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The correlates of dietary intake among HIV-positive adults^1,2,3

¹ From the Departments of Population and International Health, of Biostatistics, of Epidemiology, and of Nutrition, Harvard School of Public Health, Boston, and the Department of Family Medicine and Community Health, Tufts University School of Medicine, Boston.

Background: Dietary adequacy, as distinct from weight loss, has not been examined thoroughly in a diverse cohort of HIV-infected individuals.

Objective: An analysis was undertaken to determine the correlates of inadequate dietary intake among HIV-infected adults.

Design: In a cross-sectional study of 463 men and 170 women (aged 21–70 y) with HIV infection, dietary adequacy was evaluated by using 3-d diet records.

Results: Among nondieting males, whites had higher energy intakes than did nonwhites. Injection drug users consumed less energy than did nonusers. Among nondieting females, only the absence of nausea and vomiting was marginally associated with higher energy intakes. Inadequate energy intake, which occurred in 38% of this population, was independently associated with female sex among nondieters. A significant proportion of the study cohort (52%) was consuming less than the recommended dietary allowance of vitamin A. Inadequate protein intake, found in 11% of the study population, occurred more often in females, those without a caregiving adult in the household, and individuals with reduced appetite. A considerable proportion of the participants (23%) reported that they were dieting to lose weight.

Conclusions: Dietary inadequacy was strongly correlated with being in the sociodemographic groups that are at heightened risk of adverse clinical outcomes. It may be worthwhile to study dietary intake as a potential determinant of the clinical outcomes of HIV infection.

Key Words: Diet • sociodemographics • AIDS • HIV • human immunodeficiency virus • wasting • nutrition • socioeconomics

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