June 16, 2004
Also, according to Alina Gavrila, M.D., a clinical researcher at Beth Israel Deaconess Medical Center in Boston, a recent observational study found a significant association between serum triglycerides levels and exercise in HIV-positive patients. "It's a negative association," Gavrila said, "meaning the patients who exercise more had lower levels of triglycerides and less insulin resistance." The researchers also found that participants taking vitamin E supplements had lower blood pressure. That study, "Exercise and Vitamin E Intake Are Independently Associated with Metabolic Abnormalities in Human Immunodeficiency Virus-Positive Subjects: A Cross-Sectional Study," appeared in Clinical Infectious Diseases (2003;36(12):1593-1601).
Robinson said that at the very least, exercise appears to have a positive impact on HIV patients with metabolic disorders, noting that exercise increases energy and helps people feel better about themselves. "And to a certain extent," Robinson said, "there is evidence that exercise does promote a more competent immune system." Also, weight lifting builds muscle mass in the arms and legs and improves the body's appearance, which in turn provides a psychological boost to HIV patients, he noted.
Robinson said that even if clinical tests showed no significant impact on lipodystrophy and HIV-related metabolic disorders, it would still be a good idea for clinicians to recommend both aerobic and weight-lifting exercises for patients for whom it is physically possible.
"Basically, there are two mechanisms at work: With endurance exercise or aerobic exercise, you are increasing the oxidated rate, including the metabolism -- the oxidating profile of cells," Robinson explained. "Weight lifting, on the other hand, probably has the most significant effect on the insulin resistance because when you increase muscle mass, you increase the amount of muscle that is available to transport glucose into."
Clinicians who recommend exercise to HIV patients might give them the achievable goal of engaging in aerobic exercise for 20-30 minutes, three or four days a week, and performing muscle group repetitions in sets of 10, twice a week, according to Robinson. "Everyone should be exercising, and people with HIV are no exception," he added.