Skip to main content

Lifestyle

  • Chapter
  • First Online:
Cardiovascular Care in Patients With HIV
  • 291 Accesses

Abstract

HIV infection is now a chronic medical condition with good prognosis for most individuals. Use of antiretroviral therapy has decreased mortality and morbidity related to HIV infection. Chronic diseases such as diabetes, hypertension, and coronary artery disease are increasingly prevalent in patients with HIV infection. These chronic diseases can be managed with medical treatment as well as with lifestyle modification. It is extremely important to discuss lifestyle changes such as exercise, healthy diet, and stress management and to counsel patients about smoking cessation and avoidance of addictive substances. Mediterranean diet with ample amounts of vegetables and fruits, and nuts, seeds, legumes, beans, whole grains, and olive oil should be recommended to all patients with HIV. Lifestyle recommendations will help reduce the prevalence of various chronic medical conditions in people living with HIV infection and help them live healthier, productive lives.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Mocroft A, Ledergerber B, Katlama C, et al. EuroSIDA study group. Decline in the AIDS and death rates in the EuroSIDA study: an observational study. Lancet. 2003;362(9377):22–9.

    Article  CAS  Google Scholar 

  2. Antiretroviral Therapy Cohort Collaboration. Life expectancy of individuals on combination antiretroviral therapy in high-income countries: a collaborative analysis of 14 cohort studies. Lancet. 2008;372(9635):293–9.

    Article  Google Scholar 

  3. Raiten DJ, Mulligan K, Papathakis P, Wanke C. Executive summary – nutritional care of HIV-infected adolescents and adults, including pregnant and lactating women: what do we know, what can we do, and where do we go from here? Am J Clin Nutr. 2011;94(6):1667S–76S.

    Article  CAS  Google Scholar 

  4. Nutrient requirements for people living with HIV/AIDS: report of a technical consultation, World Health Organization, Geneva, 13–15 May 2003.

    Google Scholar 

  5. Dubé MP, Stein JH, Aberg JA, et al. Adult AIDS Clinical Trials Group Cardiovascular Subcommittee; HIV Medical Association of the Infectious Disease Society of America. Guidelines for the evaluation and management of dyslipidemia in human immunodeficiency virus (HIV)-infected adults receiving antiretroviral therapy: recommendation of the HIV Medical Association of the Infectious Disease Society of America and the Adult AIDS Clinical Trials Group. Clin Infect Dis. 2003;37:613–27.

    Article  Google Scholar 

  6. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA. 2001;285:2486–97.

    Article  Google Scholar 

  7. Lazzaretti RK, Kuhmmer R, Sprinz E, et al. Dietary intervention prevents dyslipidemia associated with highly active antiretroviral therapy in human immunodeficiency virus type 1-infected individuals: a randomized trial. J Am Coll Cardiol. 2012;59(11):979–88.

    Article  CAS  Google Scholar 

  8. Fitch KV, Anderson EJ, Hubbard JL, et al. Effects of a lifestyle modification program in HIV-infected patients with the metabolic syndrome. AIDS. 2006;20(14):1843–50.

    Article  CAS  Google Scholar 

  9. Sofi F, Cesari F, Abbate R, et al. Adherence to mediterranean diet and health status: meta-analysis. BMJ. 2008;337:a1344. https://doi.org/10.1136/bmj.a1344.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Baum MK, Shor-Posner G, Bonvehi P, et al. Influence of HIV infection on vitamin status and requirements. Ann N Y Acad Sci. 1992;669:165–73; discussion 173-4.

    Article  CAS  Google Scholar 

  11. Kaiser JD, Campa AM, Ondercin JP, et al. Micronutrient supplementation increases CD4 count in HIV-infected individuals on highly active antiretroviral therapy: a prospective, double-blinded, placebo-controlled trial. J Acquir Immune Defic Syndr. 2006;42(5):523–8.

    Article  CAS  Google Scholar 

  12. Fawzi WW, Msamanga GI, Spiegelman D, et al. A randomized trial of multivitamin supplements and HIV disease progression and mortality. N Engl J Med. 2004;351(1):23–32. PubMed.

    Google Scholar 

  13. Wheeler DA. Weight loss and disease progression in HIV infection. AIDS Read. 1999;9(5):347–53.

    CAS  PubMed  Google Scholar 

  14. Dauchet L, Amouyel P, Hercberg S, Dallongeville J. Fruit and vegetable consumption and risk of coronary heart disease: a meta-analysis of cohort studies. J Nutr. 2006;136(10):2588–93.

    Article  CAS  Google Scholar 

  15. Vivekananthan DP, Penn MS, Sapp SK, et al. Use of antioxidant vitamins for the prevention of cardiovascular disease: meta-analysis of randomised trials. Lancet. 2003;361(9374):2017–23. Erratum in: Lancet. 2004 Feb 21;363(9409):662.

    Google Scholar 

  16. Stephens NG, Parsons A, Schofield PM, et al. Randomised controlled trial of vitamin E in patients with coronary disease: Cambridge heart antioxidant study (CHAOS). Lancet. 1996;347:781–6.

    Article  CAS  Google Scholar 

  17. Vani Gandhi MD, George Psevdos MD, Logan Paolo L, Felix MD. The role of vitamin D in human immunodeficiency virus infection. Chapter in “Health of HIV infected people, food, nutrition and Lifestyle with antiretroviral drugs”. Elsevier. 2015.

    Google Scholar 

  18. Kim JH, Gandhi V, Psevdos G Jr, Espinoza F, Park J, Sharp V. Evaluation of vitamin D levels among HIV-infected patients in New York City. AIDS Res Hum Retrovir. 2012;28(3):235–41.

    Article  CAS  Google Scholar 

  19. Bang UC, Shakar SA, Hitz MF, et al. Deficiency of 25-hydroxyvitamin D in male HIV-positive patients: a descriptive cross-sectional study. Scand J Infect Dis. 2010;42(4):306–10.

    Article  CAS  Google Scholar 

  20. Lai H, Gerstenblith G, Fishman EK, et al. Vitamin D deficiency is associated with silent coronary artery disease in cardiovascularly asymptomatic African Americans with HIV infection. Clin Infect Dis. 2012;54:1747.

    Article  CAS  Google Scholar 

  21. Lai S, Fishman EK, Gerstenblith G, et al. Vitamin D deficiency is associated with coronary artery calcification in cardiovascularly asymptomatic African Americans with HIV infection. Vasc Health Risk Manag. 2013;9:493–500.

    Article  Google Scholar 

  22. Choi AI, Lo JC, Mulligan K, Schnell A, Kalapus SC, Li Y, Hunt PW, Martin JN, Deeks SG, Hsue PY. Association of vitamin D insufficiency with carotid intima-media thickness in HIV-infected persons. Clin Infect Dis. 2011;52(7):941–4. https://doi.org/10.1093/cid/ciq239. Epub 2011 Jan 27.

  23. Muhammad J, Chan ES, Brown TT, Tebas P, McComsey GA, Melbourne K, Hardin R, Willig AL, Yin MT, Ribaudo H, Overton ET. Vitamin D supplementation does not affect metabolic changes seen with ART initiation. Open Forum Infect Dis. 2017;4(4):ofx210. https://doi.org/10.1093/ofid/ofx210. eCollection 2017 Fall.

  24. Eckard AR, Raggi P, O'Riordan MA, Rosebush JC, Labbato D, Chahroudi A, Ruff JH, Longenecker CT, Tangpricha V, McComsey GA. Effects of vitamin D supplementation on carotid intima-media thickness in HIV-infected youth. Virulence. 2018;9(1):294–305.

    Article  CAS  Google Scholar 

  25. Isanaka S, Mugusi F, Hawkins C, et al. Effect of high-dose vs standard-dose multivitamin supplementation at the initiation of HAART on HIV disease progression and mortality in Tanzania: a randomized controlled trial. JAMA. 2012;308(15):1535–44.

    Article  CAS  Google Scholar 

  26. Thompson-Paul AM, Wei SC, Mattson CL, Robertson M, Hernandez-Romieu AC, Bell TK, Skarbinski J. Obesity among HIV-infected adults receiving medical care in the United States: data from the cross-sectional medical monitoring project and National Health and nutrition examination survey. Medicine (Baltimore). 2015;94(27):e1081.

    Article  Google Scholar 

  27. Koethe JR, Grome H, Jenkins CA, Kalams SA, Sterling TR. The metabolic and cardiovascular consequences of obesity in persons with HIV on long-term antiretroviral therapy. AIDS. 2016;30(1):83–91.

    CAS  PubMed  PubMed Central  Google Scholar 

  28. De Wit S, Sabin CA, Weber R, Worm SW, Reiss P, Cazanave C, El-Sadr W, Monforte AD, Fontas E, Law MG, Friis-Møller N, Phillips A, Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study. Incidence and risk factors for new-onset diabetes in HIV-infected patients: the data collection on adverse events of anti-HIV drugs (D:A:D) study. Diabetes Care. 2008;31(6):1224–9.

    Article  Google Scholar 

  29. Crum-Cianflone N, Roediger MP, Eberly L, Headd M, Marconi V, Ganesan A, Weintrob A, Barthel RV, Fraser S, Agan BK, Infectious Disease Clinical Research Program HIV Working Group. Increasing rates of obesity among HIV-infected persons during the HIV epidemic. PLoS One. 2010;5(4):e10106.

    Article  Google Scholar 

  30. From the Study of Fat Redistribution and Metabolic, Change in HIV Infection (FRAM). Fat distribution in women with HIV infection. J Acquir Immune Defic Syndr. 2006;42(5):562–71.

    Article  Google Scholar 

  31. From the Study of Fat Redistribution and Metabolic Change in HIV Infection (FRAM). Fat distribution in men with HIV infection. J Acquir Immune Defic Syndr. 2005;40(2):121–31.

    Article  Google Scholar 

  32. Wohl D, Scherzer R, Heymsfield S, et al. The associations of regional adipose tissue with lipid and lipoprotein levels in HIV-infected men. J Acquir Immune Defic Syndr. 2008;48(1):44–52.

    Article  CAS  Google Scholar 

  33. Meininger G, Hadigan C, Rietschel P, Grinspoon S. Body-composition measurements as predictors of glucose and insulin abnormalities in HIV-positive men. Am J Clin Nutr. 2002;76(2):460–5.

    Article  CAS  Google Scholar 

  34. Gavrila A, Tsiodras S, Doweiko J, et al. Exercise and vitamin E intake are independently associated with metabolic abnormalities in human immunodeficiency virus-positive subjects: a cross-sectional study. Clin Infect Dis. 2003;36:1593–601.

    Article  Google Scholar 

  35. Shah M, Tierney K, Adams-Huet B, Boonyavarakul A, Jacob K, Quittner C, Dinges W, Peterson D, Garg A. The role of diet, exercise and smoking in dyslipidaemia in HIV-infected patients with lipodystrophy. HIV Med. 2005;6(4):291–8.

    Article  CAS  Google Scholar 

  36. Alexander DD, et al. A meta-analysis of randomized controlled trials and prospective cohort studies of eicosapentaenoic and docosahexaenoic long-chain omega-3 fatty acids and coronary heart disease risk. Mayo Clin Proc. 2017;92(1):15–29.

    Article  CAS  Google Scholar 

  37. Mozaffarian D, Aro A, Willett WC. Health effects of trans-fatty acids: experimental and observational evidence. Eur J Clin Nutr. 2009;63(Suppl 2):S5–21. https://doi.org/10.1038/sj.ejcn.1602973. Review.

  38. Soodini G, Morgan JP. Can cocaine abuse exacerbate the cardiac toxicity of human immunodeficiency virus? Clin Cardiol. 2001;24(3):177–81.

    Article  CAS  Google Scholar 

  39. Hone-Blanchet A, Fecteau S. Overlap of food addiction and substance use disorders definitions: analysis of animal and human studies. Neuropharmacology. 2014;85:81–90.

    Article  CAS  Google Scholar 

  40. Petoumenos K, Worm S, Reiss P, et al. Rates of cardiovascular disease following smoking cessation in patients with HIV infection: results from the D:A:D study. HIV Med. 2011;12(7):412–21.

    Article  CAS  Google Scholar 

  41. Pool ERM, Dogar O, Lindsay RP, et al. Interventions for tobacco use cessation in people living with HIV and AIDS. Cochrane Database Syst Rev. 2016;(6):CD011120.

    Google Scholar 

  42. Benard A, Bonnet F, Tessier JF, Fossoux H, Dupon M, Mercie P, Ragnaud JM, Viallard JK, Dabis F, Chene G, Groupe d’Epidemiologie Clinique du SIDA en Aquitaine (GECSA). Tobacco addition and HIV infection: toward the implementation of cessation programs. ANRS CO3. Aquitaine cohort. AIDS Patient Care STDs. 2007;21(7):458–68.

    Article  Google Scholar 

  43. Anda RF, Williamson DF, Escobedo LG, et al. Depression and the dynamics of smoking. A national perspective. JAMA. 1990;264:1541–5.

    Article  CAS  Google Scholar 

  44. Kelly SG, Plankey M, Post WS, Li X, Stall R, Jacobson LP, et al. Associations between tobacco, alcohol, and drug use with coronary artery plaque among HIV-infected and uninfected men in the multicenter AIDS cohort study. PLoS One. 2016;11(1):e0147822. https://doi.org/10.1371/journal.pone.0147822

    Article  Google Scholar 

  45. Freiberg MS, McGinnis KA, Kraemer K, Samet JH, Conigliaro J, Curtis Ellison R, Bryant K, Kuller LH, Justice AC, VACS Project Team. The association between alcohol consumption and prevalent cardiovascular diseases among HIV-infected and HIV-uninfected men. J Acquir Immune Defic Syndr. 2010;53(2):247–53. https://doi.org/10.1097/QAI.0b013e3181c6c4b7.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Webel AR, Sattar A, Funderburg N, Kinley B, Longenecker CT, Labbato D, Alam SK, McComsey GA. Alcohol and dietary factors associate with gut integrity and inflammation in HIV-infected adults. HIV Med. 2017;18(6):402–11. https://doi.org/10.1111/hiv.12442. Epub 2016 Nov 9.

  47. Freiberg MS, Kraemer KL. Focus on the heart: alcohol consumption, HIV infection, and cardiovascular disease. Alcohol Res Health. 2010;33(3):237–46.

    PubMed  PubMed Central  Google Scholar 

  48. Butt AA, Chang CC, Kuller L, Goetz MB, Leaf D, Rimland D, Gibert CL, Oursler KK, Rodriguez-Barradas MC, Lim J, Kazis LE, Gottlieb S, Justice AC, Freiberg MS. Risk of heart failure with human immunodeficiency virus in the absence of prior diagnosis of coronary heart disease. Arch Intern Med. 2011;171(8):737–43.

    Article  Google Scholar 

  49. Hsu JC, Li Y, Marcus GM, Hsue PY, Scherzer R, Grunfeld C, Shlipak MG. Atrial fibrillation and atrial flutter in human immunodeficiency virus-infected persons: incidence, risk factors, and association with markers of HIV disease severity. J Am Coll Cardiol. 2013;61(22):2288–95. https://doi.org/10.1016/j.jacc.2013.03.022. Epub 2013 Apr 3.

  50. Khambaty T, Stewart JC, Gupta SK, Chang CH, Bedimo RJ, Budoff MJ, Butt AA, Crane H, Gibert CL, Leaf DA, Rimland D, Tindle HA, So-Armah KA, Justice AC, Freiberg MS. Association between depressive disorders and incident acute myocardial infarction in human immunodeficiency virus-infected adults: veterans aging cohort study. JAMA Cardiol. 2016;1(8):929–37.

    Article  Google Scholar 

  51. White JR, Chang CC, So-Armah KA, Stewart JC, Gupta SK, Butt AA, Gibert CL, Rimland D, Rodriguez-Barradas MC, Leaf DA, Bedimo RJ, Gottdiener JS, Kop WJ, Gottlieb SS, Budoff MJ, Khambaty T, Tindle HA, Justice AC, Freiberg MS. Depression and human immunodeficiency virus infection are risk factors for incident heart failure among veterans: veterans aging cohort study. Circulation. 2015;132(17):1630–8.

    Article  CAS  Google Scholar 

  52. Rubak S, Sandbæk A, Lauritzen T, Christensen B. Motivational interviewing: a systematic review and meta-analysis. Br J Gen Pract. 2005;55(513):305–12.

    PubMed  PubMed Central  Google Scholar 

  53. Dillard PK, et al. An integrative review of the efficacy of motivational interviewing in HIV management. Patient Educ Couns. 2016;100(4):636–46.

    Google Scholar 

  54. Dabbo N. Motivational interviewing: preparing people for change. UTMJ. 2010;87(2):1–2.

    Google Scholar 

  55. Rollnick S, Miller W. What is motivational interviewing? Behav Cogn Psychother. 1995;23(4):325–34.

    Article  Google Scholar 

  56. Rusch M, Nixon S, Schilder A, et al. Impairments, activity limitations and participation restrictions: prevalence and associations among persons living with HIV/AIDS in British Columbia. Health Qual Life Outcomes. 2004;2:46.

    Article  Google Scholar 

  57. Walsh NP, Gleeson M, Shephard RJ, et al. Position statement. Part one: immune function and exercise. Exerc Immunol Rev. 2011;17:6–63.

    PubMed  Google Scholar 

  58. Somarriba G, Neri D, Schaefer N, Miller TL. The effect of aging, nutrition, and exercise during HIV infection. HIV/AIDS (Auckland, NZ). 2010;2:191–201.

    CAS  Google Scholar 

  59. Gonzalez JS, Batchelder AW, Psaros C, Safren SA. Depression and HIV/AIDS treatment nonadherence: a review and meta-analysis. J Acquir Immune Defic Syndr. 2011;58(2):181–7.

    Article  Google Scholar 

  60. Neidig JL, Smith BA, Brashers DE. Aerobic exercise training for depressive symptom management in adults living with HIV infection. J Assoc Nurses AIDS Care. 2003;14(2):30–40.

    Article  Google Scholar 

  61. Fillipas S, Cherry CL, Cicuttini F, Smirneos L, Holland AE. The effects of exercise training on metabolic and morphological outcomes for people living with HIV: a systematic review of randomised controlled trials. HIV Clin Trials. 2010;11(5):270–82.

    Article  CAS  Google Scholar 

  62. Mutimura E, Crowther NJ, Cade TW, Yarasheski KE, Stewart A. Exercise training reduces central adiposity and improves metabolic indices in HAART-treated HIV-positive subjects in Rwanda: a randomized controlled trial. AIDS Res Hum Retrovir. 2008;24(1):15–23.

    Article  CAS  Google Scholar 

  63. Ogalha C, Luz E, Sampaio E, Souza R, Zarife A, Neto MG, et al. A randomized, clinical trial to evaluate the impact of regular physical activity on the quality of life, body morphology and metabolic parameters of patients with AIDS in Salvador, Brazil. J Acquir Immune Defic Syndr. 2011;57(Suppl 3):S179–85.

    Article  Google Scholar 

  64. Riley KE, Kalichman S. Mindfulness-based stress reduction for people living with HIV/AIDS: preliminary review of intervention trial methodologies and findings. Health Psychol Rev. 2015;9(2):224–43.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Vani Gandhi .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Abdallah, H.H., Gandhi, V. (2019). Lifestyle. In: Myerson, M., Glesby, M. (eds) Cardiovascular Care in Patients With HIV. Springer, Cham. https://doi.org/10.1007/978-3-030-10451-1_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-10451-1_8

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-10450-4

  • Online ISBN: 978-3-030-10451-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics