Dietary patterns and the risk of metabolic syndrome among HIV positive individuals from selected health facilities in Lusaka district, Zambia.

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Kalaluka, Kekelwa Peryson
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The University of Zambia
The relationship between diet and the risk of metabolic syndrome has not yet been established among HIV positive individuals in Zambia. Around 37.9 million people globally are believed to be living with HIV infection and in Zambia 1.2 million people are living with the same infection. HIV infection and antiretroviral therapy use are associated with disturbance in glucose and lipid metabolism. It is estimated that approximately 25% of the world’s population has metabolic syndrome. The prevalence of metabolic syndrome among HIV positive individuals in Zambia is not known. In the Sub-Saharan Africa population, including Zambia, the prevalence of metabolic syndrome and its differential contribution by HIV status is not yet established. However, the rapid urbanization, demographic and epidemiological transitions and as well as changes in lifestyle that have been observed in SSA have been associated with the emergency of cardiovascular diseases which are metabolic syndrome components. The main objective of this study was to determine the dietary patterns and the risk of metabolic syndrome among HIV positive individuals. A cross-sectional study was conducted among the 180 subjects from April to July 2020 in the three sampled health facilities that offer antiretroviral services from the twenty six health facilities in Lusaka District. Participants completed a structured questionnaire on socio-demographic characteristics and a 53-item food frequency questionnaire. Anthropometric measurements (weight, height and waist circumference) were also obtained and analysed. Blood pressure was also analysed by the use of the sygmomanometre. Blood metabolites for cholesterol, triglycerides and glucose were analysed at the laboratory. Dietary patterns from food frequent questionnaire were identified using Principal Component Analysis (PCA). Binary logistic regression analysis was performed to evaluate the association of extracted dietary patterns as well as other lifestyles patterns with metabolic syndrome and its metabolic abnormalities. Out of the 180 participants, 53% (n=96) of them were women. Physical measurements indicated that 39% (n=70) of the respondents had high waist to hip ratio, high waist circumference was observed among females 21% (n=38) than among males 4% (n=7). Respondents with elevated blood pressure were 33% (n=60), elevated total cholesterol levels were 52% (n=93) and elevated triglycerides levels were 46% (n=83). Through PCA analysis, three dietary clusters were identified which included omnivorous; “staples, animal products and vi fruits”, vegetarian; “legumes and nuts” and the other one, unclassified; “fats and oils, other foods and beverages and vegetables”. None of the food clusters showed significant association with metabolic syndrome or its components. The findings of this study showed that metabolic syndrome among HIV positive individuals is zero. However, raised blood pressure, 33% (n=60) was the only metabolic syndrome predictor with the rest of the parameters being predictors of non-communicable disease. Therefore interventions such as consumption of low energy yielding foods during group and community health messaging sessions could be implemented so as to keep the zero prevalence levels of metabolic syndrome in Zambia at bay.
Dietary needs--HIV patients.