Document Type

Dissertation

Degree

Doctor of Philosophy (PhD)

Major/Program

Dietetics and Nutrition

First Advisor's Name

Adriana Campa

First Advisor's Committee Title

Committee Chair

Second Advisor's Name

Marianna Baum

Second Advisor's Committee Title

Committee Member

Third Advisor's Name

Fatma Huffman

Third Advisor's Committee Title

Committee Member

Fourth Advisor's Name

Florence George

Fourth Advisor's Committee Title

Committee Member

Fifth Advisor's Name

Mary Jo Trepka

Fifth Advisor's Committee Title

Committee Member

Keywords

HIV, prediabetes, diabetes, antiretroviral therapy, nutrition, intervention

Date of Defense

11-6-2019

Abstract

The objective of this study was to assess the effectiveness of a 6-month randomized, controlled nutrition intervention targeting prediabetes in people living with HIV (PLWH) and have prediabetes. Participants (n=38) were randomized into the intervention group (n=20) or the control group (n=18). Participants randomized into the intervention group met once a month for approximately 1 hour to receive medical nutrition therapy, nutrition counseling and nutrition education; participants randomized into the control group received educational material at baseline. Fasting blood glucose (FBG) for the 6-month follow-up for the intervention group was significantly reduced compared to baseline (p=0.03). No significant difference was found in the control group between the baseline and 6-month blood glucose values (p=0.11). A significant reduction in body mass index (BMI) was also observed within the intervention group (p=0.03) at the end of the 6-month intervention; but not in the control group (p=0.10). No significant difference was observed for inflammation as measured by high sensitivity C-reactive protein (hs-CRP) in either the intervention group (p=0.40) or the control group (p=0.12). There was a significant improvement in oxidative stress as measured by 8-hydroxyguanosine (8OHdG) in the intervention group (p=0.04); but no improvement was seen in the control group (p=0.43). Furthermore, significant improvement in stage of behavioral change was observed in the intervention group for physical activity, fruit/vegetable intake and fiber intake. Significant improvement was also observed for nutrition knowledge and self-efficacy in the intervention group; but not in the control group. Participants with high compliance with treatment, were more able to achieve better fruit and vegetable intake, fiber intake, nutrition knowledge and self-efficacy than those with poor compliance with study visits. The results from this intervention support the notion that a nutrition intervention is effective in low-income PLWH and prediabetes to lower diabetes risk by significantly lowering fasting blood glucose, BMI and oxidative stress (8OHdG), as well as improving participants through the stages of behavioral change. This pilot study also demonstrated that a 6-month intervention, provided adherence and attendance, is feasible to improve prediabetes condition and this type of intervention could be implemented into a larger scale.

Identifier

FIDC008871

Previously Published In

Sneij-Perez A, Campa A, Seminario L, Martinez S, Huffman F, Trepka M, George F, Baum M. Preliminary Results on the Effectiveness of a Nutrition Intervention in Lowering Diabetes Risk in Prediabetic People Living with HIV (PLWH) in MASH Cohort (OR36-06-19). Current Developments in Nutrition. 2019;3(1):1148.

Available for download on Wednesday, December 08, 2021

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