Abstract
The study objectives were to measure dietary diversity (DD) of an urban US population and to determine if associations of 10 year atherosclerotic cardiovascular (ASCVD) risk with DD were independent of dietary quality. Participants were drawn from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study, wave 4 (n = 2066, 1259 African Americans (AA), 807 Whites (W). Three DD measures were derived from 2 days of 24 h recall data collected with the USDA automated-multiple-pass-method. Count was based on consumption of at least half an equivalent of food from 21 subgroups. Evenness was calculated using Berry Index (BI) and BI-adjusted by food health values. Dissimilarity was calculated by Mahalanobis Distance. Diet quality was assessed by Mean Nutrient Adequacy (MAR) and DASH scores. Associations of DD and quality with ASCVD risk, calculated using 2013 American College of Cardiology and American Heart Association guidelines, were assessed with multivariable regression. Covariates included income, education, food security, and energy/kg weight. Count and MAR were positively associated whereas dissimilarity was negatively associated with ASCVD risk. There was no evidence that evenness contributed to cardiovascular health. The findings suggest more diversity in food attributes and diets rich in micronutrients rather than increased count support cardiovascular health.
Highlights
Diet, a collection of nutrients and other chemical substances, can have a protective role in reducing the risk of development of selected chronic conditions
Despite the consumption of a Western-type diet, the study findings suggest that more diversity in food attributes and diets rich in micronutrients support cardiovascular health
Even among persons with poor food choices it seems it is still possible that small dietary differences may reduce risk for cardiovascular disease
Summary
A collection of nutrients and other chemical substances, can have a protective role in reducing the risk of development of selected chronic conditions. Prior to the development of animal husbandry and agriculture, the universal characteristics of hominin diets can be described as minimally processed, wild plant and animal foods [1]. Industrialization, technology advancement, urbanization, globalization, and the developments in animal husbandry and agriculture transformed our food systems, reducing food biodiversity [1,2,3,4,5]. In the 1980s in the United States, dietary changes and worsening in diet quality were observed [6]. There was more reliance on processed foods, and greater use of edible oils and sugar-sweetened beverages [6].
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