Diet, physical activity, and obesity among ART-experienced people with HIV in South Africa

ABSTRACT

The prevalence of non-communicable diseases (NCDs) is increasing in South Africa, in part due to poor nutrition, physical inactivity, and obesity. We characterized the habits and understanding of diet, exercise, and obesity among people with HIV (PWH) taking antiretroviral therapy (ART). We conducted a cross-sectional study of ART-experienced PWH attending an HIV community health center near Cape Town, South Africa. We included PWH currently prescribed ART, older than 21y, and not pregnant. We collected demographic and clinical information and interviewed participants regarding their behaviors and knowledge related to diet, physical activity, and obesity. From March 2015 – February 2016, we enrolled 458 participants. Self-reported diets were low in nutritional diversity: 202 reported eating only starch and protein without vegetable/fruit in the prior 24 h. Although most participants (96%) acknowledged that exercise had health benefits, only 215 participants engaged in daily 30-minute walking or exercise. One quarter of participants recognized nocontributors to obesity, and almost 20% identified no health problems associated with obesity. Participants had diets low in nutritional diversity, modest exercise habits, and limited understanding of the impact of obesity on health. Further understanding of barriers to improving diet and exercise and reducing obesity are essential, especially as PWH age.

KEYWORDS:

• HIV
• nutrition
• physical activity
• obesity

Acknowledgements

The authors would like to acknowledge Ms. Heidi Freislich, Ms. Alicia Letago, and Ms. Nokukanya Tiyane for their assistance with data collection in this study and Ms. Bridget Bunda, Ms. Mary Feser, and Ms. Maya Hajny Fernandez for their assistance on manuscript preparation.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Authorship

EPH, RAP, and KM designed the study. EPH and EBM wrote the first draft of the manuscript. EPH, EBM, LGB, AX, RAP, RPW, and KM provided critical revisions of the manuscript. All authors have read and approved the final version of the paper.

Ethical standards disclosure

This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all procedures involving research study participants were approved by the Human Research Ethics Committee at University of Cape Town (575/2014) and by the Partners Human Research Committee (Institutional Review Board) at Massachusetts General Hospital (2014P001661/PHS). Written informed consent was obtained from all subjects/patients.

Disclaimer

The findings, conclusions, and views expressed in this report are those of the author(s) and do not necessarily represent the official position of their affiliated institutions.

Additional information

Funding

This work was supported by the National Institutes of Health [K01 HL123349 (EPH); R37 AI058736; Harvard University Center for AIDS Research (HU CFAR) NIH/NIAID P30 AI060354 (AX; RAP)]; the Steve and Deborah Gorlin MGH Research Scholars Award (RPW) and the Jerome and Celia Reich Scholar Award (EPH). The content is solely the responsibility of the authors, and the study’s findings and conclusions do not necessarily represent the official views of the National Institues of Health (NIAID, NHLBI) or Massachusetts General Hospital.