Muhammad J N, Fernandez J R, Clay O J, Saag M S, Overton E T, Willig A L
a Department of Nutrition Sciences , The University of Alabama at Birmingham , Birmingham, Alabama , United States.
b Department of Psychology , The University of Alabama at Birmingham , Birmingham, Alabama , United States.
AIDS Care. 2019 May;31(5):554-562. doi: 10.1080/09540121.2018.1554239. Epub 2018 Dec 17.
People aging with HIV face social stressors which may negatively affect their overall nutrition. Here, we assess relationships between self-reported measures of depression, perceived stress, social support, and food insecurity with diet quality in older adults with HIV. A retrospective analysis of self-reported data from parent study at The University of Alabama at Birmingham 1917 HIV Clinic was performed. The study sample consisted of sixty people living with HIV (PLWH) with controlled HIV infection (<50 copies/mL), aged 50 years or older who participated in a cross-sectional microbiome study. Dietary intake was measured using the NHANES 12-month Food Frequency Questionnaire (FFQ) and three Automated Self-Administered (ASA) 24-hr diet recalls to calculate diet quality scores using the Mediterranean Diet Score (MDS); alternative Healthy Eating Index (aHEI); and the Recommended Food Score (RFS) indices. Food insecurity was measured with the Food Security Questionnaire (FSQ). Participants completed the following psychosocial scales: (1) depression - Patient Health Questionnaire-8 (PHQ8); (2) perceived stress - Perceived Stress Scale (PSS-10); (3) social support - Multidimensional Scale of Perceived Social Support (MSPSS). Linear regression models were used to investigate relationships among variables controlling for gender and income. The cohort was characterized as follows: Mean age 56 ± 4.6 years, 80% African-American, and 32% women. Mean body mass index (BMI) was 28.4 ± 7.2 with 55% reporting food insecurity. Most participants reported having post-secondary education (53%), although 77% reported annual incomes <$20,000. Food insecurity was independently associated with measures of poor dietary intake: aHEI (β = -0.08, p = .02) and MDS (β = -0.23, p < 0.01) and with low dietary intake of fibre (β = -0.27, p = .04), vitamin E (β = -0.35, p = .01), folate (β = -0.31, p = .02), magnesium (β = -0.34, p = .01) and copper (β = -0.36, p = .01). These data indicate food insecurity is associated with poor diet quality among PLWH. Clinical interventions are needed to improve food access for PLWH of low SES.
感染艾滋病毒的老年人面临着可能对其整体营养产生负面影响的社会压力源。在此，我们评估了感染艾滋病毒的老年人自我报告的抑郁、感知压力、社会支持和粮食不安全状况与饮食质量之间的关系。对阿拉巴马大学伯明翰分校1917艾滋诊所母研究中的自我报告数据进行了回顾性分析。研究样本包括60名艾滋病毒感染者（PLWH），他们的艾滋病毒感染得到控制（<50拷贝/毫升），年龄在50岁及以上，参与了一项横断面微生物组研究。饮食摄入量通过美国国家健康与营养检查调查（NHANES）的12个月食物频率问卷（FFQ）和三次自动自我管理（ASA）的24小时饮食回忆来测量，以使用地中海饮食评分（MDS）、替代健康饮食指数（aHEI）和推荐食物评分（RFS）指数计算饮食质量得分。粮食不安全状况通过粮食安全问卷（FSQ）进行测量。参与者完成了以下心理社会量表：（1）抑郁——患者健康问卷-8（PHQ8）；（2）感知压力——感知压力量表（PSS-10）；（3）社会支持——多维感知社会支持量表（MSPSS）。使用线性回归模型研究控制性别和收入后变量之间的关系。该队列的特征如下：平均年龄56±4.6岁，80%为非裔美国人，32%为女性。平均体重指数（BMI）为28.4±7.2，55%报告存在粮食不安全。粮食不安全与不良饮食摄入指标独立相关：aHEI（β=-0.08，p=0.02）和MDS（β=-0.23，p<0.01），以及膳食纤维（β=-0.27，p=0.04）、维生素E（β=-0.3
