Adherence to Mediterranean Diet is favorably associated with metabolic parameters in HIV positive patients with the HAART-induced metabolic syndrome and lipodystrophy

Objective— To investigate whether closer adherence to a Mediterranean dietary pattern is associated with metabolic aspects of the Highly Active Antiretroviral Therapy (HAART)-induced metabolic syndrome (fat redistribution, insulin resistance, dyslipidemia) in HIV positive patients. Design— Cross sectional study. Methods— 227 HIV- infected patients were evaluated during a single outpatient visit to the General Clinical Research Center of Beth Israel Deaconess Medical Center. Usual dietary intake and physical activity habits were evaluated; the Mediterranean Diet Score (MedDietScore) was calculated. Dual-energy x-ray absorptiometry, CT findings anthropometrics and data from the study interviews and questionnaires were used for the assessment of body composition using specific criteria. A complete metabolic profile was available for all subjects. Results— In the entire study sample, a weak inverse association was found between insulin resistance, estimated using the homeostasis model (HOMA-IR), and MedDietScore (standardized β = -0.15, p = 0.03). Interaction models revealed that this was largely driven by an inverse association in patients with fat redistribution (FR) (standardized β = -0.13, p = 0.02). Moreover, MedDietScore was positively correlated with HDL-cholesterol (standardized β = 0.15, p = 0.01) and marginally negatively associated with circulating triglyceride levels (standardized β = -0.16, p = 0.13) in this group of patients. Conclusions— Adherence to a Mediterranean dietary pattern was favorably related to cardiovascular risk factors in HIV-positive patients with FR. Further clinical studies are needed, to confirm our data in different populations and to explore the underlying mechanisms.