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Open Forum Infect Dis. 2018 Mar 23;5(4):ofy067. doi: 10.1093/ofid/ofy067. eCollection 2018 Apr.

Dietary Patterns and Physical Activity Correlate With Total Cholesterol Independently of Lipid-Lowering Drugs and Antiretroviral Therapy in Aging People Living With Human Immunodeficiency Virus.

Author information

1
Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Switzerland.
2
Institute of Medical Virology, University of Zurich, Switzerland.
3
Division of Infectious Diseases, University Hospital Geneva, University of Geneva, Switzerland.
4
Clinic for Internal Medicine, University of Zurich, Switzerland.
5
Division of Infectious Diseases, University Hospital Berne, University of Berne, Switzerland.
6
University Department of Medicine and Division of Infectious Diseases and Hospital Epidemiology, Kantonsspital Baselland, University of Basel, Bruderholz, Switzerland.

Abstract

Background:

Hypercholesterolemia is a well established risk factor for coronary heart disease and is highly prevalent among human immunodeficiency virus (HIV)-positive persons. Antiretroviral therapy (ART) can both directly modify total cholesterol and have drug-drug interactions with statins. This makes investigating modifiable behavioral predictors of total cholesterol a pertinent task.

Methods:

To explore the association between diet and physical activity with cross-sectionally measured total cholesterol, we administered a validated Food-Frequency-Questionnaire to participants of the Swiss HIV Cohort Study ≥45 years old. Linear mixed-effects models were applied to explore the associations between dietary patterns and physical activity with total cholesterol, after adjustment for clinical and demographic covariates.

Results:

In total, 395 patients were included. Forty percent (158 of 395) had elevated total cholesterol (>5.2 mmol/L), and 41% (164 of 395) were not regularly physically active. In multivariable analysis, 2 factors were positively associated with total cholesterol; female sex (β = 0.562; 95% confidence interval [CI], 0.229-0.896) and the combined consumption of meat, refined/milled grains, carbonated beverages, and coffee (β = 0.243; 95% CI, 0.047-0.439). On the other hand, regular physical activity (β = -0.381; 95% CI, -0.626 to -0.136), lipid-lowering drugs (β = -0.443; 95% CI -0.691 to -0.196), ART containing tenofovir (β = -0.336; 95% CI -0.554 to -0.118), and black ethnicity (β = -0.967; 95% CI -1.524 to -0.410) exhibited a negative association.

Conclusions:

We found independent associations between certain dietary patterns and physical activity with total cholesterol. Increasing physical activity might achieve cardiovascular and other health benefits in HIV-positive individuals. The clinical relevance of the identified dietary patterns requires further investigation in prospective cohort studies and randomized controlled trials.

KEYWORDS:

HIV; aging; diet; physical activity; total cholesterol

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