Interventions to Address Chronic Disease and HIV: Strategies to Promote Exercise and Nutrition Among HIV-Infected Individuals

Abstract

Food insecurity, micronutrient deficits, dyslipidemia, insulin resistance, obesity, cardiovascular disease, and bone disorders complicate the treatment of HIV infection. Nutrition and exercise interventions can be effective in ameliorating these symptoms that are associated with HIV and antiretroviral therapy (ART). In this literature review, we examine the most recent nutrition and exercise interventions for HIV-infected patients. Macronutrient supplementation can be useful in treating malnutrition and wasting. Multivitamin (vitamin B complex, vitamin C, and vitamin E) supplements and vitamin D may improve quality of life and decrease morbidity and mortality. Nutritional counseling and exercise interventions are effective for treating obesity, fat redistribution, and metabolic abnormalities. Physical activity interventions improve body composition, strength, and fitness in HIV-infected individuals. Taken collectively, the evidence suggests that a proactive approach to nutrition and physical activity guidance and interventions can improve outcomes and help abrogate the adverse metabolic, cardiovascular, and psychological consequences of HIV and its treatments.

Combining nutrition and exercise to optimize survival and recovery from critical illness: Conceptual and methodological issues

“…For instance, in older people, exercise along with protein supplementation may promote greater rates of protein synthesis [24,25] and greater improvements in strength compared with exercise alone or nutritional supplements [26e28]. Other studies in patients with obesity [29], HIV/AIDs [30], chronic obstructive pulmonary disease [31] and healthy volunteers undergoing 60 days of bed rest [32,33] suggest that the nutritional intervention, alone, has minimal effect on muscle, but that the combination of exercise and nutritional intervention yields the greatest improvement in muscle mass and strength. In a recent meta-analysis, protein supplementation, when combined with resistance-type exercise training, enhanced gains in strength and muscle mass in both young and elderly non-critically ill adults compared with groups that did not supplement with protein [34].…”

Dyslipidemia, Diet and Physical Exercise in Children on Treatment With Antiretroviral Medication in El Salvador

“…In resource poor countries, only few options are available to prevent and treat lipid abnormalities in HIV-infected children, because the use of statins is recommended only for specific cases 18 and the switch from PIs to more lipid-favorable drugs 19 may not always be possible. A recent review suggests that dietary counseling and physical exercise can improve metabolic abnormalities in adults with HIV/AIDS, 20 but little information is available for children. 21,22 …”

Nutrition and Food in AIDS Patients

“…Foods that cause gastrointestinal disorders should be excluded from the diet. The diet needs modification in the cases of body weight changes, symptoms of lipodystrophy, elevated blood LDL and triglyceride concentrations, diagnosis of prediabetes or diabetes, metabolic syndrome, hepatic or renal impairment, arterial hypertension, gastrointestinal symptoms (diarrhea, constipation), and implementation of ART [83]. Meals should be smaller in volume and eaten four to six times per day [13,24,25].…”