Diet quality in adults living with HIV/AIDS: associated factors

Author(s)

Ana Clara da Fonseca Leitão Duran

• Document type: Master's Dissertation
• Press: São Paulo.
• Institution: Universidade de São Paulo (USP). Faculdade de Saúde Pública (FSP/CIR)
• Defense date: 2009-05-07

Examining board members

Patrícia Constante Jaime; Regina Mara Fisberg; Aluisio Augusto Cotrim Segurado

• Advisor: Patrícia Constante Jaime

Abstract

Aims: The main aim was to assess the associated factors to diet quality among adults living with HIV/AIDS on highly active antiretroviral therapy (HAART) in São Paulo, Brazil. Secondary aim was the assessment of the reliability and validity of self-reported weight and height in adults living with HIV/Aids. Methods: Cross-sectional study with 508 men and women, between 20 and 59 years old, who were on HAART for at least three months. There were two research streams: 1) assessment of reliability and validity of self-reported height and weight of adults living with HIV/ AIDS; 2) assessment of the associated factors to diet quality among people living with HIV/AIDS (PLWHA). In order to assess validity of self-reported height and weight sensitivity and specificity analyses were performed. Reliability was evaluated by means of intra-class coefficients. Height and weight were direct measured in a sub-sample. Diet quality was assessed with the use of an adapted Healthy Eating Index (HEI-A) for the studied population. Food intake was collected with a 24-hour Food Recall. Associated factors to diet quality were determined by multivariate linear regression. HEI-A was the dependent variable and demographic, lifestyle, laboratorial, and clinical variables were the independent variables. Analyses were gender-specific. Results: Most of the sample were men (57.7%), mean age of 41.7 years (Standard Deviation - SD = 7.9), and average schooling of 8.3 years (SD=3.7). Mean differences of weight were -0.96 kg for men and -0.54 kg for women. For height, differences were below 2 cm for men and women, leading to a good reliability for the self-reported Body Mass Index (BMI). Overweight (BMI25 kg/m²) diagnosis sensitivity was 89.5% for men and 92.3% for women. Specificity was 71.4% and 100.0%, respectively. HEI-A mean was 61.9. Scores were low (< 5) for fruits, dairy products, and sodium. Among the sample, 5.3% had an adequate diet and 72.1% a diet that needed improvement. Overweight individuals scored lower for grains and beans, as well as for the total HEI-A. Time since HAART start was associated to diet quality among women. Older men who had an undetectable viral load had higher scores of HEI-A. Both models were adjusted by energy. Conclusion: Self-reported weight and height showed good reliability and validity when compared to direct measured weight and height. Regarding diet quality of PLWHA, it was associated with time since HAART start and an undetectable viral load. Low scores for fruits, dairy products, and sodium, as well as an association between nutritional status and diet quality, point out the need for interventions to promote healthy eating among people living with HIV/Aids, taking into consideration differences between women and men. (AU)