(14-12-09) Effect of a dietary intervention and n?3 fatty acid supplementation

on measures of serum lipid and insulin sensitivity in persons with HIV1,2,3


Margo N Woods, Christine A Wanke, Pei-Ra Ling, Kristy M Hendricks, Alice M Tang, Tamsin A Knox, Charlotte E Andersson, Kimberly R Dong, Sally C Skinner and Bruce R Bistrian

1 From the Department of Public Health and Community Medicine, Nutrition/Infection Unit, Tufts University School of Medicine, Boston, MA (MNW, CAW, KMH, AMT, TK, KRD, and SK); the Divisions of Clinical Nutrition (P-RL, and BRB) and Gastroenterology (CEA), Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (CEA).
2 Supported by the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health (grants R01 DK63619, P01-D45734, and P30 DA013868), and by the General Clinical Research Center of Tufts Medical Center, Boston MA (Division of Research Resources of the National Institutes of Health grant M01-RR00054).
3 Address correspondence to MN Woods, Tufts University School of Medicine, Departments of Public Health and Community Medicine, Nutrition/Infection Unit, 150 Harrison Avenue, Jaharis 265, Boston, MA 02111. E-mail: [email protected] .
Background: Elevated serum triglyceride and low HDL-cholesterol concentrations have been reported in persons with HIV.
Objective: The effect of a dietary intervention plus n?3 ( ?3) fatty acid supplementation on serum triglycerides and markers of insulin sensitivity was investigated.
Design: Fifty-four persons with HIV and elevated serum triglycerides (>150 mg/dL) and/or abnormal Quantitative Insulin Sensitivity Check Index values (<0.35 but >0.30) were recruited for a dietary intervention in which total fat, type of fat, fiber, and glycemic load were controlled along with supplementation with n?3 fatty acids to achieve an intake of 6 g/d. The subjects were randomly assigned to an intervention or control group, and serum lipids, markers of insulin sensitivity, and serum phospholipid fatty acids were measured in both groups at baseline, 3 wk, and 13 wk.
Results: Triglycerides in the intervention group decreased from a median of 180 mg/dL (interquartile range: 141, 396) to 114 mg/dL (interquartile range: 84, 169) from baseline to 3 wk, whereas they remained stable in the control group (P = 0.003). Serum phospholipid fatty acids indicated a decrease in de novo lipogenesis and a decrease in arachidonic acid (% nmol; P 0.001) in the intervention group. At 3 wk, the insulin area under the curve decreased but not significantly.
Conclusions: Diet and n?3 fatty acid supplementation dramatically reduced serum triglycerides, decreased arachidonic acid in the phospholipids fraction, and appeared to decrease the de novo lipogenesis associated with the metabolic syndrome in the intervention group.

Source: American Journal of Clinical Nutrition, doi:10.3945/ajcn.2009.28137
Vol. 90, No. 6, 1566-1578, December 2009

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