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. 2023 Jun;30(3):356-365.
doi: 10.1007/s12529-022-10096-4. Epub 2022 May 9.

Association Between VACS Index and Health-Related Quality of Life in Persons with HIV: Moderating Role of Fruit and Vegetable Consumption

Laura M Campbell  1   2 , Jessica L Montoya  2 , Pariya L Fazeli  3 , Maria J Marquine  2 , Ronald J Ellis  2 , Dilip V Jeste  2   4   5 , David J Moore  2 , Raeanne C Moore  6
Affiliations

Association Between VACS Index and Health-Related Quality of Life in Persons with HIV: Moderating Role of Fruit and Vegetable Consumption

Laura M Campbell et al. Int J Behav Med. 2023 Jun.

Abstract

Background: The health status of people with HIV (PWH) influences their health-related quality of life (HRQOL). Modifiable lifestyle factors may improve HRQOL. This study (1) explores the association between modifiable lifestyle factors (physical activity and nutrition) and HRQOL and (2) examines if these lifestyle factors moderate the association health status and HRQOL.

Methods: Participants included 91 community dwelling PWH (age 36-65 years) from the university lab. Participants reported mental and physical HRQOL via the Medical Outcome Study 36-Item Short-Form (SF-36). Physical activity was examined via the International Physical Activity Questionnaire and nutrition (i.e., fruit and vegetable consumption) was assessed with the By-Meal Screener. Health status was ascertained via the Veterans Aging Cohort Study (VACS) Index.

Results: Aim 1 analyses indicated that neither physical activity nor nutrition was related to mental HRQOL (p's > .05). However, greater physical activity (β = .33, p < .01) and nutrition (β = .23, p = .03) were each independently related to better physical HRQOL and remained significant after accounting for co-occurring medical conditions. For aim 2, the interaction between health status and nutrition was statistically significant (β = .24, p = .02), such that the association between worse health status and worse physical HRQOL was weaker with better nutrition. There was not a statistically significant interaction between physical activity and health status on physical HRQOL (p > .05).

Conclusion: Physical HRQOL is related to self-reported physical activity and nutrition, with nutrition showing a moderating effect on the association between health status and physical HRQOL. Thus, future interventional studies designed to improve physical HRQOL should target both physical activity and nutrition.

Keywords: Behavioral health; Healthcare; Infectious disease; Outcome assessment; Prevention; Wellbeing.

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Conflict of interest statement

Raeanne C. Moore is a co-founder of KeyWise, Inc. and a consultant for NeuroUX. The terms of these arrangements have been reviewed and approved by the University of California, San Diego, in accordance with its conflict of interest policies. For the remaining authors, no conflicts of interest were declared. The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of the Navy, Department of Defense, nor the United States Government.

Figures

Fig. 1
Fig. 1
The relationship between physical activity and physical health-related quality of life (left) and nutrition and physical health-related quality of life (right). Note. MET, metabolic equivalents; nutrition, daily fruit and vegetable servings
Fig. 2
Fig. 2
Nutrition moderates the negative relationship between VACS Index and physical health-related quality of life. Note. Model was run with nutrition as a continuous variable but was dichotomized into low (< 5 daily servings) and high (≥ 5 daily servings) nutrition for demonstrative purposes. Regression lines adjust for other variables in the model (i.e., physical activity, diabetes). VACS Index, The Veterans Aging Cohort Study Index; nutrition, daily fruit and vegetable servings
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