[Nutritional therapy in metabolic changes in individuals with HIV/AIDS].
OBJECTIVE
To analyze the effect of nutritional treatment on metabolic changes caused by the use of antiretroviral therapy in adults with HIV/AIDS.


METHODS
A systematic review of literature was conducted in the PubMed, Lilacs and Cochrane databases, between 1996 and 2010, including crossover and randomized controlled clinical trials performed in adults with HIV/AIDS using antiretroviral therapy and without opportunistic diseases. The intervention of interest was oral nutritional supplementation and/or a change in lifestyle due to specific dietary treatment: dyslipidemia, insulin resistance, lipodystrophy and systemic arterial hypertension. The Jadad scale was used for a qualitative classification of articles.


RESULTS
A total of 385 articles were found, of which seven were included. The interventions used in these studies were as follows: diet, diet and physical exercises, diet and supplementation, and only supplementation. Dyslipidemia was the outcome assessed in all studies. Studies that assessed omega-3 supplementation found a significant reduction in triglycerides. The specific diet with omega-3 supplementation showed an increase in HDL-cholesterol. Chrome nicotinate supplementation did not have an effect on dyslipidemia. Changing one's lifestyle, including diet and physical activity, significantly reduced waist circumference, lipodystrophy and systolic blood pressure.


CONCLUSIONS
Reduction in tryglicerides with omega-3 supplementation was the nutritional intervention with the strongest scientific evidence. Prescribing a specific diet appeared to be the most adequate intervention to increase HDL-cholesterol. Inferences could not be made about the nutritional treatment of total cholesterol, LDL-cholesterol and insulin resistance. Changes in lifestyle can promote an improvement in lipodystrophy and blood pressure.
Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Goiás. Goiânia, Goiânia, GO, Brasil. mariannefalco@hotmail.com
Marianne
M
Falco
Aline de Cássia de Oliveira
Ade C
Castro
Erika Aparecida
EA
Silveira
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D002784:Cholesterol / Q000097:blood; D002986:Clinical Trials as Topic; D019587:Dietary Supplements; D050171:Dyslipidemias / Q000178:diet therapy*; D015444:Exercise; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use; D005260:Female; D039682:HIV-Associated Lipodystrophy Syndrome / Q000178:diet therapy*; D006801:Humans; D007333:Insulin Resistance; D008019:Life Style; D008297:Male; D014280:Triglycerides / Q000097:blood
D015525:Fatty Acids, Omega-3; D014280:Triglycerides; D002784:Cholesterol