Dietary intake, dietary quality, and prevalence of obesity among HIV-infected and HIV-uninfected adolescents and young adults in the REACH study

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2002-01-01
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Kruzich, Laurie
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Food Science and Human Nutrition
Abstract

Objective: To examine dietary quality and weight status among HIV-infected and HIV-uninfected youth. Methods: A cross-sectional dietary intake study was conducted with 264 HIV-infected and 127 HIV-uninfected youth from the REACH cohort study (67% black/non-Hispanic; 75% female). Dietary intake was collected using the Block Food Frequency Questionnaire (98.2). The REACH study provided additional clinical, biochemical, and demographic data. Logistic and linear regression models were used for the analyses. Results: Dietary quality: HIV was associated with a mixed effect on dietary intake; however, differences in macro- and micronutrient intakes were noted only among males. HIV-infected males had higher energy, fat, saturated fat, and cholesterol intakes than HIV-uninfected males. Although HIV-infected males had higher intakes of vitamin E, almost 40% of all participants had vitamin E intakes below the Estimated Average Requirements (EAR). A modified USDA's Healthy Eating Index (HEI) was used to look at overall dietary quality. The HEI was lower (indicating poor dietary quality) among HIV-infected compared to HIV-uninfected participants. Increased television watching was also associated with a lower HEI. Being female and having a higher self-perceived health was associated with a higher HEI. Obesity: Half of the HIV-infected (50.4%) and HIV-uninfected (54.3%) were overweight or obese. Prevalence of obesity decreased once CD4+ T-cells were <500 cells/[Mu]L. HIV did not modulate the effect of factors that increased the risk of obesity (female, living independently from parents/family, watching television [Greater than or equal to]3 hours/d, previous dieting, and being from the Northeast or South). Summary: These results demonstrate two important areas of health concern among HIV-infected adolescents. First, the dietary quality is poor, intakes of energy and dietary fat components are excessive, and the prevalence of obesity is high. Overweight and obese individuals with HIV infection may be at greater risk of developing metabolic abnormalities associated with HIV and antiretroviral therapy, such as hyperlipidemia, lipodystrophy, and insulin resistance. Second, the high prevalence of inadequacy in vitamin E intake may place individuals at increased oxidative stress associated with HIV infection. Nutrition educators should focus on developing individualized behavioral goals emphasizing improved dietary quality and physical activity to improve health and quality of life for these adolescents.

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Tue Jan 01 00:00:00 UTC 2002