Diet

Studies have not looked at the effect of dietary changes on body fat redistribution, but an Australian study of fat intake in people with and without lipodystrophy found no significant difference in the proportion of total calories derived from saturated fats. They pointed out that in the HIV-negative population, people with body changes indicating a high risk of heart disease (such as visceral fat accumulation) do derive a higher proportion of their calorie intake from saturated fats than the rest of the population, and can modify their risk of heart disease and reduce fat accumulation by adjusting their diet. In contrast, dietary changes probably have little impact on the mechanisms causing body fat changes and elevated lipids in HIV-related lipodystrophy, the authors argued. ¹

However, a cross-sectional American study found that high intakes of polyunsaturated fats and alcohol, and a low fibre intake were strongly associated with metabolic abnormalities and lipodystrophy. ² Some dietary patterns observed may have been a consequence of a changing need for calories due to body fat changes. For example, those experiencing fat loss had a higher daily calorie intake than those with either abnormal fat accumulation or a mixture of fat accumulation and wasting. The authors suggested that a prospective study (which follows people before they develop metabolic or body fat changes) may help to establish the extent to which pre-existing dietary patterns influence metabolic changes.