title: HIV-infected US youth are at high risk of obesity and poor diet quality: a challenge for improving short- and long-term health outcomes.
abstract: OBJECTIVE
  To examine the relationships among dietary quality, weight status, and human immunodeficiency virus (HIV) infection in US adolescents and young adults.
  
  
  METHODS
  This cross-sectional study was embedded in the Reaching for Excellence in Adolescent Care and Health cohort study of HIV-infected and HIV-uninfected, at-risk youth. Biochemical, clinical, and sociodemographic data were available. Dietary intake was collected using the Block Food Frequency Questionnaire and a modified Healthy Eating Index was calculated to measure diet quality.
  
  
  METHODS
  Participants included 264 HIV-infected and 127 HIV-uninfected youth 13 to 23 years old (75.2% women, 67.3% African American/non-Hispanic, 20.5% Hispanic, 12.3% other) at 14 clinic sites.
  
  
  METHODS
  Determinants of obesity and the modified Healthy Eating Index were tested using logistic and generalized linear regression.
  
  
  RESULTS
  About half (51.7%) of participants were overweight or obese. Obesity was positively associated with being a woman, living independently, watching television >or=3 hours per day, previous dieting, and being from the northeastern or southern United States. Youth who were HIV uninfected or HIV infected with CD4 + T cells >or=500 cells/microL had similar obesity rates; overweight (25%) and obesity (20%) was prevalent among women even with CD4 + T cells <200 cells/microL. The modified Healthy Eating Index score was 56.2+/-0.6, reflecting a diet needing improvement. HIV infection, watching television >or=3 hours/day, and being from the Chicago, IL, area were associated with a lower-quality diet.
  
  
  CONCLUSIONS
  Obesity is a common nutrition problem for both HIV-infected and uninfected youth; however, HIV-infected youth are at increased risk of developing metabolic abnormalities. Culturally appropriate, client-focused nutrition education will help youth improve their diet and increase physical activity to reduce health consequences associated with both obesity and HIV infection.
authors.affiliation: Department of Food Science and Human Nutrition, Iowa State University, Ames 50011, USA. lkruzich@iastate.edu <lkruzich@iastate.edu>
authors.forename: Laurie A
authors.initials: LA
authors.lastname: Kruzich
authors.forename: Grace S
authors.initials: GS
authors.lastname: Marquis
authors.forename: Craig M
authors.initials: CM
authors.lastname: Wilson
authors.forename: Charles B
authors.initials: CB
authors.lastname: Stephensen
mesh_terms: D000293:Adolescent; D017195:Adolescent Nutritional Physiological Phenomena; D000328:Adult; D001835:Body Weight / Q000502:physiology*; D018791:CD4 Lymphocyte Count; D016022:Case-Control Studies; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004032:Diet / Q000592:standards*; D004034:Diet Surveys; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000378:metabolism*; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D009765:Obesity / Q000150:complications* / Q000453:epidemiology / Q000378:metabolism; D012307:Risk Factors; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013690:Television; D014481:United States / Q000453:epidemiology