Dietary counselling and exercise training for lipid management in people living with HIV: A systematic review and meta-analysis.

In 30 seconds

This systematic review and meta-analysis assessed randomized trials of dietary counselling and exercise training for lipid management in people living with HIV, predominantly those with dyslipidaemia. Seven trials involving 474 participants were included. Compared with usual care, dietary counselling significantly reduced LDL-C, total cholesterol and triglycerides; reported LDL-C reductions ranged from approximately 6 to 13 mg/dL. Evidence from two trials suggested exercise training may increase HDL-C, but showed no consistent effects on LDL-C, total cholesterol or triglycerides. The authors conclude that lifestyle interventions may be adjuncts to lipid management, while noting the need for larger studies, particularly of exercise.

Key findings

• Across seven randomized trials involving 474 participants, dietary counselling significantly reduced LDL-C, total cholesterol and triglycerides compared with usual care.
• LDL-C reductions with dietary counselling ranged from approximately 6 to 13 mg/dL.
• Evidence from two trials suggested exercise training may increase HDL-C, with no consistent effects on LDL-C, total cholesterol or triglycerides.

Why it matters

Dyslipidaemia is common among people living with HIV and contributes to cardiovascular risk. This synthesis indicates that dietary counselling may improve several lipid measures in this population, while the lipid effects of exercise training remain uncertain. Distinguishing the evidence for these approaches can inform consideration of lifestyle measures as adjuncts to lipid management without overstating their demonstrated effects.

What to keep in mind

Only seven trials were included, and evidence for exercise training came from two trials; differences in exercise protocols may have contributed to the findings. The authors call for larger studies, particularly to evaluate exercise.