A Gram Research analysis of 44 HIV patients in Greece found that while malnutrition affects only 4.5% of those on HIV treatment, depression, low physical activity, and younger age significantly increase malnutrition risk. Modern HIV medications work well, but comprehensive care addressing mental health and lifestyle—not just medication—appears essential for preventing nutrition problems in this population.
A new pilot study of 44 people living with HIV in Greece found that even though modern HIV medications work well, some patients still face nutrition problems. Researchers used three different screening tools to check for malnutrition and discovered that depression, low physical activity, and younger age were connected to higher malnutrition risk. The study highlights that HIV care needs to address not just the virus, but also mental health, exercise, and eating habits together. Understanding these connections could help doctors provide better, more complete care for people living with HIV.
Key Statistics
A 2026 pilot study of 44 people living with HIV in Greece found that malnutrition prevalence was 4.5% according to two screening tools, but the three different assessment methods showed poor agreement with each other.
According to research reviewed by Gram, higher depression symptom scores were independently associated with increased odds of malnutrition in HIV patients on antiretroviral therapy, while greater physical activity levels were associated with reduced malnutrition risk.
A 2026 Greek study of 44 HIV patients identified two distinct groups through clustering analysis: younger participants with lower body weight and lower physical activity showed significantly increased malnutrition risk (p = 0.003 for MUST, p = 0.006 for MNA).
Research shows that among 44 HIV patients on treatment, depression, low physical activity, and younger age were the strongest factors associated with malnutrition risk, suggesting that comprehensive care must address psychological and lifestyle factors alongside medication.
The Quick Take
- What they studied: Whether people living with HIV who are taking HIV medications experience malnutrition, and what factors (like depression, exercise, and age) are connected to nutrition problems.
- Who participated: 44 adults living with HIV in Greece who were taking antiretroviral therapy (HIV medications). The study included people of various ages and backgrounds.
- Key finding: Only 4.5% of participants showed signs of malnutrition using two screening tools, but depression, low physical activity, and younger age were strongly linked to higher malnutrition risk. Interestingly, the three screening tools didn’t always agree with each other.
- What it means for you: If you’re living with HIV on treatment, paying attention to your mental health, staying physically active, and maintaining a healthy weight may help prevent nutrition problems. However, this is a small pilot study, so larger research is needed to confirm these findings.
The Research Details
This was a pilot study, meaning it was a small test run to explore a topic before conducting larger research. Researchers recruited 44 people living with HIV in Greece who were taking antiretroviral therapy (HIV medications). They assessed malnutrition using three different screening tools—the Mini Nutritional Assessment (MNA), the Malnutrition Universal Screening Tool (MUST), and the Subjective Global Assessment (SGA)—to get a complete picture of nutrition status.
The researchers also measured depression using the Beck Depression Inventory, appetite using the Council on Nutrition Appetite Questionnaire, and physical activity using the Athens Physical Activity Questionnaire. They analyzed the data to find connections between malnutrition and factors like age, depression, and exercise levels. They also used a statistical technique called K-means clustering to identify different groups of people based on their nutrition and lifestyle patterns.
Using multiple screening tools and measuring several factors (depression, activity, appetite) gives a more complete picture than looking at just one thing. This approach helps researchers understand that malnutrition in HIV patients isn’t just about food—it’s connected to mental health and lifestyle. A pilot study like this is important because it tests methods and identifies patterns that larger studies can then investigate more deeply.
This is a small pilot study with only 44 participants from one country, so the results may not apply to all people living with HIV worldwide. The three malnutrition screening tools didn’t always agree with each other, which suggests that measuring malnutrition is tricky and may need better methods. Because this is a pilot study, the findings are preliminary and need confirmation from larger, more diverse research.
What the Results Show
The study found that malnutrition was relatively uncommon in this group of HIV patients on treatment. When using the MNA and MUST screening tools, 4.5% of participants showed signs of malnutrition. However, when using the SGA tool, no participants were identified as malnourished. This disagreement between the three tools is important—it suggests that different methods of checking for malnutrition may give different answers.
The researchers discovered that depression was strongly connected to malnutrition risk. People with higher depression scores were significantly more likely to have malnutrition. In contrast, people who were more physically active had lower malnutrition risk. The study also identified two distinct groups: younger participants with lower body weight and lower physical activity showed increased malnutrition risk compared to older participants with higher body weight and more activity.
The clustering analysis revealed important patterns. Younger age, lower body mass index (BMI), and lower physical activity levels were all associated with increased malnutrition risk. These factors often go together—younger participants in the study tended to have lower BMI and exercise less, creating a higher-risk group. The study also highlighted that appetite problems and dietary knowledge gaps may play a role, though these weren’t the strongest predictors.
Previous research has shown that people living with HIV face higher malnutrition risks than the general population, even with modern HIV medications. This study’s finding of relatively low malnutrition prevalence (4.5%) is encouraging and suggests that modern antiretroviral therapy has improved outcomes. However, the connection between depression and malnutrition aligns with existing research showing that mental health significantly impacts nutrition. The emphasis on physical activity as a protective factor also matches broader nutrition science.
This pilot study has several important limitations. With only 44 participants from Greece, the results may not apply to HIV patients in other countries or populations. The disagreement between the three malnutrition screening tools raises questions about which method is most accurate. The study is cross-sectional, meaning it captures a snapshot in time rather than following people over months or years, so we can’t determine if depression causes malnutrition or if malnutrition causes depression. Finally, as a pilot study, these findings need confirmation through larger, more rigorous research before making broad recommendations.
The Bottom Line
Based on this research, people living with HIV on treatment should consider: (1) monitoring mental health and seeking support for depression, as it appears strongly connected to nutrition problems; (2) maintaining regular physical activity, which appears protective against malnutrition; (3) maintaining a healthy body weight. However, these recommendations are based on a small pilot study, so discuss them with your healthcare provider. Confidence level: Moderate—the findings are promising but need confirmation in larger studies.
This research is most relevant to people living with HIV who are taking antiretroviral therapy, their healthcare providers, and HIV specialists. It’s particularly important for younger HIV patients and those experiencing depression. Healthcare systems should consider these findings when designing comprehensive HIV care programs. General population readers should understand that HIV treatment has improved significantly, though comprehensive care addressing mental health and lifestyle remains important.
Changes in physical activity and mental health support may show benefits within weeks to months, though nutrition improvements typically take 4-12 weeks to become measurable. Long-term benefits of addressing depression and increasing activity would likely accumulate over months and years.
Frequently Asked Questions
Can people with HIV on medication still get malnutrition?
Yes, though it’s less common than before modern HIV drugs. A 2026 study of 44 HIV patients found 4.5% had malnutrition despite taking HIV medications. Depression, low physical activity, and younger age increased risk, showing that medication alone isn’t enough—mental health and exercise matter too.
What’s the connection between depression and malnutrition in HIV patients?
Research shows depression strongly increases malnutrition risk in HIV patients on treatment. The 2026 study found higher depression scores were independently linked to malnutrition. Depression may reduce appetite, motivation to eat well, or ability to prepare nutritious meals.
Does exercise help prevent malnutrition in people with HIV?
Yes, according to a 2026 pilot study of 44 HIV patients, greater physical activity was associated with reduced malnutrition risk. The study identified younger, less-active participants as highest risk, suggesting exercise is protective for nutrition health in HIV patients.
How do doctors check for malnutrition in HIV patients?
The 2026 study used three different screening tools (MNA, MUST, and SGA), but they didn’t always agree. This suggests malnutrition assessment in HIV patients is complex and may need better methods. Your doctor can discuss which approach works best for your situation.
What age group of HIV patients is most at risk for malnutrition?
The 2026 study found younger HIV patients had higher malnutrition risk, especially those with lower body weight and lower physical activity. Younger participants formed a distinct higher-risk group, suggesting age-specific nutrition interventions may be needed.
Want to Apply This Research?
- Track weekly physical activity minutes (target: 150 minutes moderate activity per week) and mood scores using a simple 1-10 scale. Monitor these alongside weight and appetite to identify patterns between activity, mood, and nutrition status.
- Set a specific weekly exercise goal (e.g., three 30-minute walks) and log mood daily. When mood dips, use the app to connect with mental health resources or reminders to reach out to support networks. Link activity completion to nutrition tracking to reinforce the connection between exercise and appetite.
- Create a dashboard showing the relationship between weekly physical activity, mood scores, and appetite/nutrition markers. Set alerts if depression scores rise or activity drops below target, prompting users to check in with healthcare providers. Monthly reviews can identify whether increased activity correlates with improved appetite and nutrition.
This research is a small pilot study with 44 participants and should not replace professional medical advice. If you are living with HIV, consult your healthcare provider or HIV specialist before making changes to your treatment, diet, exercise, or mental health care. The findings are preliminary and need confirmation through larger research. If you experience depression or nutrition concerns, seek professional help immediately. This article is for educational purposes only and does not constitute medical advice.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.