Can a Mediterranean diet reduce the effects of lipodystrophy syndrome in people living with HIV? A pilot randomised controlled trial

Sex Health. 2011 Mar;8(1):43-51. doi: 10.1071/SH09065.


Background: HIV and highly active antiretroviral therapies have been associated with changes in individuals' lipid profiles and fat distribution (lipodystrophy). A pilot study was conducted for a randomised controlled trial to evaluate whether lipodystrophy in HIV patients can be controlled by adopting the low-fat and low-cholesterol diet or the modified Mediterranean diet.

Methods: Forty-eight HIV patients were randomised into two diet groups. Thirty-six (75%) completed the 1-year pilot study with regular dietetic consultations, during which time lipid levels, weight, body mass index and fat distribution were recorded. Differences between and within groups were determined.

Results: Undesirable body fat changes in the low-fat diet group included decreases in tricep skinfold (from 19.9 mm to 15.4 mm (P = 0.03)), hip circumference (from 93.6 cm to 91.7 cm (P = 0.01)) but a significant increase in waist-to-hip ratio (from 0.87 to 0.89 (P = 0.003)). Serum cholesterol increased significantly in the Mediterranean diet group at 9 and 12 months (from 4.6 to 5.06 mmol L(-1) (P = 0.03) and 5.12 mmol L(-1) (P = 0.01)) with no obvious change in the low-fat diet group. Serum triglyceride levels remained the same in the Mediterranean diet group, whereas it increased from 1.9 to 3.22 mmol L(-1) (P = 0.07) in the low-fat diet group.

Conclusions: A Mediterranean diet seems to have an advantage over the low-fat diet in maintaining serum triglyceride levels and avoiding lipodystrophy, but this advantage was offset by a rise in cholesterol level. Several procedural and methodological issues were identified which must be rectified before a similar large-scale trial taking place.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cholesterol / blood
  • Diet, Fat-Restricted / statistics & numerical data*
  • Diet, Mediterranean / statistics & numerical data*
  • Female
  • HIV Infections / diet therapy
  • HIV-Associated Lipodystrophy Syndrome / diet therapy*
  • Humans
  • Male
  • Middle Aged
  • Pilot Projects
  • Treatment Outcome
  • Triglycerides / blood*


  • Triglycerides
  • Cholesterol