Effect of a dietary intervention and n-3 fatty acid supplementation on measures of serum lipid and insulin sensitivity in persons with HIV.
BACKGROUND
Elevated serum triglyceride and low HDL-cholesterol concentrations have been reported in persons with HIV.


OBJECTIVE
The effect of a dietary intervention plus n-3 (omega-3) fatty acid supplementation on serum triglycerides and markers of insulin sensitivity was investigated.


METHODS
Fifty-four persons with HIV and elevated serum triglycerides (>150 mg/dL) and/or abnormal Quantitative Insulin Sensitivity Check Index values (<0.35 but >0.30) were recruited for a dietary intervention in which total fat, type of fat, fiber, and glycemic load were controlled along with supplementation with n-3 fatty acids to achieve an intake of 6 g/d. The subjects were randomly assigned to an intervention or control group, and serum lipids, markers of insulin sensitivity, and serum phospholipid fatty acids were measured in both groups at baseline, 3 wk, and 13 wk.


RESULTS
Triglycerides in the intervention group decreased from a median of 180 mg/dL (interquartile range: 141, 396) to 114 mg/dL (interquartile range: 84, 169) from baseline to 3 wk, whereas they remained stable in the control group (P = 0.003). Serum phospholipid fatty acids indicated a decrease in de novo lipogenesis and a decrease in arachidonic acid (% nmol; P <or= 0.001) in the intervention group. At 3 wk, the insulin area under the curve decreased but not significantly.


CONCLUSIONS
Diet and n-3 fatty acid supplementation dramatically reduced serum triglycerides, decreased arachidonic acid in the phospholipids fraction, and appeared to decrease the de novo lipogenesis associated with the metabolic syndrome in the intervention group.
Department of Public Health and Community Medicine, Nutrition/Infection Unit, Tufts University School of Medicine, Boston, MA, USA.
Margo N
MN
Woods
Christine A
CA
Wanke
Pei-Ra
PR
Ling
Kristy M
KM
Hendricks
Alice M
AM
Tang
Tamsin A
TA
Knox
Charlotte E
CE
Andersson
Kimberly R
KR
Dong
Sally C
SC
Skinner
Bruce R
BR
Bistrian
D000328:Adult; D016718:Arachidonic Acid / Q000097:blood; D019540:Area Under Curve; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood; D019587:Dietary Supplements; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D005260:Female; D015658:HIV Infections / Q000378:metabolism*; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D010743:Phospholipids / Q000097:blood; D014280:Triglycerides / Q000097:blood*
D008076:Cholesterol, HDL; D015525:Fatty Acids, Omega-3; D010743:Phospholipids; D014280:Triglycerides; D016718:Arachidonic Acid