Diet, Alcohol Linked to HIV-Related Fat Deposits

Dietary levels of fiber, alcohol and fat may play important roles in lipodystrophy, the abnormal body-fat distribution seen in some HIV patients, according to a new report. The condition can cause sunken cheeks, increased fat around the waist and the development of a fat pad on the back of the neck.

While various metabolic problems have been found in HIV patients with lipodystrophy, and certain HIV drugs are linked to the condition, it remains unclear how the abnormality arises. But the new study's findings suggest that some dietary changes might help HIV patients with the problem. The research, conducted by Dr. Colleen Hadigan of Massachusetts General Hospital in Boston and colleagues, was reported in Clinical Infectious Diseases (2001; 33: 710-717).

"Our data indicate that certain modifiable components, such as polyunsaturated fats, fiber and alcohol, are strongly associated with insulin resistance and [high cholesterol] among these patients," Hadigan and colleagues concluded. The researchers examined the associations between dietary habits, metabolism and body composition in 85 men and women with HIV and body-fat redistribution. They questioned the patients on their eating and drinking habits in the previous month, and they examined them after a day of fasting.

The researchers found that low fiber and high polyunsaturated fat intakes were linked to insulin resistance among the patients. Insulin resistance, a problem with the body's use of insulin, is one of the metabolic disturbances seen in HIV patients who develop lipodystrophy. In addition, heavier drinking was associated with higher levels of LDL ("bad") cholesterol. These dietary associations with metabolism and lipodystrophy were independent of factors like patients' age and sex, and length of time on protease inhibitors, which are believed to contribute to the condition.

The authors called for studies to determine whether changing patients' fat intake, increasing fiber consumption and reducing alcohol would affect the metabolic factors associated with lipodystrophy.

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