A Systematic Review of the Effects of Exercise Interventions on Body Composition in HIV+ Adults

Abstract

Over the years, physical activity and exercise have been used to positively impact the health and quality of life of persons infected with HIV and, more recently, has been associated with a spectrum of body composition changes. The aim of this review was to examine the effects of various exercise interventions on body composition in HIV positive adults, using a search strategy of randomized, controlled trials (RCTs). A systematic review was performed by five independent reviewers using a predetermined protocol adapted from previous research for assessing the articles for inclusion, the extracted data, and methodological quality. Eight RCTs involving 430 (26% female) HIV positive adults performing exercise a minimum of thrice weekly for at least six weeks were finally selected: Four were progressive resistance training (PRT) studies, three were aerobic training (AT) studies, and one involved yoga. In the PRT studies, there were significant increases in three anthropometric measures, namely, body mass, sum of skinfolds and sum of limb girths. In the AT studies, significant decreases were found in seven anthropometric measures, namely, body mass index, waist-hip ratio, body mass, triceps skinfold, waist circumference and sum of skinfolds. With yoga, the changes were non-significant. Exercise contributes to improved body composition and, when applied safely, appears to be beneficial for adults living with HIV/AIDS. However, these findings should be interpreted cautiously due to the relatively few RCTs published to date. Future studies would benefit from increased attention to sample size, female participants, participant follow-up, complete statistical analysis and intention-to-treat analysis.

Anthropometric Changes Following Aerobic and Resistance Training Programmes Among Hiv-Seropositive Female Patients

“…This result is however in contrast with another systematic review that found a reduction in BMI when they examined the effect of a twice-weekly aerobic and progressive resistance exercise on body composition (Leach et al, 2015). The result was also not in line with the conclusion of Smith et al (2001) who found that 12 weeks of supervised aerobic exercise training safely decreases fatigue, weight, BMI, subcutaneous fat and abdominal girth (central fat) in HIV-1-infected individuals.…”

Physical activity correlates in people living with HIV/AIDS: a systematic review of 45 studies

“…While physical activity can be defined here as any bodily movement produced by skeletal muscles that results in energy expenditure, exercise is a planned, structured, repetitive and purposive form of physical activity that aims to improve or maintain one or more components of physical fitness [12]. Regular physical activity is considered to contribute to an improved body composition, cardiorespiratory and muscular fitness, lower levels of depressive symptoms and an improved physical and mental health related quality of life [13,14,15,16,17,18]. It is therefore strongly recommended that people living with HIV/AIDS augment their physical activity levels, while adequate information and awareness is spread among service users and health care professionals, and corresponding opportunities for physical activity are built and maintained [19].…”

Cardiorespiratory fitness levels and moderators in people with HIV: A systematic review and meta-analysis

“…Current hypotheses link the increased incidence of these comorbidities to side-effects of antiviral therapy (Dillon et al, 2013;El-Sadr, 2007), HIV-related chronic inflammation (Hearps et al, 2014) and modifiable lifestyle factors, such as increased tobacco use (Lifson and Lando, 2012) and decreased physical activity (Schuelter-Trevisol et al, 2012). There is evidence in PLWH that participation in physical activity might reduce cardio-metabolic risk factors and improve quality of life (Fillipas et al, 2010;Gomes-Neto et al, 2013;Leach et al, 2015;Neto et al, 2015;O'Brien et al, 2008). In the general population, there is robust evidence demonstrating that low cardiorespiratory fitness (CRF, the ability of the circulatory and respiratory systems to supply oxygen to working muscles during sustained physical activity) is a strong predictor for CVD [relative risk (RR)=1.56; 95% confidence interval (CI)=1.39-1.75; p<0.001] and allcause mortality (RR=1.70; 95%CI=1.51-1.92; P<0.001) (Kodama et al, 2009).…”