title: Use of diet, nutritional supplements and exercise in HIV-infected patients receiving combination antiretroviral therapies: a systematic review.
abstract: BACKGROUND
  The use of combination antiretroviral therapy (cART) has improved the prognosis of HIV infection, but it has also been linked to a spectrum of body composition changes and metabolic alterations known as the lipodystrophy syndrome. Nutritional status could influence body composition changes.
  
  
  METHODS
  We performed a systematic search of published peer-reviewed data on the effects of diet, nutrition support and exercise on body composition and metabolic complications in patients receiving cART.
  
  
  RESULTS
  Few controlled studies, most of them with small sample size, were found. Oral nutritional support increases protein and energy intake, and results in body weight and fat mass gains. Resistance exercise, with or without an aerobic component, increases lean mass and can improve insulin resistance. Low-fat diets or exercise can result in loss of fat mass, and they should be used with caution in subjects with lipoatrophy.
  
  
  CONCLUSIONS
  Nutritional support and exercise result in small but significant body composition changes and can be used as complementary interventions. There is a need for further research on nutritional interventions in HIV-infected patients receiving cART.
authors.affiliation: Nutrition and Dietetics Unit, Endocrinology Service, Hospital Clinic de Barcelona, 08036 Barcelona, Spain. pleyes@clinic.ub.es
authors.forename: Pere
authors.initials: P
authors.lastname: Leyes
authors.forename: Esteban
authors.initials: E
authors.lastname: Martínez
authors.forename: Maria de Talló
authors.initials: Mde T
authors.lastname: Forga
mesh_terms: D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001823:Body Composition; D004032:Diet; D019587:Dietary Supplements; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D015444:Exercise; D015658:HIV Infections / Q000188:drug therapy*; D039682:HIV-Associated Lipodystrophy Syndrome / Q000517:prevention & control*; D006801:Humans; D009752:Nutritional Status; D016032:Randomized Controlled Trials as Topic; D018894:Reverse Transcriptase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D019380:Anti-HIV Agents; D018894:Reverse Transcriptase Inhibitors