Author and graduation date: Camella J. RISING, October, 2002

Committee members: Audrey A. Spindler (Cchair), Patricia Patterson, Judy Price

Thesis title: The Relationship of Diet and Body Image to HIV-associated Fat Redistribution Syndrome

The objective of this thesis was to characterize the body composition, diet, and body image of people with HIV-associated fat redistribution syndrome (FRS).

Clinical presentation of FRS was described through clinician and patient reports. Body composition (anthropometry, bioelectrical impedance analysis), dietary intake (4-day food records), physical activity (questionnaire), and body image (questionnaire) were evaluated. Metabolic parameters were obtained by chart review. Relevant variables were compared to risk assessment guidelines for cardiovascular disease and other obesity co-morbidities.

Eighteen HIV-infected men with body shape changes and/or metabolic abnormalities were referred through a university hospital-affiliated HIV clinic. Descriptive statistics were performed.

More than 1/4 of participants reported changes in their faces, arms, legs, buttocks, and abdomen. Mean body mass index was 25.6 kg/m². Mean waist:hip ratio was above the desirable level (0.96), though mean waist circumference was acceptable (89.7 cm). Mean thigh circumference was 46.4 cm. Percent body fat and body cell mass were within normal limits. Mean HDL-cholesterol (0.83 mmol/L) and triglyceride levels (5.47 mmol/L) were suboptimal. Mean caloric intake was 29 kcal/kg/d. Percent total fat, percent saturated fat, and cholesterol were slightly above National Cholesterol Education Program (NCEP) recommendations. Physical activity level was moderate. Evidence of poor body image was found in several participants.

It was concluded from this study that some people with FRS may be at increased risk for cardiovascular disease and other obesity co-morbidities. Possible directions for non-drug therapy include trial of the NCEP diet and exercise. Recommendations should be offered in a supportive environment due to poor body image in some people with FRS.

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