Association between diet quality, physical activity and anthropometric status of people living with HIV in Cape Town

Research on the diet of PLWH in South Africa is limited. We assessed the association between BMI and diet quality of PLWH on ART in Cape Town. We recruited 246 participants between 2021 and 2022. Information on demographics, infection, treatment, anthropometry, and physical activity was obtained. Diet quality was assessed using the Alternate Healthy Eating Index (aHEI). Anthropometry was measured using BMI, waist circumference, mid-upper-arm circumference, and waist-to-hip ratio. Participants were mostly females (70%) with an average age of 46 years, 28% were overweight, and 40% obese. Females were more obese than males (91% vs 9%, p < 0.001). Age was not associated with BMI. Leisure physical activity score was significantly different within BMI categories (p < 0.001). Over one-third of participants were being treated for at least one comorbidity, mostly hypertension, dyslipidemia, and dysglycemia. Average daily intakes of the components of the aHEI indicated a low compliance with the index recommendation. The mean aHEI score was 41.9, indicating diet quality was lower than average, and was not significantly different between BMI categories. Diet quality among PLWH in this study is suboptimal, irrespective of BMI; this needs to be addressed. Investigations of psychosocial factors affecting the nutritional and health status of PLWH is needed.