Plasma Fatty Acids in Zambian Adults with HIV/AIDS: Relation to Dietary Intake and Cardiovascular Risk Factors

Abstract

Objective. To determine whether 24 hr dietary recalls (DR) are a good measure of polyunsaturated fatty acid (PUFA) intake when compared to plasma levels, and whether plasma PUFA is associated with markers of HIV/AIDS progression and cardiovascular disease (CVD) risk. Methods. In a cross-sectional study among 210 antiretroviral therapy-naïve HIV-infected adults from Lusaka, Zambia, we collected data on medical history and dietary intake using 24 hr DR. We measured fatty acids and markers of AIDS progression and CVD risk in fasting plasma collected at baseline. Results. PUFA intakes showed modest correlations with corresponding plasma levels; Spearman correlations were 0.36 (p < 0.01) for eicosapentaenoic acid and 0.21 (p = 0.005) for docosahexaenoic acid. While there were no significant associations (p > 0.05) between total plasma PUFA and C-reactive protein (CRP) or lipid levels, plasma arachidonic acid was inversely associated with CRP and triglycerides and positively associated with HDL-C, CD4+ T-cell count, and plasma albumin (p < 0.05). Plasma saturated fatty acids (SFA) were positively associated with CRP (β = 0.24; 95% CI: 0.08 to 0.40, p = 0.003) and triglycerides (β = 0.08; 95% CI: 0.03 to 0.12, p < 0.01). Conclusions. Our data suggest that a single DR is inadequate for assessing PUFA intake and that plasma arachidonic acid levels may modulate HIV/AIDS progression and CVD risk.

Linoleic acid and the pathogenesis of obesity

“…A similar study performed in wild type B6C3FE mice found a diet with a LA:ALA ratio of 77 resulted in an increase in adiposity, heart hypertrophy, hepatic lipid droplet deposition and a 6-fold upregulation of stearoyl-coenzyme A desaturase 1 (SCD-1) when compared to an isoenergetic diet with a LA:ALA ratio of 9.5 in third generation offspring fed the diets [110].…”

“…Interestingly, this study used diets with approximately 2/3 rd the amount of energy from n-6 PUFA compared to what is generally found in the American diet [10]. Another study has found that a 12 week diet with lowered levels of LA (and the equivalent of the average American diet n-3 composition [110]) resulted in increased plasma esterified n-3 levels, which was further increased with an increase in dietary n-3 [126]. Moreover, a 2 week crossover study in diabetic men has found that a high MUFA OA diet resulted in lower blood glucose and insulin levels than a high LA diet [127].…”

“…In southern African countries the World Health Organisation (WHO) estimates that 40-60% of adults aged 25-64 are overweight, with urban southern Africans having a higher fat intake than their rural counterparts (due to an increase of all fat classes) [24,25]. This increased fat intake is possibly influenced by the increase in vegetable oil consumption due to its lower purchase price, with an intake of 11.5% of energy from LA being found in a Zambian population subset [26]. Additionally, Inuit populations of the Canadian Arctic are also currently undergoing a nutrition transition, demonstrated by a decrease in the intake of traditional foods (including marine products) and an increase in dietary and erythrocyte LA levels, with a concomitant decrease in all major n-3 FA [27].…”

Plasma n-6 Fatty Acid Levels Are Associated With CD4 Cell Counts, Hospitalization, and Mortality in HIV-Infected Patients

“…12 Our study among ART-naïve Zambian adults followed for 90 days showed that n6-fatty acids, particularly higher plasma levels of arachidonic acid, were positively associated with clinical markers of improved patient survival (e.g., CD4 cell counts and serum albumin). 13 …”

“…12 Consistent with this finding, we recently showed that among ART-naïve HIV patients in Zambia, higher plasma levels of arachidonic acid are associated with better CD4 cell counts and other markers of improved survival. 13 A positive association between plasma linoleic acid, another n6-fatty acid, and CD4 cell counts has been reported in a study of 14 HIV-infected children. 14 …”