October 1, 2001

This article is part of The Body PRO's archive. Because it contains information that may no longer be accurate, this article should only be considered a historical document.

HIV-Positive Individuals and Fat Redistribution: Diet Modification May Be the Key

Body fat distribution refers to the relative proportion of fat tissue in specific regions of the body. Fat distribution has been classified in a variety of ways (examples include: upper body fat versus lower body fat, central fat versus peripheral fat, visceral fat versus subcutaneous fat). The importance of understanding body fat distribution is derived from observations that fat tissue in the different parts of the body affects metabolism differently.

Lipodystrophy, defined as any disturbance of fat metabolism, is associated in some variation with many medical conditions, including HIV/AIDS. While the term "lipodystrophy" is not accurate in its current usage in regard to HIV drug complications, it is widely used since no better word or definition of the condition has yet come along to replace it. Another common phrase for lipodystrophy is "metabolic complications of HIV." The condition is sometimes referred to as lipoatrophy (loss of fat), fat redistribution or fat maldistribution syndrome, among others.

A recent study in 85 HIV-infected patients with fat redistribution may link dietary factors and explain their role in the lipodystrophy syndrome. Physical changes associated with lipodystrophy syndrome are related to body shape and body composition, mostly body fat losses and fat gains. No consensus yet exists on the best way to measure these body changes or if body changes are a product of a single process. The ultimate consequences of upper body and visceral fat accumulation are adverse effects on health outcomes, especially those that relate to insulin resistance and cardiovascular disease. Many factors, including sex, race, age, and total body fat content, that affect body fat throughout the body under normal circumstances are thought to be associated with increased fat that is widely and evenly distributed throughout the body.

Of the 85 HIV-infected individuals studied, altered body fat distribution was measured by dietary history, laboratory tests (fasting glucose, insulin, lipids, oral glucose tolerance), standard measurements (mean body mass index, waist-to-hip ratio), and protease inhibitor use, alcohol use, dietary fiber intake, and polyunsaturated-to-saturated fat ratio. The purpose of this study was to compare dietary factors and find an association with insulin resistance. The dietary intake, body composition, and metabolic parameters were measured and the authors found that potential targets for dietary modification include polyunsaturated fats, fiber, and alcohol.



  1. Hadigan C., Jeste S., Anderson E.J., Tsay R., Cyr H., Grinspoon S. "Modifiable dietary habits and their relation to metabolic abnormalities in men and women with human immunodeficiency virus infection and fat redistribution." CID 2001;33:710.

This article was provided by Seattle Treatment Education Project. It is a part of the publication STEP Ezine.


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