title: Dietary intervention prevents dyslipidemia associated with highly active antiretroviral therapy in human immunodeficiency virus type 1-infected individuals: a randomized trial.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the efficacy of dietary intervention on blood lipids of human immunodeficiency virus (HIV)-1-infected patients who are started on highly active antiretroviral therapy (HAART).
  
  
  BACKGROUND
  Current guidelines recommend diet as first-step intervention for HIV-1-infected individuals with HAART-related dyslipidemia, but there is no evidence from randomized trials to support this recommendation.
  
  
  METHODS
  Eighty-three HIV-1-infected patients, naive from HAART, were randomly assigned to HAART with dietary intervention (diet group, n = 43) or HAART without dietary intervention (control group, n = 40) for 12 months. Diet, according to the National Cholesterol Education Program, was given every 3 months. Before and after intervention, 24-h food records and lipid profile were obtained. Data were analyzed by intention to treat, using mixed-effects models.
  
  
  RESULTS
  Diet resulted in reduction of percentage of fat intake (from 31 ± 7% to 21 ± 3% of calories), while controls presented no change in percentage of fat intake. Plasma cholesterol (from 151 ± 29 mg/dl to 190 ± 33 mg/dl) and low-density lipoprotein cholesterol (from 85 ± 24 mg/dl to 106 ± 31 mg/dl) increased in the control group and were unchanged in the diet group. Plasma triglycerides were reduced by diet (from 135 ± 67 mg/dl to 101 ± 42 mg/dl) and increased in the control group (from 134 ± 70 mg/dl to 160 ± 76 mg/dl). After 1-year follow-up, 21% of patients who received diet had lipid profile compatible with dyslipidemia compared with 68% (p < 0.001) of controls.
  
  
  CONCLUSIONS
  Among HIV-1-positive individuals naive of previous treatment, diet prevents dyslipidemia associated with HAART. (Effect of Nutritional Intervention on the Lipid Profile of HIV-Positive Patients Who Start HAART: a Randomized Trial; NCT00429845).
authors.affiliation: Cardiology Division, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Porto Alegre, Brazil.
authors.forename: Rosmeri K
authors.initials: RK
authors.lastname: Lazzaretti
authors.forename: Regina
authors.initials: R
authors.lastname: Kuhmmer
authors.forename: Eduardo
authors.initials: E
authors.lastname: Sprinz
authors.forename: Carísi A
authors.initials: CA
authors.lastname: Polanczyk
authors.forename: Jorge P
authors.initials: JP
authors.lastname: Ribeiro
mesh_terms: D000328:Adult; D000886:Anthropometry; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D002784:Cholesterol / Q000097:blood; D050171:Dyslipidemias / Q000139:chemically induced / Q000150:complications / Q000178:diet therapy / Q000517:prevention & control*; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D015497:HIV-1; D006801:Humans; D008297:Male; D008875:Middle Aged; D014280:Triglycerides / Q000097:blood
chemical_list: D014280:Triglycerides; D002784:Cholesterol