(P14-004-24) Diet, Health, and Inflammation: A Comparative Analysis of Dietary Patterns Between People Living With HIV and Their Family Members

Objectives: Availability of pro-inflammatory foods is increasing in low- and middle-income countries, contributing to increased disease susceptibility. In resource-poor settings, families prioritize dietary needs of people living with HIV (PLHIV). Understanding variations in dietary inflammation among household members can inform nutrition messaging for chronic disease management. This study compares diet-associated inflammation and nutrient intake in PLHIV v. family members.

Methods: PLHIV and family member dyads dietary intake was assessed via 24-hour recall in the Diet, Environment, and Choices of positive living study in Dar es Salaam, Tanzania, in 2019. Nutrient intake was calculated via Tanzanian food composition tables. Dietary Inflammatory Index (DII) quantified dietary inflammation, higher scores indicating pro-inflammatory diets. Energy-adjusted DII (E-DII) adjusted for variation in HIV-related caloric needs and body composition. Linear regressions assessed associations between PLHIV and family member characteristics with E-DII scores, stratified by gender.

Results: Dyads (n=185) were mostly female (76% PLHIV, 66% family members) and food insecure (68% households). E-DII scores were higher for male PLHIV (2.43±1.37 v. females 1.72±1.62) and family members (2.34±1.48 v. 1.81±1.56). Male PLHIV had higher intake of total calories (3531±1773 v. 2654±1480 kcal) and most macro- and micro-nutrients than females. No gender differences existed in family members’ nutrient intake. PLHIV E-DII scores positively associated with family members’ kcal (p=0.01) and family members’ E-DII with PLHIV kcal (p < 0.01). PLHIV E-DII positively associated with kcal, kcal/weight, and family members’ health (all p< 0.05). PLHIV had higher E-DII with opposite-gender family members: female PLHIV with male family member (β=0.52, p< 0.001), and male PLHIV with female family member (β=0.30, p=0.01).

Conclusions: In resource-poor settings, diets were pro-inflammatory and associated with household health. PLHIV diets were more anti-inflammatory than family members. Females had lower nutrient adequacy than males. Nutrition messaging for chronic diseases should consider gender differences and interconnected dietary dynamics within families.

Funding Sources: UK Government’s Foreign, Commonwealth & Development Office, and the Bill & Melinda Gates Foundation