Abstract
BackgroundTo evaluate the association between diet and disease, the consideration of a whole diet has appeared to be more effective than the examination of single-nutrient intake. This study aimed to examine the relationship between dietary diversity score (DDS) and obesity in Iranian children.MethodsA cross-sectional study was conducted on 456 children aged 11–18 years, who were selected by random cluster sampling. The usual food intake for each participant assessed using a validated Food frequency questionnaire (FFQ). To calculate the dietary diversity score, food items were categorized into 5 broad groups and 23 subgroups based on the US Department of Agriculture Food Guide Pyramid. Participants were categorized based on the DDS tertile cut-off points. Anthropometric measurements were conducted based on standard protocols. Overweight and obesity were defined as 85th ≤ BMI < 95th, and ≥ 95th percentiles of BMI, respectively. Additionally, abdominal obesity was considered as WC ≥ 85th percentile.ResultsMean and standard deviation (SD) of subjects’ Body Mass Index (BMI) and waist circumference were 20.88 (SD 4.22) kg/m2 and 74.27 (SD 10.31) cm, respectively. The probability of overweight and obesity was increased as tertiles of DDS increased (OR among tertiles: 1.00, 1.82 and 2.13 for overweight and 1.00, 2.60 and 3.45 for obesity; this was the same for abdominal obesity: 1.00, 2.22 and 3.45, P < 0.001 for all). However, no statistically significant results were found after adjustment for energy intake.ConclusionDietary diversity positively affected obesity through higher energy intake. Despite the wide recommendation of having high dietary diversity, public health programs should emphasize to improve dietary diversity only in selective food items.
Highlights
To evaluate the association between diet and disease, the consideration of a whole diet has appeared to be more effective than the examination of single-nutrient intake
This study was conducted on a representative sample of Iranian school-aged children, and the results showed a positive association between dietary diversity score (DDS) and obesity via higher energy intake
The results of the present study showed a direct association between DDS and energy intake, which are in line with those of previous studies showing a positive association between DDS and energy intake [25, 26]
Summary
To evaluate the association between diet and disease, the consideration of a whole diet has appeared to be more effective than the examination of single-nutrient intake. Golpour-Hamedani et al BMC Endocrine Disorders (2020) 20:181 cancers * [5, 6] In addition to these long-term complications, childhood obesity results in inflammation and increased inflammatory markers, related to endothelial dysfunction, cardiovascular disease and metabolic syndrome [7]. The consumption of many nutrients, foods and food groups is associated with this health problem * [11]. Given their synergistic effects on health, and the possible interactions of food nutrients eating together [12], it is better to examine indices showing the overall dietary characteristics in relation to chronic disease * [13]. DDS is inversely associated with cardiovascular disease and metabolic syndrome * [15]
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