Diet Quality Is Suboptimal in Proportion of Global Population With HIV

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href="/research-and-innovation/topic.aspx?id=1088">HIV</a> </li> </ul> </div> <h1 class="content-header__heading" itemprop="name">Diet Quality Is Suboptimal or Poor in Large Proportion of Global Population With HIV</h1> <div class="content-header__metadata"> <p class="content-metadata"> <span class="content-metadata__media -journal">Journal</span> <time class="date" datetime="2022-11-07" itemprop="datePublished">Published on November 7, 2022 </time> </p> <p data-module="share-links"> </p> <p class="citation"> Originally published on <cite itemprop="citation"><a href="https://journals.lww.com/aidsonline/Abstract/9900/Diet_in_a_global_cohort_of_adults_with_HIV_at_Low.79.aspx">AIDS</a></cite> </p> </div> </div> </header> <div class="-padding--vertical -padding--horizontal"> <div class="layout-columns -width--wide -centered"> <div class="layout-columns__main"> <div class="layout-columns__main__content"> <div class="content-summary"> <h3 class="content-summary__heading">Key findings</h3> <ul> <li>This study analyzed data from the Randomized Trial to Prevent Vascular Events in HIV on 7,736 people with HIV on antiretroviral therapy at low-to-moderate risk of atherosclerotic cardiovascular disease</li> <li>The participants completed a questionnaire about their diet at baseline, and 42% of participants reported suboptimal or poor diet quality</li> <li>There were notable variations in diet quality by region of the world, with poor or suboptimal diets more commonly reported in sub-Saharan Africa</li> <li>Established risk factors for cardiovascular disease—atherosclerotic cardiovascular disease risk scores, body mass index, and waist circumference—increased with worsening category of diet quality</li> <li>These data suggest the need to focus on diet quality as a potential modifiable risk for cardiovascular disease in people with HIV</li> </ul> </div> <p>Diet quality is acknowledged to be an important factor related to the development of chronic comorbid diseases in people with<span> </span><a class="SWhtmlLink" title="Advances in HIV" href="https://advances.massgeneral.org/research-and-innovation/topic.aspx?id=1088">HIV</a><span> </span>(PWH). 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Fitch, MSN" href="https://advances.massgeneral.org/contributors/contributor.aspx?id=2364">Kathleen V. Fitch, MSN</a>, a<span> </span>principal associate in medicine at Massachusetts General Hospital,<span> </span><a title="Research contributions by Steven K. Grinspoon, MD" href="https://advances.massgeneral.org/contributors/contributor.aspx?id=1069">Steven K. Grinspoon, MD</a>, chief of the<span> </span><a title="The Metabolism Unit at Mass General" href="https://www.massgeneral.org/endocrinology/metabolism-unit">Metabolism Unit</a>, and colleagues recently conducted the first analysis of diet quality across a multinational cohort of PWH. In the journal<span> </span><a title="Diet in a global cohort of adults with HIV at low-to-moderate traditional cardiovascular disease risk" href="https://journals.lww.com/aidsonline/Abstract/9900/Diet_in_a_global_cohort_of_adults_with_HIV_at_Low.79.aspx" target="_blank" rel="noopener noreferrer"><em>AIDS</em></a>, they report that diet quality was poor or suboptimal in 42% of individuals.</p> <h2>Methods</h2> <p>The researchers analyzed data from the<span> </span><a title="Leveraging a Landmark Trial of Primary Cardiovascular Disease Prevention in Human Immunodeficiency Virus: Introduction From the REPRIEVE Coprincipal Investigators" href="https://academic.oup.com/jid/article/222/Supplement_1/S1/5869454?login=false" target="_blank" rel="noopener noreferrer">Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE)</a>, an ongoing randomized phase 3 trial assessing the effects of a statin to prevent major adverse cardiovascular events in PWH.</p> <p>From 2015 to 2019, on five continents, the trial enrolled individuals without known atherosclerotic cardiovascular disease (ASCVD), 40 to 75 years of age, who were receiving antiretroviral therapy and were judged to be at low-to-moderate traditional risk of ASCVD at baseline, with an average ASCVD risk score of approximately 5%.</p> <p>The current analysis examined data on 7,736 REPRIEVE participants who completed the<span> </span><a title="Development and Evaluation of the Nutrition Component of the Rapid Eating and Activity Assessment for Patients (REAP): A New Tool for Primary Care Providers" href="https://www.jneb.org/article/S1499-4046%2805%2900043-6/fulltext" target="_blank" rel="noopener noreferrer">Rapid Eating Assessment for Participants (REAP)</a>, a 31-item questionnaire developed to assess diet quality in primary care settings. REAP scores were analyzed on a continuous scale from 1 (worst) to 30 (best) and grouped into four categories: optimal, good, suboptimal, or poor.</p> <h2>Diet Quality Scores</h2> <p>The median diet quality score for the cohort was 17. Diet quality was optimal in 13% of participants, good in 45%, suboptimal in 38%, and poor in 4%.</p> <p>Substantial percentages of participants had diet component scores categorized as suboptimal or poor:</p> <ul> <li>Fiber—66% of participants</li> <li>Saturated fat—47%</li> <li>Added sugar—41%</li> <li>Sodium—36%</li> </ul> <h2>Diet Quality by Region</h2> <p>The REPRIEVE sites were grouped into five of the<span> </span><a title="Global, regional, and national age-sex-specific mortality and life expectancy, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017" href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2818%2931891-9/fulltext" target="_blank" rel="noopener noreferrer">Global Burden of Disease (GBD)</a><span> </span>super-region subgroups using classifications developed by the World Health Organization. Diet quality differed across GBD regions, with the best scores reported in South Asia (median of 23) and the worst in sub-Saharan Africa (median of 15). Likewise, 61% of participants in South Asia reported optimal diet quality versus only 6% in sub-Saharan Africa.</p> <h2>Diet Quality and Cardiometabolic Characteristics</h2> <p>ASCVD risk scores, body mass index, and waist circumference increased with the worsening category of diet quality score. Interestingly, though, there were no clinical differences in glucose or total cholesterol across categories. Participants with poor diet quality were the most likely to have hypertension.</p> <h2>Opportunities to Improve Care</h2> <p>Diet quality may be an important modifiable factor for cardiometabolic diseases in the large global population of PWH. These results are particularly important because a recent systematic review concluded the highest HIV-associated burden of cardiovascular disease is in sub-Saharan Africa. In this region, it is essential to develop and sustain care models that incorporate nutrition assessment and counseling for PWH, as well as improve the availability of and access to affordable, healthy foods.</p> <figure class="stat" data-plaintext="42% of a global population of people with HIV reported suboptimal or poor diet quality" data-module="stat"><span class="stat__number"><span data-stat-number="">42</span>%</span> <figcaption class="stat__caption">of a global population of people with HIV reported suboptimal or poor diet quality</figcaption> <p data-module="share-links"></p> </figure><p class="fat-link__wrapper u-text-right"> <a class="fat-link -caret -large" href="https://journals.lww.com/aidsonline/Abstract/9900/Diet_in_a_global_cohort_of_adults_with_HIV_at_Low.79.aspx">view original journal article <em>Subscription may be required</em></a> </p> <div class="article-attribution" itemscope itemtype="http://schema.org/ScholarlyArticle"> <p class="article-attribution__logo" itemscope itemtype="http://schema.org/Periodical"> <a href="https://journals.lww.com/aidsonline/Abstract/9900/Diet_in_a_global_cohort_of_adults_with_HIV_at_Low.79.aspx"> <span class="a11y-sr-only" itemprop="name">AIDS</span> </a> </p> <p class="article-attribution__metadata" itemscope itemtype="http://schema.org/PublicationIssue"> <span> Journal Article Published: <time datetime="2022-07-27" itemprop="datePublished">July 27, 2022</time> </span> </p> </div> <p class="cta">Learn about the <a href="https://www.massgeneral.org/endocrinology/metabolism-unit">Metabolism Unit</a></p> <p class="cta">Explore <a href="https://www.massgeneral.org/endocrinology/metabolism-unit/research-studies">research in the Metabolism Unit</a></p> </div> </div> <aside class="layout-columns__sidebar -article__contributors"> <div class="layout-columns__sidebar__content"> <div class="profile-compact__wrapper"> <p class="u-no-margin"> <strong>Contributors</strong> </p> <div class="profile -compact" itemscope itemtype="http://schema.org/Person"> <div class="profile__content"> <h3 class="profile__name" itemprop="name"> <a href="/contributors/contributor.aspx?id=2364" itemprop="url">Kathleen V. Fitch, MSN ›</a></h3><p class="profile__title" itemprop="jobTitle">Principal Associate in Medicine, Massachusetts General Hospital</p> </div> </div> <div class="profile -compact" itemscope itemtype="http://schema.org/Person"> <div class="profile__content"> <h3 class="profile__name" itemprop="name"> <a href="/contributors/contributor.aspx?id=1069" itemprop="url">Steven Kyle Grinspoon, MD ›</a></h3><p class="profile__title" itemprop="jobTitle">Chief, Metabolism Unit, Massachusetts General Hospital, Director, Nutrition Obesity Research Center, Harvard</p> </div> <p class="profile__image"> <img alt="Steven Kyle Grinspoon, MD" itemprop="image" srcset="/assets/images/contributors/steven_grinspoon_advances.png, /assets/images/contributors/steven_grinspoon_advances_2x.png 2x" src="/assets/images/contributors/steven_grinspoon_advances.png"> </p> </div> </div> </div> </aside> <section class="topics-layout -article__related"> <div class="topics-layout__inner"> <div class="topics-layout__sidebar"> <h2 class="section-heading">Related topics</h2> </div> <div class="topics-layout__main"> <ul class="topics-list" data-module="topics-list"> <li><a href="/research-and-innovation/topic.aspx?id=1089">Global Health</a></li> <li><a href="/research-and-innovation/topic.aspx?id=1088">HIV</a></li> </ul> </div> </div> </section> <section class="-padding--horizontal -padding--vertical -article__related"> <div class="layout-columns -width--wide -centered"> <div class="layout-columns__pod--half"> <div class="content-tease" itemscope itemtype="http://schema.org/ScholarlyArticle"> <p class="content-tease__topic"> <span class="highlight">Related</span> </p> <h3 class="content-tease__heading" itemprop="name"> <a href="/endocrinology/article.aspx?id=1453" itemprop="url">Treating Metabolic Disease in HIV Infection</a> </h3> <p itemprop="description"> <p><span>Massachusetts General Hospital investigators have developed an effective drug, tesamorelin, to treat HIV lipodystrophy and non-alcoholic fatty liver disease.</span></p></p> <p class="content-tease__related"> <a href="/endocrinology/specialty.aspx?id=1015" itemprop="relatedLink">Endocrinology</a>, <a href="/research-and-innovation/topic.aspx?id=1088" itemprop="relatedLink">HIV</a> </p> <p class="content-metadata"> <span class="content-metadata__media -article">Article</span> <time class="date" datetime="2022-01-18" itemprop="datePublished">January 18, 2022</time> </p> </div> </div> <div class="layout-columns__pod--half"> <div class="content-tease" itemscope itemtype="http://schema.org/ScholarlyArticle"> <p class="content-tease__topic"> <span class="highlight">Related</span> </p> <h3 class="content-tease__heading" itemprop="name"> <a href="/endocrinology/article.aspx?id=1465" itemprop="url">Preventing Heart Disease After HIV Infection</a> </h3> <p itemprop="description"> <p><span>Research at Massachusetts General Hospital has led to several landmark studies, including the REPRIEVE trial, aimed at understanding and preventing HIV-related heart disease.</span></p></p> <p class="content-tease__related"> <a href="/cardiovascular/specialty.aspx?id=1002" itemprop="relatedLink">Cardiovascular</a>, <a href="/endocrinology/specialty.aspx?id=1015" itemprop="relatedLink">Endocrinology</a>, <a href="/research-and-innovation/topic.aspx?id=1088" itemprop="relatedLink">HIV</a> </p> <p class="content-metadata"> <span class="content-metadata__media -article">Article</span> <time class="date" datetime="2022-02-28" itemprop="datePublished">February 28, 2022</time> </p> </div> </div> </div> </section> </div> </div> </article> </div> </main>  <footer class="site-footer"> <div class="-padding--horizontal"> <nav aria-label="Footer links" class="content-container -width--wide -centered -padding--bottom"> <ul class="footer__nav" role="presentation"> <li> <a href="https://www.massgeneral.org/about">About Mass General</a> </li> <li> <a href="https://www.massgeneral.org/about/support">Giving</a> </li> <li> <a 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Diet Quality Is Suboptimal in Proportion of Global Population With HIV - Mass General Advances in Motion