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Metabolism. 2009 Jun;58(6):854-9. doi: 10.1016/j.metabol.2009.02.012.

Adherence to Mediterranean diet is favorably associated with metabolic parameters in HIV-positive patients with the highly active antiretroviral therapy-induced metabolic syndrome and lipodystrophy.

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Division of Infectious Diseases, Department of Internal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.


The objective of the study was 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 [FR], insulin resistance, dyslipidemia) in HIV-positive patients. This was a cross-sectional study. Two hundred twenty-seven 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, computed tomographic 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. In the entire study sample, a weak inverse association was found between insulin resistance, estimated using the homeostasis model assessment, and MedDietScore (standardized beta = -0.15, P = .03). Interaction models revealed that this was largely driven by an inverse association in patients with FR (standardized beta = -0.13, P = .02). Moreover, MedDietScore was positively correlated with high-density lipoprotein cholesterol (standardized beta = 0.15, P = .01) and marginally negatively associated with circulating triglyceride levels (standardized beta = -0.16, P = .13) in this group of patients. 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.

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