Abstract
Knowledge of various aspects of dietary diversity (DD)—an essential healthful dietary component—across adulthood is limited. This study examined three DD aspects over time in racially diverse adults. Participants were from the National Institute on Aging, Healthy Aging in Neighborhoods of Diversity across the Life Span study. DD measures were calculated at baseline (N = 2177), and first and second examination follow-ups (N = 2140 and N = 2066, respectively) using two 24-h recalls. The count was based on the consumption of ≥50% of an equivalent from 21 food groups. Evenness was derived using the Berry-Index adjusted by the food’s health value; dissimilarity, by Mahalanobis Distance. Mixed-effects linear regression models were conducted to test changes in DD across adulthood, adjusting for sex, race, poverty status and education as fixed effects, and adjusting for smoking, age and energy as time-dependent variables. Only dissimilarity showed significant interactions of time × race (p = 0.0005), and time × poverty status (p = 0.0325), indicating a slower rate of increase over time in dissimilarity scores among Whites compared with African–Americans and those with income >125% poverty versus <125% poverty. A significant interaction between time×energy (p < 0.0001) was noted for both evenness and dissimilarity scores. To our knowledge, this is the first study to document the differential change in dissimilarity scores by race and income over time.
Highlights
Dietary Diversity (DD) is a universally recognized key component of a healthful diet and is considered to reflect variety [1]
Dietary variety is one of the important components incorporated in the 2015–2020 Dietary Guidelines for Americans with the recommendation for including a variety of nutrient-dense foods across and within food groups, especially
The HANDLS survey sample is a fixed cohort consisting of African–American (AA) and White adults from 13 neighborhoods in the city of Baltimore
Summary
Dietary Diversity (DD) is a universally recognized key component of a healthful diet and is considered to reflect variety [1]. DD is defined as eating varieties of distinct and wholesome foods that promote nutrient adequacy, high dietary quality, and the maintenance of optimal health [1,2,3,4,5,6,7,8,9,10]. Increased variety within food groups has been recommended to improve public health in the United States and worldwide [11,12,13]. Dietary variety is one of the important components incorporated in the 2015–2020 Dietary Guidelines for Americans with the recommendation for including a variety of nutrient-dense foods across and within food groups, especially. DD helps to promote biodiversity and sustainability [14] along with reducing the risk for various diet-related chronic conditions, such as metabolic syndrome [15], obesity [16] and cardiovascular risk [17,18]
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