Can a Mediterranean Diet Reduce the Effects of Lipodystrophy Syndrome in People Living With HIV? A Pilot Randomized Controlled Trial

HIV infection and the highly active antiretroviral therapies that fight it both are associated with changes in patients’ lipid profile and fat distribution (lipodystrophy). A pilot study was carried out for a randomized controlled trial to determine whether lipodystrophy in HIV patients can be controlled by adopting a low-fat and low-cholesterol diet or a modified Mediterranean diet.

The participants, 48 HIV patients, were randomized into two diet groups. The one-year study involved regular dietetic consultations during which lipid levels, weight, body mass index, and fat distribution were recorded. Of participants, 36 (75 percent) completed the study.

In the low-fat group, undesirable body fat changes included decreases in tricep skinfold (from 19.9 mm to 15.4 mm (P=0.03)) and hip circumference (from 93.6 cm to 91.7 cm (P=0.01)), but a significant increase in waist-to-hip ratio (from 0.87 to 0.89 (P=0.003)). Serum cholesterol increased significantly at nine and 12 months (from 4.6 to 5.06 mmol L-1 (P=0.03) and 5.12 mmol L-1 (P=0.01)) in the Mediterranean diet group, with no obvious change in the low-fat diet group. While serum triglyceride levels remained the same in the Mediterranean diet group, they increased from 1.9 to 3.22 mmol L-1 (P=0.07) in the low-fat group.

"A Mediterranean diet seems to have an advantage over the low-fat diet in maintaining serum triglyceride levels and avoiding lipodystrophy, but this advantage was offset by a rise in cholesterol level," the authors concluded. "Several procedural and methodological issues were identified which must be rectified before a similar large-scale trial taking place."

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