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Dietary fat intake and relationship to serum lipid levels in HIV-infected patients with metabolic abnormalities in the HAART era

Joy, Tishaa; Keogh, Hester Ma; Hadigan, Colleena,b; Lee, Hangc; Dolan, Sara Ea; Fitch, Kathleena; Liebau, Jamesa; Lo, Janeta; Johnsen, Stinea; Hubbard, Janed; Anderson, Ellen Jd; Grinspoon, Stevena

doi: 10.1097/QAD.0b013e32823644ff
Epidemiology and Social

Objective: To evaluate dietary intake and its relationship to lipid parameters in HIV-infected patients with metabolic abnormalities.

Method: We prospectively determined dietary intake (4-day food records or 24-h recall) in 356 HIV-infected patients and 162 community-derived HIV-negative controls evaluated for metabolic studies between 1998–2005. Differences in dietary intake between HIV-infected patients and non-HIV-infected controls, in relation to the established 2005 USDA (United States Department of Agriculture) Recommended Dietary Guidelines, were determined. The relationship between dietary fat intake and serum lipid levels among HIV-infected individuals was also evaluated.

Results: Assessment of dietary intake in this group of HIV-infected patients demonstrated increased intake of total dietary fat (P < 0.05), saturated fat (P = 0.006), and cholesterol (P = 0.006) as well as a greater percentage of calories from saturated fat (P = 0.002) and from trans fat (P = 0.02), despite similar caloric intake to the control individuals. A significantly higher percentage of HIV-infected patients were above the 2005 USDA Recommended Dietary Guidelines for saturated fat (> 10%/day) (76.0% HIV vs. 60.9% controls, P = 0.003), and cholesterol (> 300 mg/day) (49.7% HIV vs. 37.9% controls, P = 0.04). Saturated fat intake was strongly associated with triglyceride level [triglyceride level increased 8.7 mg/dl (parameter estimate) per gram of increased saturated fat intake, P = 0.005] whereas total fat was inversely associated with triglyceride level [triglyceride level decreased 3.0 mg/dl (parameter estimate) per gram of increased total fat intake, P = 0.02] among HIV-infected individuals.

Conclusions: Increased intake of saturated fat is seen and contributes to hypertriglyceridemia among HIV-infected patients who have developed metabolic abnormalities. Increased saturated fat intake should be targeted for dietary modification in this population.

From the aProgram in Nutritional Metabolism, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA

bNational Institutes of Health, Bethesda, Maryland, USA

cMGH Biostatistics Center, USA

dGeneral Clinical Research Center, Massachusetts General Hospital, Boston, Massachusetts, USA.

Received 23 January, 2007

Revised 19 March, 2007

Accepted 21 March, 2007

Correspondence to Steven K. Grinspoon, MD, Director, Program in Nutritional Metabolism, Massachusetts General Hospital, Boston, MA 02114, USA. E-mail:

© 2007 Lippincott Williams & Wilkins, Inc.