Dietary patterns and physical activity correlate with total cholesterol independently of lipid lowering drugs and ART in aging HIV positive individuals. Open Forum Infectious Diseases
Marzel et al. et al. aimed (1) to describe the predictors of total cholesterol in an aging HIV-positive population living in a resource-rich setting; (2) describe the major dietary patterns of this population; (3) and examine whether behavioral determinants such as dietary patterns and physical activity independently correlate with total cholesterol after adjustment for highly active ART, lipid-lowering drugs, and other confounders.
Information on diet was obtained by a short and validated Food-Frequency Questionnaire (FFQ) among patients ≥45 years old. Linear mixed-effects model with per center random intercept was used to assess the correlation between dietary patterns and total cholesterol.
In total, 395 patients were included. Forty percent (158 of 395) had elevated total cholesterol (>5.2 mmol/L), and 41% (164 of 395) were not regularly physically active. In multivariable analysis, 2 factors were positively associated with total cholesterol; female sex (β = 0.562; 95% confidence interval [CI], 0.229–0.896) and the combined consumption of meat, refined/milled grains, carbonated beverages, and coffee (β = 0.243; 95% CI, 0.047–0.439). On the other hand, regular physical activity (β = −0.381; 95% CI, −0.626 to −0.136), lipid-lowering drugs (β = −0.443; 95% CI −0.691 to −0.196), ART containing tenofovir (β = −0.336; 95% CI−0.554 to −0.118), and black ethnicity (β = −0.967; 95% CI −1.524 to −0.410) exhibited a negative association.
In summary, this cross-sectional study suggests that there are independent associations between certain dietary patterns and physical activity with total cholesterol. Physical activity should be substantially scaled up in this population to meet WHO guidelines and to achieve cardiovascular and other health benefits. The reported dietary patterns pave the way for further investigations in in prospective cohort studies and randomized controlled trials.