(P22-051-23) Protocol for Exploring Relationships Between Diet, Microbiome Profiles, and Food Insecurity Among a Community-Based Sample of People Living With HIV: The NOURISH-OK Study

Objectives: People living with HIV (PLWH) are disproportionately impacted by food insecurity, which can affect health through several nutritional pathways. However, little is known about how food insecurity may affect health directly via nutritional modulation of the gut microbiome, which may be impacted differently throughout the month due to fluctuations in the quantity and quality of food supply. The objective of the present study protocol is to observe temporal relationships between dietary intake and gut microbiome profiles and to explore how diet, food insecurity, and other personal factors modulate microbiome profiles among PLWH.

Methods: Participants from the Nutrition to Optimize, Understand, and Restore Insulin Sensitivity in HIV for Oklahoma (NOURISH-OK) Aim 1 main study will be randomly invited to separately enroll in this 4-week observational sub-study (n=100). For this community-based study, we developed our protocol to maximize accessibility and inclusion of people with limited resources and/or clinical research experience. Enrollments will be held at a social services agency where participants provide a one-time saliva sample (OMNIgene Oral OM-501) and receive in-depth orientation to stool sample collection kits (OMNIgene Gut OM-200) for use at home. On a randomly selected day each week for the next four weeks, participants will complete a phone survey and 24-h food recall, then collect one stool sample from their next bowel movement.

We will conduct 16S ribosomal RNA gene sequencing using an Illumina MiSeq system and establish a bioinformatics pipeline for correlational analyses of microbiota composition, diversity, and differential abundances with dietary and clinical metadata (e.g., c-reactive protein, insulin resistance) collected through the main study. Biomarker discovery will employ statistical approaches such as linear mixed effect models.

Results: N/A

Conclusions: The NOURISH-OK will deepen understanding of associations and fluctuations between microbiome profiles, dietary, and clinical covariates over multiple time points, shedding light on the relationship between food insecurity, insulin resistance, and other health risk factors among PLWH. Findings will inform a future dietary intervention to reduce co-morbidity risk in PLWH.

Funding Sources: National Institute of Diabetes and Digestive and Kidney Diseases