Diet Quality And Cardiovascular Disease Risk Factors Among People Living With Hiv.
Date
2022-10
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
University of Ghana
Abstract
Introduction: With improved life expectancy, people living with HIV (PLHIV) are burdened with cardiovascular diseases (CVD) as a result of prolonged exposure to the traditional risk factors for CVD (smoking, obesity, alcohol, and sedentary lifestyle), and complications associated with HIV infection such as inflammation, endothelial dysfunction, hyper-coagulation, and immune activation. The role of diet and prolonged use of antiretroviral medications (ARVs) in CVD is also well established. Interactions between dietary habits, HIV infection itself, and ART may escalate the risk of developing CVDs among PLHIV. These complex relationships between HIV, diet, and CVD risk factors among PLHIV is yet to be comprehensively studied in Ghana.
Aim: To assess diet quality and cardiovascular disease risk factors among ARV-exposed PLHIV.
Methodology: A multi-methods study was conducted; a systematic review and meta-analysis, and a facility-based analytical cross-sectional design study. The systematic review and meta-analysis preceded the facility-based analytical cross-sectional study. Cochrane Central, Scopus, PubMed, and Google Scholar databases were systemically searched for papers that compared prevalence of CVD risk factors (diabetes, hypertension, dyslipidemia, and obesity) between PLHIV on ART and PLHIV who are ART-naive in low and middle-income countries (LMIC). Papers that satisfied the inclusion criteria were included in the meta-analysis. Pooled estimates for prevalence were generated using random fixed effects models.
The cross-sectional study was conducted among 440 adults living with HIV randomly selected from two hospitals - St. Martins De Porres Hospital and Atua Government Hospital - providing specialized HIV care in the Lower Manya Krobo Municipality of the Eastern Region, Ghana.
Medline, Cochrane, A structured questionnaire was administered to collect data on socio-demographic information, and lifestyle factors. Dietary intake of participants was measured with a two-day 24-hour recall of their usual food intake (one weekday and one weekend). Individual Dietary Diversity Score (IDDS) was used to measure diet quality of the participants. Height was measured with a stadiometer calibrated to 1.0 cm. Omron Body Composition Monitor and Scale (Model HBF-516) was used to determine weight, Body Mass Index (BMI), percentage muscle mass, percentage body fat, and visceral fat of the participants. Three measurements of participants’ blood pressure were taken at a minute’s interval in the right arm with participants sitting upright using the Omron HEM 907 oscillometric monitor (Matsusaka, Japan).
Lipid Profile and blood glucose were checked using LipidPlus Lipid Profile and Glucose Monitoring System and Blood glucose with OneTouch Select glucometer respectively. Mean and standard deviations of continuous variables were determined. Frequencies and percentages were used to describe categorical variables. Univariate, bivariate, and multivariate analyses were conducted using Chi-square test, independent Student’s t-test, binary logistic regression, and ordinal logistic regression. Statistical significance was set at p < 0.05. Data analyses were conducted using SPSS for windows version 20, and Microsoft Excel 2016.
Results: Results from the systematic review and meta-analysis showed an association between ART intake and prevalence of hypertension, dyslipidemia, and obesity among PLHIV (p<0.01 for all). Results from the cross-sectional study showed that proportion of PLHIV with high IDDS (diet quality) was about 14 percent, proportion of those having diet needing improvement was 56 percent, whiles about 30 percent actually had low IDDS (poor diet). Prevalence of cardiovascular risk factors including diabetes, hypertension, and dyslipidemia were found to 20.1%, 33.3%, and 63.5% respectively. The average IDDS (diet quality) was significantly higher among PLHIV who
Description
PHd. Public Health
Keywords
Diet, Cardiovascular Disease, People, HIV, Risk