks cluster and fruit, vegetable, and low-fat dairy cluster gained 0.33 (P = 0.06) and 0.42 (P = 0.02), respectively, more in BMI than the juice and soda cluster across the study interval in a multivariate model. CONCLUSIONS: In a cohort of HIV-positive men, we identified 3 distinct dietary patterns; each pattern was associated with specific nutrition, demographic, and HIV-related variables.