Randomized parallel-group pilot trial (Best foods for your heart) comparing the effects of a Mediterranean Portfolio diet with a low saturated fat diet on HIV dyslipidemia.
Study Goal
The researchers aimed to compare the effects of reducing saturated fat intake versus adopting a Mediterranean Portfolio Diet on LDL-cholesterol and cardiovascular risk factors in adults with HIV dyslipidemia.
Results Summary
The Mediterranean Portfolio Diet (Diet2) led to significant short-term reductions in LDL-cholesterol and systolic blood pressure compared to simply reducing saturated fat intake (Diet1), but these effects were not sustained at 1 year.
Population
Adults with stable HIV infection on antiretroviral therapy (ART) and LDL-cholesterol >3 mmol/l.
Effective Dosage
Saturated fat intake reduced to <10% of energy intake (Diet1); Mediterranean Portfolio Diet with cholesterol-lowering foods (Diet2).
Duration
6 months
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Mediterranean diets | decrease | cardiovascular disease (CVD) | - | - | reduce the risk | #1 |
dietary advice to reduce saturated fat intake to <10% of energy intake (Diet1) | neutral | - | adults with stable HIV infection on ART and LDL-cholesterol >3 mmol/l | - | - | #2 |
Mediterranean Portfolio Diet (Diet2) with additional cholesterol-lowering foods (nuts, stanols, soya, oats, beans) | neutral | - | adults with stable HIV infection on ART and LDL-cholesterol >3 mmol/l | - | - | #3 |
Mediterranean Portfolio Diet (Diet2) | decrease | LDL-cholesterol | Diet2 participants (n = 29) | mean difference adjusted for baseline -0.4 mmol/l, 95%CI -0.7 to -0.1 | had a significantly lower | #4 |
Mediterranean Portfolio Diet (Diet2) | decrease | systolic blood pressure | Diet2 participants (n = 29) | -7 mmHg, 95%CI -2 to -12 | had a significantly lower | #5 |
Mediterranean Portfolio Diet (Diet2) | no change | LDL-cholesterol | - | -0.05 mmol/l, 95%CI -0.33 to 0.23 | effects were not sustained | #6 |
Mediterranean Portfolio Diet (Diet2) | no change | systolic blood pressure | - | -3.5 mmHg, 95%CI -9.4 to 2.5 | effects were not sustained | #7 |
Mediterranean Portfolio diet | increase | diet quality | people living with HIV | - | might equate to short term improvements | #8 |
Mediterranean Portfolio diet | decrease | blood pressure | people living with HIV | - | might equate to short term improvements | #9 |
Mediterranean Portfolio diet | decrease | LDL-cholesterol | people living with HIV | - | might equate to short term improvements | #10 |
BACKGROUND & AIMS: Mediterranean diets reduce the risk of cardiovascular disease (CVD). However, the effect is unknown in people living with HIV, who have an increased risk potentially due to the additional burdens of infection, inflammation and antiretroviral treatment (ART). We examined the feasibility of a 6-month dietary intervention in adults with HIV dyslipidemia using a sample size adequate to detect differences in LDL-cholesterol. METHODS: Sixty adults with stable HIV infection on ART and LDL-cholesterol >3 mmol/l were recruited. Participants were randomized (1:1) to receive dietary advice to reduce saturated fat intake to <10% of energy intake (Diet1), or supported to adopt the Mediterranean Portfolio Diet (Diet2) with additional cholesterol-lowering foods (nuts, stanols, soya, oats, beans) for 6 months. Recruitment, retention and intervention fidelity were monitored. Measurements were conducted at baseline, 6 and 12 months. A secondary analysis examined between group differences in CVD risk factors at month 6 adjusted for baseline values and potential confounders. RESULTS: Rates of recruitment, participation and attrition were 35%, 91%, and 12% respectively. Reported dietary adherence was 68% to Mediterranean foods and 59% to Portfolio components. At 6 months Diet2 participants (n = 29) had a significantly lower LDL-cholesterol (mean difference adjusted for baseline -0.4 mmol/l, 95%CI -0.7 to -0.1, P = 0.01), and systolic blood pressure (-7 mmHg, 95%CI -2 to -12, P = 0.008) compared to those in Diet1 (n = 31). These effects were not sustained at 1 year (LDL-cholesterol -0.05 mmol/l, 95%CI -0.33 to 0.23, P = 0.7; systolic blood pressure -3.5 mmHg, 95%CI -9.4 to 2.5, P = 0.2). CONCLUSION: We showed the feasibility of adopting a Mediterranean Portfolio diet in people living with HIV. Our findings suggest this intervention might equate to short term improvements in diet quality, blood pressure, and LDL-cholesterol. Further definitive evaluations are required to determine if this is a viable strategy to facilitate cardiovascular risk reduction. CLINICAL TRIAL REGISTRY: ISRCTN32090191 Best Foods For your heart trial.