HIV-Related Lipodystrophy May Improve With Diet and Exercise -- HIV/AIDS INFO AND UPDATES

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Date Posted: 22:10:00 02/28/02 Thu
Author: Anonymous
Subject: HIV-Related Lipodystrophy May Improve With Diet and Exercise

HIV-Related Lipodystrophy May Improve With Diet and Exercise

NEW YORK (Reuters Health) Feb 21 - A program combining diet and exercise led to "dramatic improvement" in body composition and metabolic parameters in a 44-year-old man with HIV-associated lipodystrophy. Dr. Ronenn Roubenoff of Tufts University and Boston colleagues report the case in the February 1st issue of Clinical Infectious Diseases.

"The main message from this case report is the proof of principle that exercise and diet, when prescribed intensively and adhered to closely, can make a huge change in abdominal obesity and cardiac risk factors in patients with HIV lipodystrophy," Dr. Roubenoff told Reuters Health.

The man developed lipodystrophy during the two years after initiating HAART, which is typical, the authors note in the report. As a participant in a 4-month trial of the effects of diet and exercise on lipodystrophy, he was put on a progressive cardiovascular and resistance training program consisting of three sessions per week each lasting roughly 70-minutes, minus warm-up and cool-down. A personal fitness trainer supervised one session per week.

The man also attended weekly nutrition counseling sessions during the 4-month study to help him maintain the prescribed "moderate-fat, low-glycemic index, high-fiber diet." During the study he continued his antiretroviral regimen of stavudine, lamivudine, and nevirapine.

In this patient, diet and exercise modification had a "profound " effect on abdominal obesity, insulin resistance, and hyperlipidemia, the investigators report. For example, body composition analysis showed a 28% decline in percent body fat, while abdominal CT revealed a 52% decline in visceral fat, a 43% reduction in total abdominal fat area and a 38% reduction in subcutaneous abdominal fat area. There was no reduction in peripheral fat atrophy in this patient.

Marked improvement in metabolic parameters were also evident including an 18% drop in total cholesterol, a 13% drop in fasting glucose and a 52% drop in insulin resistance.

"The gentleman in this case report was the first one to complete the clinical trial, which is ongoing. We expect fuller results in about a year," Dr. Roubenoff told Reuters Health.

Diet and exercise, it appears, "can reverse several aspects of lipodystrophy, and, until specific treatment is available, should be considered for treatment of lipodystrophy," the investigators conclude.

Clin Infect Dis 2002;34:390-393.

Reuters Health Information 2002. � 2002 Reuters Ltd
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