Associations of diet quality and food security with risks of cardiovascular diseases among people living with HIV: a scoping review

The introduction of antiretroviral therapy reduced HIV mortality, but was followed by increased comorbidities, including hypertension and dyslipidemia. A higher-quality diet can delay the onset of comorbidities related to HIV infection. Diet quality measures are not established among People Living with HIV (PLWH). This review identified the diet quality and food insecurity indices used among PLWH and their associations with risks of cardiovascular diseases (CVD). We used recommendations from Arksey and O’Malley, the Joanna Briggs Institute’s manual, and the Preferred Reporting Items for Systematic Review and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. A preliminary search was conducted on MEDLINE to develop a comprehensive search strategy. The final search was conducted on PubMed, EbscoHost, Scopus, Web of Science, and COCHRANE databases. Screening was conducted by two independent reviewers. Of 1094 retrieved records, 46 passed full-text screening. Forty-two were cross-sectional, and thirteen were in the United States. Seven studies assessed food security; all indicated a high level of food insecurity. One study used the Healthy Eating Index, and six used the Mediterranean Diet Score to assess diet quality with varying outcomes. Other studies compared dietary intake with various dietary guidelines. Hypertension, diabetes, obesity, and dyslipidemia were the most reported risk factors for CVD, with varying degrees of association with diet. Established diet quality indices are not widely used in studies among PLWH. Studies assessing this use heterogeneous methods, making it difficult to compare and summarize findings. The included studies suggest potential associations between diet and CVD among PLWH, but we need standardized methods to study this association.