Browsing by Author "Policarpo, Sara"
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- Adherence to Mediterranean diet in HIV infected patients: relation with nutritional status and cardiovascular riskPublication . Policarpo, Sara; Rodrigues, Teresa; Moreira, Ana Catarina; Valadas, EmíliaBackground & aims: The Mediterranean diet (MedDiet) has been associated to a lower prevalence of metabolic syndrome (MS) and a lower cardiovascular risk (CVR). Our aim was to assess HIV infected individual's adherence to the MedDiet and its relationship with nutritional status and CVR. Methods: Clinical and anthropometric data were collected and a nutritional assessment was performed. Adherence to the MedDiet was assessed using the questionnaire MedDietScore, ranging from 0 to 55, where higher scores indicated a higher adherence. CVR was estimated for each patient using the Framingham Risk Score (FRSs-CVD). Results: We included 571 individuals, mostly males (67.1%; n = 383). MedDiet adherence score was 27.5 ± 5.5 points. The proportion of overweight/obese individuals was 40.3% (n = 230) and MS 33.9% (n = 179); CVD estimation showed that 53.2% (n = 304), 30.1% (n = 172) and 16.6% (n = 95) of patients had a low, moderate and very high CVR, respectively. The group with BMI below 25 kg/m2 presented lower adherence to MedDiet and patients within moderate CVR category and with MS presented a higher adherence to MedDiet. Conclusions: Overall we found a moderate adherence to the Mediterranean diet. A higher adherence was associated to individuals with a BMI ≥ 25 kg/m2, those with MS and to patients with moderate to high cardiovascular risk, suggesting the adoption of this food pattern in the presence of comorbidities.
- Cardiovascular risk in HIV-infected individuals: a comparison of three risk prediction algorithmsPublication . Policarpo, Sara; Rodrigues, Teresa; Moreira, Ana Catarina; Valadas, EmíliaABSTRACT - Introduction: Cardiovascular (CV) risk is known to be increased in HIV-infected individuals. Our aim was to assess CV risk in HIV-infected adults. Methods: CV risk was estimated for each patient using three different risk algorithms: SCORE, the Framingham risk score (FRS), and DAD. Patients were classified as at low, moderate or high CV risk. Clinical and anthropometric data were collected. Results: We included 571 HIV-infected individuals, mostly male (67.1%; n=383). Patients were divided into two groups according to antiretroviral therapy (ART): naïve (7.5%; n=43) or under ART (92.5%; n=528). The mean time since HIV diagnosis was 6.7±6.5 years in the naive group and 13.3±6.1 years in the ART group. Metabolic syndrome (MS) was identified in 33.9% (n=179) and 16.3% (n=7) of participants in the ART and naïve groups, respectively. MS was associated with ART (OR=2.7; p=0.018). Triglycerides ≥150 mg/dl (OR=13.643, p<0.001) was one of the major factors contributing to MS. Overall, high CV risk was found in 4.4% (n=23) of patients when the SCORE tool was used, in 20.5% (n=117) using the FRS, and in 10.3% (n=59) using the DAD score. The observed agreement between the FRS and SCORE was 55.4% (k=0.183, p<0.001), between the FRS and DAD 70.5% (k=0.465, p<0.001), and between SCORE and DAD 72.3% (k=0.347, p<0.001). Conclusion: On the basis of the three algorithms, we detected a high rate of high CV risk, particularly in patients under ART. The FRS was the algorithm that classified most patients in the high CV risk category (20.5%). In addition, a high prevalence of MS was identified in this patient group.
- Mediterranean diet: the impact on cardiovascular risk and metabolic syndrome in HIV patients, in Lisbon, PortugalPublication . Policarpo, Sara; Valadas, Emilia; Rodrigues, Teresa; Moreira, Ana CatarinaIntroduction - Metabolic syndrome (MS) is common in HIV-infected individuals and it is associated with higher cardiovascular risk (CVR). Mediterranean diet has been associated with a better metabolic control and lower CVR. Materials and methods - From December 2013 to May 2014, individuals between 18 and 65 years of age, who attended the outpatient HIV Clinic at the University Hospital Santa Maria, Lisbon, were selected. Adherence to Mediterranean diet was evaluated with MedDietScore, a scale from 0 to 55 that punctuates 11 food items according to the frequency of intake. Higher scores represent higher adherence. CVR was assessed using D.A.D tool (classified as low, moderate or high risk). We excluded individuals with opportunistic disease, hospitalized in the past three months or with renal disease diagnosis. All participants gave written informed consent. Results - In the 571 HIV patients included, 67.1% (n=383) were male, 91.6% (n=523) Caucasian, with a mean age of 46.5±8.9 years. Patients were divided in two groups: naïve (7.5%; n=43) or on antiretroviral treatment (ART) (92.5%; n=528). Mean length of HIV diagnosis was 6.7±6.5 years (naïve) and 13.3±6.1 years (ART); TCD4+ counts were above 500 cel/mm3 in 55.8% (n=24) and 67.6% (n=357) of the patients, respectively. MS was present in 33.9% (n=179) of patients in ART group and 16.3% (n=7) in naïve group. Presence of MS was associated with ART group (OR=2.7; p=0.018). MS was also associated with older age in this group (p=0.000). Overall, mean MedDietScore was 27.3±5.5. Higher score was associated with older age (r=0.319; p=0.000). Naïve patients presented a trend to higher adherence to Mediterranean diet (65.1% vs 51.7% in naïve group; p=0.090). No relation between MS and Mediterranean diet was found. Higher CVR was associated with the presence of MS in the ART group (p=0.001). In this group, individuals with moderate CVR presented higher rates of adherence to Mediterranean diet (p=0.036) when compared to low and high CVR score. Conclusions - In this cross-sectional study, naïve individuals presented a trend to higher adherence to Mediterranean diet. On the ART group, higher adherence to Mediterranean diet was found in individuals with moderate CVR score. We think that this might suggest that this group of patients adopt this diet only in the presence of metabolic alterations or perceived CVR. Prospective studies in HIV patients are required to determine the impact of adherence to Mediterranean diet on the reduction of CVR.
- Nutritional status and quality of life in HIV-infected patientsPublication . Carvalho, Barbara Fernandes; Policarpo, Sara; Moreira, Ana CatarinaIntroduction: Nutritional status and the progression of the human immunodeficiency virus (HIV) are interlinked; though some studies have looked at the impact nutritional status has on quality of life (QoL) in patients with chronic diseases, few have studied this in HIV-infected individuals. Objective: To investigate the relationship between nutritional status and QoL in adults with a recent HIV diagnosis. Methods: Individuals with an HIV diagnosis performed in the fourteen months prior to a medical visit to one of Lisbon’s central hospitals were eligible. Nutritional status was assessed by anthropometry, body composition analysis, and dietary intake. QoL was assessed using the WHOQOLHIV-BREF questionnaire. Sociodemographic and clinical data were also considered. Results: Fifty-one subjects were eligible for enrollment; the majority were male, Caucasian, employed, single, and under highly active antiretroviral therapy (HAART). Lower QoL scores were observed in subjects with inadequate energy intakes, reported weight loss, and a high waist circumference in bivariate analysis (p < 0.05); the same variables influenced QoL negatively after adjusting for confounders in multivariate analysis (p < 0.05). Various sociodemographic characteristics such as level of education, age, gender, and current health problems also predicted QoL significantly (p < 0.05). Conclusion: Various aspects of nutritional status were responsible for the variations observed in QoL, suggesting a potential for nutritional intervention in improving QoL in this population.
- Nutritional status, physical activity and quality of life in children and adolescents with human immunodeficiency virus infectionPublication . Martins, Inês de Carvalho; Asseiceira, Inês; Policarpo, Sara; Carolino, Elisabete; Prata, Filipa; Mouzinho, Ana; Marques, José GonçaloABSTRACT - Introduction: The growth and cellular immune function of the human immunodeficiency virus (HIV) infected children are impaired by their nutritional status. The majority experience nutrition deficits and malnutrition, but with longer follow-up metabolic syndrome have been described. The aim of the study was to assess nutritional status, physical activity, and quality of life in HIV-infected children and adolescents. Methods: Cross-sectional study. 31 HIV-infected patients were assessed based on anthropometry: weight, height, body mass index (BMI), triceps skinfolds (TSF), and mid-upper arm circumference (MUAC). Body composition obtained by electrical bioimpedance and expressed as fat mass (FM) and lean body mass (LBM); dietary intake through recall 24-hour, physical activity (PA) through BQHPA, and health-related quality of life (HRQoL) through Kidscreen 27. Statistical analysis IBM® SPSS® v.25. Results: Z-scores of BMI: 25% overweight and 7,1% obese. Dietary intake of critical vitamins, nutrients, minerals, sugar, and energy does not correspond to DRI’s. BQHPA demonstrated that males PA are higher than females. Differences by gender were found in physical well-being (p<0,05) and psychological well-being (p<0,05), with males being associated with better well-being, they also presented higher physical and psychological well-being, autonomy & parent relation, and social support & pears. Higher BMI z-score values were associated with lower values of resistance, reactance, fiber intake, physical well-being. Discussion: Patients presented an unbalanced dietary intake. However, most were eutrophic. The subjects follow the trends of healthy children concerning physical activity, the same is not seen about health-related quality of life.