People with HIV (PWH) are at an increased risk for cognitive impairment as they age compared to their HIV-negative counterparts. Lifestyle factors can have protective effects on cognitive outcomes among PWH. However, little work has examined diet quality and cognitive function in PWH. Examining the association between diet quality and cognitive function among PWH is particularly important given this population’s increased risk for both poor diet quality and cognitive impairment. The purpose of this study was to examine the relationship between diet and cognitive function in aging PWH.

This cross-sectional study was conducted in Birmingham, Alabama and Cleveland, Ohio. Eighty-six PWH (mean age 56 years) completed standard triple-pass 24-hour diet recalls and a neurocognitive assessment. Partial Pearson’s correlations were conducted between diet variables and global neurocognitive function T scores, adjusting for total calories, sex, and education level.

Overall diet quality of the sample was poor. The overall sample presented with low Healthy Eating Index (HEI)-2015 scores, high glycemic index, twice the goal amount for saturated fatty acids (SFAs), and inadequate consumption of several nutrients typically associated with cognitive health including omega-3 fatty acids, dietary protein, fiber, Vitamin D, Zinc, and several B-vitamins. Greater total calories per day (r=0.28, p<0.05), greater percentage of total calories of SFAs (r=0.26, p<0.01), and lower glycemic index (r=-0.24, p<0.05) were associated with better cognition. Higher intake of several individual fatty acids, particularly SFAs, were associated with better cognition (correlations ranging from 0.23 to 0.31). Higher intakes of phosphorus (r=0.29, p<0.01), magnesium (r=0.25, p<0.05), and potassium (r=0.22, p<0.05) were associated with better cognition. Higher grams/day of several amino acids were associated with better cognition (correlations ranging from 0.22 to 0.27).

In a sample with overall poor diet quality not meeting recommended guidelines, findings suggest that being nourished in itself is associated with better cognitive function. Associations with several individual nutrients may inform potential intervention targets to protect brain health in PWH. Further, targeting food insecurity in interventions may have downstream effects on cognition in PWH.