The Impact of Yogurt, Legumes, and Coffee on Health Outcomes in HIV: You are What You Eat?

Background: HIV-induced immunodeficiency and comorbidities highlight the importance of nutritional support. While the World Health Organization (WHO) advocates for dietary interventions in people living with HIV (PLWH), robust clinical evidence remains limited.

Methods: This study continuously enrolled 280 newly diagnosed PLWH (≥16 years) without opportunistic infections or malignancies. Participants were stratified into high- and low-consumption groups based on dietary intake: yogurt (≥300 mL/week vs <300 mL/week), legumes (≥180 g/week vs <180 g/week), and black coffee (≥3 cups/week vs <3 cups/week), excluding sugary and milk-based coffee. Clinical assessments included laboratory tests, liver fibrosis and steatosis evaluation (FibroScan, AST-to-platelet ratio index [APRI], and controlled attenuation parameter [CAP]), and physical and mental health assessments using the 36-Item Short Form Health Survey (SF-36), the Self-Rating Anxiety Scale (SAS), and the Self-Rating Depression Scale (SDS).

Results: At baseline, high-yogurt consumption group had higher CD4+ (P=0.027) and higher CD8+ T-cell counts (P=0.043), lower alcohol use (P=0.001), and higher alanine aminotransferase (ALT) levels (P<0.001). Post antiretroviral therapy (ART), the T-cell count differences disappeared, but BMI and weight gain remained higher (both P<0.001). Legume consumption was not significantly associated with serum lipid profiles but was correlated with lower smoking prevalence (P=0.021), higher ALT levels (P=0.007), and higher CD4+ T-cell counts (P=0.011) at baseline. High coffee consumption was associated with lower APRI scores post-ART (P=0.025) but showed no other significant associations with clinical parameters. No significant associations were found between diet and SF-36, SAS, or SDS scores, except reduced social functioning in high legume and coffee groups.

Conclusion: High yogurt consumption was associated with high baseline CD4+ and CD8+ T counts but also associated with increased BMI after ART. However, no significant interactions between dietary intake and ART outcomes were observed.