Modifiable dietary habits and their relation to metabolic abnormalities inmen and women with human immunodeficiency virus infection and fat redistribution

We assessed the relationship between dietary intake, body composition, and metabolic parameters in 85 consecutive human immunodeficiency virus (HIV)-i nfected patients with fat redistribution. Dietary history and values for fa sting glucose, insulin, lipids, and oral glucose tolerance were obtained fo r 62 men and 23 women with HIV infection and fat redistribution (mean age s tandard error of the mean [SEM], 43.5 +/- 0.9 years; mean body mass index [ BMI] +/- SEM, 26.3 +/- 0.5 kg/m(2)). A multivariate regression analysis was used to predict insulin area under the curve (AUC) following the oral gluc ose tolerance test; this included age, sex, BMI, waist-to-hip ratio, kiloca lories, duration of protease inhibitor (PI) use, fat redistribution pattern , alcohol intake, dietary fiber intake, and polyunsaturated-to-saturated (P : S) fat ratio. Only age (P=.004), PI use duration (P=.02), and P: S fat ra tio (P=.003) were positively associated with insulin AUC. Dietary fiber int ake was inversely associated with the insulin AUC (P=.001). In a similar an alysis, alcohol consumption was a significant positive predictor of low-den sity lipoprotein cholesterol. Polyunsaturated fats, fiber, and alcohol are strongly associated with insulin resistance and hyperlipidemia in this popu lation and may be important targets for dietary modification.