The Effect of a Community-Based Exercise Program on Inflammation, Metabolic Risk, and Fitness Levels Among Persons Living with HIV/AIDS

Cutrono, Stacy E.; Lewis, John E.; Perry, Arlette C.; Signorile, Joseph F.; Tiozzo, Eduard; Jacobs, Kevin A.

doi:10.1007/s10461-015-1245-1

Cited by 27 publications

(20 citation statements)

References 41 publications

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“…Our finding that moderate (∼7%) weight loss improves skeletal muscle insulin sensitivity, assessed as insulin‐mediated glucose disposal rate during insulin infusion, differs from the results of a previous study that found a 7% weight loss achieved by dietary modification and physical activity failed to improve insulin sensitivity, assessed by using the frequently sampled intravenous glucose tolerance test . The results from two other studies found that lifestyle therapy in patients with HIV infection resulted in a decrease in waist circumference without a change in body weight but failed to show any beneficial metabolic benefits . The reason for the different findings between our study and the previous study that found weight loss in HIV+ patients did not improve insulin sensitivity could be related to differences in cART regimens and in the methods used to assess insulin action.…”

Section: Discussioncontrasting

confidence: 99%

HIV infection does not prevent the metabolic benefits of diet‐induced weight loss in women with obesity

Reeds

Pietka

Yarasheski

et al. 2017

Obesity

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Objective To test the hypothesis that HIV infection impairs the beneficial effects of weight-loss on insulin-sensitivity and adipose-tissue inflammation and endoplasmic reticulum (ER) stress. Methods A prospective clinical trial to evaluate the effects of moderate diet-induced weight-loss on body-composition, metabolic function and adipose-tissue biology in women with obesity who were HIV-seronegative (HIV−) or HIV-positive (HIV+). Body-composition, multi-organ insulin-sensitivity (assessed by using a 2-stage hyperinsulinemic-euglycemic clamp procedure with stable isotopically-labeled tracer infusions), and adipose-tissue expression of markers of inflammation, autophagy and ER stress were evaluated in 8 HIV− and 20 HIV+ women with obesity before and after 6%–8% diet-induced weight-loss. Results Although weight-loss was not different between groups (~7.5%), the decrease in fat-free-mass was greater in HIV+ than HIV− subjects (−4.4±0.7 % vs −1.7±1.0%, P < 0.05). Weight loss improved insulin-sensitivity in adipose-tissue (suppression of palmitate rate of appearance [Ra]), liver (suppression of glucose Ra) and muscle (glucose disposal) similarly in both groups. Weight-loss did not affect adipose-tissue expression of markers of inflammation or ER stress in either group. Conclusions Moderate diet-induced weight-loss improves multi-organ insulin-sensitivity in HIV+ women to the same extent as women who are HIV−. However, weight loss causes a greater decline in FFM in HIV+ than HIV− women.

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Section: Discussioncontrasting

confidence: 99%

HIV infection does not prevent the metabolic benefits of diet‐induced weight loss in women with obesity

Reeds

Pietka

Yarasheski

et al. 2017

Obesity

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“…After screening titles and application of the eligibility criteria, 21 studies (Baigis et al, 2002;Cade et al, 2003;Cade et al, 2013;Cutrono et al, 2015;Dolan et al, 2006;Ezema et al, 2014;Hand et al, 2008;Jaggers et al, 2014;MacArthur et al, 1993;Mangona et al, 2015;Mapstone et al, 2014;Mutimura et al, 2008;Neto et al, 2016;Oursler et al, 2009;Perna et al, 1999;Ramírez-Marrero et al, 2014;Raso et al, 2013;Smith et al, 2001;Sullivan et al, 2014;Terry et al, 2006;Thoni et al, 2002) were eligible for inclusion in the meta-analysis. (n=31) and sub-maximal (n=5) exercise tests.…”

Section: Search Results and Flow Of Studies Through The Reviewmentioning

confidence: 99%

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

Vancampfort

Mugisha

Rosenbaum

et al. 2016

Preventive Medicine

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Cardiorespiratory fitness (CRF) is a modifiable risk factor for cardiovascular disease and premature mortality. CRF levels and moderators among people living with HIV (PLWH) are unknown. The aim of the current meta-analysis was to (1) determine mean CRF in PLWH and compare levels with age-and gender-matched healthy controls (HCs), (2) explore moderators of CRF,3and (4) explore moderators of CRF outcomes following physical activity (PA) interventions. Major electronic databases were searched systematically for articles reporting CRF expressed as maximum or peak oxygen uptake (ml/min/kg) in PLWH. A random effects meta-analysis calculating the pooled mean CRF including subgroup-and meta-regression analyses was undertaken. Across 21 eligible studies, the CRF level was 26.4 ml/kg/min (95%CI=24.6 to 28.1) (n=1,010; mean age =41years). There were insufficient data to compare CRF levels with HCs. A higher body mass index (β=-0.99, 95%CI=-1.93 to -0.06, P=0.04), older age (β=-0.31, 95%CI=-0.58 to -0.04, P=0.02) and the presence of lipodystrophy (β=-4.63, 95%CI=-7.88 to -1.39, P=0.005) were significant moderators of lower CRF levels. Higher CD4+ counts (β=0.004, 95%CI=0.0007 to 0.007, P=0.016), supervised interventions (P<0.001) and interventions with a lower frequency of weekly sessions (2 or 3 versus 4 times) (P<0.001) predicted a better CRFoutcome following PA. CRF levels of PLWH are among the lowest in comparison to other vulnerable populations. More research on the most optimal physical activity intervention characteristics is needed.

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“…[ 39 ] Yet there is evidence that HIV-infected adults are less likely to meet even these recommendations compared to the general population. [ 40 ] Furthermore, recent exercise trials in HIV-infected adults suggest that exercise intensity[ 41 ] and loss of body fat[ 42 ] are important predictors to reduce inflammation. Our preliminary findings need to be confirmed in a larger trial with a more diverse population.…”

Section: Discussionmentioning

confidence: 99%

A pilot randomized aerobic exercise trial in older HIV-infected men: Insights into strategies for successful aging with HIV

et al. 2018

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BackgroundHIV-infected adults have increased risk for age-related diseases and low cardiorespiratory fitness that can be prevented and improved with exercise. Yet, exercise strategies have not been well studied in older adults with HIV and may require substantial adaptation to this special population.ObjectiveTo determine the safety and efficacy of aerobic exercise in older HIV-infected men in a randomized trial comparing different levels of exercise intensity.MethodsWe conducted a pilot exercise trial in 22 HIV-infected men ≥50 years of age receiving antiretroviral therapy who were randomized 1:1 to moderate-intensity aerobic exercise (Mod-AEX) or high-intensity aerobic exercise (High-AEX) that was performed three times weekly for 16 weeks in a supervised setting. Primary outcome was cardiorespiratory fitness (VO2peak) measured by treadmill testing. Secondary outcomes were exercise endurance, six-minute walk distance (6-MWD), body composition measured by Dual-energy X-ray absorptiometry (DXA), and fasting plasma levels of lipids and glucose.ResultsVO2peak increased in the High-AEX group (3.6 ±1.2 mL/kg/min, p = 0.02) but not in the Mod-AEX group (0.4 ±1.4 mL/kg/min, p = 0.7) with a significant between group difference (p<0.01). Exercise endurance increased in both the High-AEX group (27 ±11%, p = 0.02) and the Mod-AEX group (11 ±4%, p = 0.04). The 6-MWD increased in both the High-AEX (62 ±18m, p = 0.01) and the Mod-AEX group (54 ±14m, p = 0.01). Changes in VO2peak and 6-MWD were clinically relevant. There were no serious exercise-related adverse events. Dropouts were similar between group (27% overall) and were related to joint pain.ConclusionsThis pilot exercise trial demonstrates that moderate to high-intensity aerobic exercise in older HIV-infected men increases endurance and ambulatory function. However, increased cardiorespiratory fitness was observed only with high-intensity aerobic exercise despite substantial baseline impairment. Future research is needed to determine exercise strategies in older HIV-infected adults that address advanced aging and comorbidity yet are durable and feasible.

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The Effect of a Community-Based Exercise Program on Inflammation, Metabolic Risk, and Fitness Levels Among Persons Living with HIV/AIDS

Cited by 27 publications

References 41 publications

HIV infection does not prevent the metabolic benefits of diet‐induced weight loss in women with obesity

HIV infection does not prevent the metabolic benefits of diet‐induced weight loss in women with obesity

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

A pilot randomized aerobic exercise trial in older HIV-infected men: Insights into strategies for successful aging with HIV

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