High dietary diversity is associated with obesity in Sri Lankan adults: an evaluation of three dietary scores

Ranil Jayawardena,Andrew P Hills,Nuala M Byrne,Bijesh Yadav,Mario J Soares,Prasad Katulanda

doi:10.1186/1471-2458-13-314

Abstract

BackgroundDietary diversity is recognized as a key element of a high quality diet. However, diets that offer a greater variety of energy-dense foods could increase food intake and body weight. The aim of this study was to explore association of diet diversity with obesity in Sri Lankan adults.MethodsSix hundred adults aged > 18 years were randomly selected by using multi-stage stratified sample. Dietary intake assessment was undertaken by a 24 hour dietary recall. Three dietary scores, Dietary Diversity Score (DDS), Dietary Diversity Score with Portions (DDSP) and Food Variety Score (FVS) were calculated. Body mass index (BMI) ≥ 25 kg.m-2 is defined as obese and Asian waist circumference cut-offs were used diagnosed abdominal obesity.ResultsMean of DDS for men and women were 6.23 and 6.50 (p=0.06), while DDSP was 3.26 and 3.17 respectively (p=0.24). FVS values were significantly different between men and women 9.55 and 10.24 (p=0.002). Dietary diversity among Sri Lankan adults was significantly associated with gender, residency, ethnicity, education level but not with diabetes status. As dietary scores increased, the percentage consumption was increased in most of food groups except starches. Obese and abdominal obese adults had the highest DDS compared to non obese groups (p<0.05). With increased dietary diversity the level of BMI, waist circumference and energy consumption was significantly increased in this population.ConclusionOur data suggests that dietary diversity is positively associated with several socio-demographic characteristics and obesity among Sri Lankan adults. Although high dietary diversity is widely recommended, public health messages should emphasize to improve dietary diversity in selective food items.

Highlights

Dietary diversity is recognized as a key element of a high quality diet
People living in the estate areas had the lowest Dietary Diversity Score (DDS), Dietary Diversity Score with Portions (DDSP) and Food Variety Score (FVS) compared to both urban and rural
Sri Lankan adults had relatively low dietary diversity values, in relatively higher FVS and DDS and lower DDSP value indicates that people consume several type of food items, the amount of consumption is low for many food groups

Summary

Introduction

Dietary diversity is recognized as a key element of a high quality diet. Dietary diversity and variety have long been recognized as key elements of high quality diets. Sri Lanka is a low-middle income country with undergoing rapid epidemiological and nutritional transition. Despite nutritional deficiencies such as iron deficiency anemia, vitamin A deficiency and protein energy malnutrition are reported in some segment of the Sri Lankan population [9], Non-Communicable Diseases (NCDs) are emerging as the major diet associated health problem in Sri Lanka. The prevalence of obesity related metabolic problems such as diabetes and hypertention among Sri Lankan adults were 13–14% and 18–19% respectively [13]. In Sri Lanka, diet-related chronic diseases currently account for 18.3% of all deaths and 16.7% of hospital expenditure [14]

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