Exercise

Exercise is also known to have an impact on reducing lipid levels. At a minimum, individuals should aim to increase their heart rate for thirty minutes at least three times a week, either by brisk walking, cycling, jogging or swimming. More structured exercise may bring greater benefits: a study of resistance training in men with lipodystrophy showed that triglyceride levels normalised in 9 of 11 individuals who lifted weights at least three times a week. 1 This is probably because larger muscles consume more triglycerides as fuel, thus removing them from the circulation.

A prospective 10 week study of aerobic exercise and resistance training in 6 HIV-positive individuals with lipodystrophy showed that total cholesterol and triglyceride levels were reduced by 17.6% and 25% respectively. This reduction was statistically significant, and there was a trend towards a reduction in the total cholesterol: HDL cholesterol ratio. There was also a significant improvement in waist-hip ratio (a possible indicator of central fat accumulation), but body fat percentage declined, suggesting that whilst exercise may improve lipid disturbances and central fat accumulation, it will not help peripheral fat wasting. This study did not use DEXA scanning to check whether the reduction in waist-hip ratio was associated with reduced central fat or subcutaneous fat. 2

In HIV-negative people insulin sensitivity can be improved by regular exercise, but the effects of exercise (and diet) on insulin resistance in HIV infection have not been reported. A small observational study of an intensive exercise regimen and dietary advice in 15 HIV-infected women produced weight loss but had virtually no effect on insulin resistance. 3 Of note, calorie intake was restricted to 1200mg a day. Weight loss averaged 6kg in this study, almost all fat, but some of this fat was subcutaneous rather than visceral.

References

  1. Yarasheski EK et al. Resistance exercise training reduces hypertriglyceridemia in HIV-infected men treated with antiviral therapy. Journal of Applied Physiology 90(1): 133-138, 2001
  2. Jones S et al. Short-term exercise training improves body composition and hyperlidemia in HIV-positive individuals with lipodystrophy. AIDS 15(15): 2049-2051, 2001
  3. Engelson ES et al. The effects of diet and exercise weight loss program in obese HIV-infected women. 14th International AIDS Conference, Barcelona, abstract ThPeB7339, 2002
Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap
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This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.