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Revista de Saúde Pública
Print version ISSN 0034-8910
FALCO, Marianne; CASTRO, Aline de Cássia de Oliveira and SILVEIRA, Erika Aparecida. Nutritional therapy in metabolic changes in individuals with HIV/AIDS. Rev. Saúde Pública [online]. 2012, vol.46, n.4, pp. 737-746. Epub July 10, 2012. ISSN 0034-8910. http://dx.doi.org/10.1590/S0034-89102012005000050.
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.
Keywords : Antiretroviral Therapy, Highly Active, adverse effects; Dietary Supplements, utilization; HIV-Associated Lipodystrophy Syndrome, diet therapy; Dyslipidemias, diet therapy; HIV Long-Term Survivors; Review.