Associations Of Dietary Diversity Score Research Articles

Dietary diversity score and the acceleration of biological aging: a population-based study of 88,039 participants

ObjectivesOur study aimed to investigate the association of dietary diversity score (DDS), as reflected by five dietary categories, with biological age acceleration. DesignA cross-sectional study. Setting and participantsThis study included 88,039 individuals from the UK Biobank. MethodsBiological age (BA) was assessed using Klemerae-Doubal (KDM) and PhenoAge methods. The difference between BA and chronological age represents the age acceleration (AgeAccel), termed as “KDMAccel” and “PhenoAgeAccel”. AgeAccel > 0 indicates faster aging. Generalized linear regression models were performed to assess the associations of DDS with AgeAccel. Similar analyses were performed for the five dietary categories. ResultsAfter adjusting for multiple variables, DDS was inversely associated with KDMAccel (βHigh vs Low = −0.403, 95%CI: −0.492 to −0.314, P < 0.001) and PhenoAgeAccel (βHigh vs Low = −0.545, 95%CI: −0.641 to −0.450, P < 0.001). Each 1-point increment in the DDS was associated with a 4.4% lower risk of KDMAccel and a 5.6% lower risk of PhenoAgeAccel. The restricted cubic spline plots demonstrated a non-linear dose-response association between DDS and the risk of AgeAccel. The consumption of grains (βKDMAccel = −0.252, βPhenoAgeAccel = −0.197), vegetables (βKDMAccel = −0.044, βPhenoAgeAccel = −0.077) and fruits (βKDMAccel = −0.179, βPhenoAgeAccel = −0.219) was inversely associated with the two AgeAccel, while meat and protein alternatives (βKDMAccel = 0.091, βPhenoAgeAccel = 0.054) had a positive association (All P < 0.001). Stratified analysis revealed stronger accelerated aging effects in males, smokers, and drinkers. A strengthening trend in the association between DDS and AgeAccel as TDI quartiles increased was noted. ConclusionsThis study suggested that food consumption plays a role in aging process, and adherence to a higher diversity dietary is associated with the slowing down of the aging process.

Dietary Diversity and Mild Cognitive Impairment in Middle-Aged and Older Chinese People: A Cross-Sectional Study.

The evidence concerning dietary diversity and cognitive function remains insufficient. To investigate the association of dietary diversity score (DDS) with mild cognitive impairment (MCI) and cognitive performance in different domains. Data from The Lifestyle and Healthy Aging of Chinese Square Dancer Study was used in this study. DDS was constructed based on the intake frequencies of 9 food groups assessed by a validated food frequency questionnaire. MCI was diagnosed by Petersen's criteria. A neuropsychological test battery was used to assess the performance on cognitive domains, and test scores were standardized to Z scores. Multiple linear regression models and logistic regression models were used to estimate the β and odds ratios and their 95% CIs, respectively. Among 1,982 participants, the mean (SD) age was 63.37 (5.00) years, 1,778 (89.71%) were women, and 279 (14.08%) had MCI. Compared to the DDS quartile (0, 6], the multivariable-adjusted odds ratios (95% CI) were 0.74 (0.48, 1.15) for DDS quartile (6, 7], 0.65 (0.43, 0.97) for DDS quartile (7, 8], and 0.55 (0.37, 0.84) for DDS quartile (8, 9]. Furthermore, higher DDS was positively associated with better performance of cognitive domains, including global cognitive function (β= 0.20, 95% CI: 0.12, 0.30), episodic memory (β= 0.21, 95% CI: 0.07, 0.35), attention (β= 0.15, 95% CI: 0.03, 0.26), language fluency (β= 0.24, 95% CI: 0.10, 0.38), and executive function (β= - 0.24, 95% CI: - 0.38, - 0.10). This study indicated that higher DDS was associated with better cognitive function among middle-aged and older Chinese people.

The Association between Dietary Diversity Score and Risk of Prostate Cancer: (A Case-Control Study)

There are few studies that evaluated the relationship between dietary diversity score (DDS) and risk of cancer. The purpose of this study was to examine the association of DDS with the risk of prostate cancer (PC) among Iranian men. This case-control study was performed among 60 cases with prostate cancer and 60 hospital-based controls. Anthropometric measurements were done and demographic information was recorded using standard protocols. A validated 160-item semi-quantitative food frequency questionnaire (FFQ) was used to assess usual dietary intakes. Also, Binary logistic regression was performed to estimate the risk of PC in relation to DDS. After controlling for several confounders (age, body mass index, physical activity, energy intake, job, education, and antihypertensive drugs usage) higher adherence to DDS (OR = 0.33; 95% CI (0.11-0.97)), fruits group (OR = 0.19; 95% CI (0.06-0.63)), and vegetables group (OR = 0.17; 95% CI (0.05 − 0.58)) were significantly associated with lower risk of PC. In contrast, greater adherence to the meat group (OR = 3.88; 95% CI (1.32-11.42)) was significantly associated with increased PC risk. Our results showed that adherence to a diet with higher DDS, especially higher amounts of fruits and vegetables and a lower amount of meat could decrease the risk of PC.

Dietary diversity score and cardio-metabolic risk factors: an updated systematic review and meta-analysis.

Dietary diversity score (DDS) has been known as a useful and convenient indicator of overall diet quality. Previous studies have reported the association between DDS and health problems such as diabetes, metabolic syndrome and cardiovascular disease. This systematic review and meta-analysis aimed to assess the association between dietary diversity score (DDS) and cardio-metabolic risk factors such as obesity and overweight, lipid profile, blood pressure, metabolic syndrome (MetS) and diabetes. We systematically searched PubMed and NLM Gateway, Scopus and Institute of Scientific Information (ISI) by up to October 2019. All observational studies which assessed the association of DDS with cardio-metabolic risk factors including anthropometric measures, blood pressure, lipid profile, glycemic indices and MetS without limitation in time of publication and language were included and critically reviewed by two independent experts. Random-effects meta-analysis was used to estimate the effect sizes. Among 843 documents retrieved from literature search, 23 studies met the inclusion criteria for systematic review, and 18 studies were eligible for meta-analysis. Random-effects meta-analysis showed that the association of DDS with obesity, abdominal obesity, overweight, body mass index, MetS, diabetes, blood pressure, and lipid profile (TC, LDL, HDL) was not statistically significant. On the other hand, the association of DDS and TG was statistically significant (SMD: - 0.23, 95% CI - 0.45, - 0.01). Our findings revealed that there was no significant association between DDS and cardio-metabolic risk factors. Reassessment of the overall DDS tool as a criterion of diet quality and production of new and valid DDS standard tools is highly desirable. More high-quality studies are also needed to confirm the findings of this study. This study is registered as PROSPERO CRD42020157127. Level I, systematic reviews and meta-analyses.

Breastfeeding Rate, Food Supplementation, Dietary Diversity Among Children Aged 6-59 Months, and Associated Factors in Papua New Guinea.

Background: Along the socioeconomic changes in the past decades, Papua New Guinea (PNG) has undergone significant food transition. Little is known about the influence of household and maternal socioeconomic demographic factors on dietary intake and diversity among children under 5 years of age (CU5).Objective: This study aimed to examine breastfeeding rate, food supplementation, dietary intake, and diversity among children aged 6–59 months and to identify associations with household and maternal socioeconomic demographic factors in PNG.Method: Data from 2,943 children were extracted from the Comprehensive Health and Epidemiological Surveillance System database, operated by the PNG Institute of Medical Research and used to estimate breastfeeding rate, food supplementation, and dietary intake of CU5 in a typical week. Dietary diversity score (DDS) was used as a proxy indicator to measure nutrient adequacy. Associations of DDS with household and maternal socioeconomic and demographic factors were examined using multivariate logistic regression analysis.Result: The breastfeeding rate among children aged 6–8 months was 85% (70% in urban and 90% in rural sectors), and 50% of children of this age group were fed with supplementary foods. Twenty percent of children aged 6–23 months were currently breastfed and received solid, semisolid, and soft foods three times or more per day. Forty-eight percent of children aged 6–59 months had a total DDS below the average level (23 scores). Place of residence, mother's education, and household wealth were associated with dietary diversity among studied children. Children in urban areas are 10% more likely to have a lower level of total DDS than those in rural areas (OR: 1.11 [0.79–1.56]; p-value: 0.5). Children whose mothers had a primary education level were 1.6-fold more likely to have a lower level of total DDS than children whose mothers had vocational training or college education (OR: 1.63 [0.68–3.92]; p-value: 0.28). Children from the poorest households were 1.2-fold more likely to have a lower DDS than those from the richest households (OR: 1.22 [0.79–1.87]; p-value: 0.37).Discussion: A range of factors has been identified, contributing to the eating behaviors among CU5 in PNG, in which mother's education and household wealth are among the most important determinants of childhood dietary diversity as they have a direct effect on accessibility to and affordability of a variety of foods at the household level.Conclusion: Evidence-based integrated and comprehensive approaches are needed to improve women education and household wealth, contributing to the improvement of food diversity among young children in PNG.

Association of dietary diversity score (DDS) and migraine headache severity among women.

Migraine is an episodic disorder that is characterized by unilateral headache lasting 4-72h along with certain associated features. Modifying dietary habits have been considered an appropriate therapeutic approach in these patients. This study was designed to examine the association between dietary diversity score (DDS) and severity, frequency, and duration of migraine attacks. The present study was conducted using a cross-sectional design on 256 women 18-50years old referred to neurology clinics for the first time. After the diagnosis of migraine by a neurologist, the data related to anthropometric measures and dietary intake (147-item semi-quantitative food frequency questionnaire) were collected. To assess migraine severity, the migraine disability assessment questionnaire (MIDAS), visual analog scale (VAS), and a 30-day headache diary were used. Multinomial logistic regression was used to evaluate the association between DDS and migraine severity. The age, physical activity, BMI, and job were considered confounding variables in regression model. Data were analyzed using SPSS software and P values < 0.05 considered statistically significant. Totally, 256 subjects participated in the present study with mean age, height, weight, and BMI of 34.28 ± 7.88years, 161.78 ± 5.18cm, 69.25 ± 13.06kg, and 26.46 ± 4.89kg/m2, respectively. Subjects with higher DDS had a lower waist circumference (P = 0.01). There was no association between DDS and other anthropometric measures and demographic characteristics (P > 0.05). In the crude model of logistic regression, participants with lower DDS had higher odds of more pain severity (OR = 2.30; 95% CI = 1.28, 4.12; P = 0.005), migraine disability (OR = 2.66; 95% CI = 1.51, 4.69; P = 0.001), and headache duration (OR = 2.32; CI = 1.22, 4.40; P = 0.01) compared to reference group. No association was found between headache frequency and DDS. Adjusting for the effect of confounding variables did not change the significant association. DDS was inversely associated with migraine disability, pain severity, and headache frequency. Additional studies are needed to replicate these findings and to explore mechanisms that mediate the association between DDS and migraine attacks.

Association of food security and other socio-economic factors with dietary diversity and nutritional statuses of children aged 6-59 months in rural Bangladesh.

IntroductionDietary diversity score (DDS) is a proxy indicator for measuring nutrient adequacy. In this study, we aimed to identify the nutritional statuses and current patterns of DDS among children between 6–59 months old and their associations with different individual and household level factors in rural Bangladesh.MethodsThe Nobokoli programme of World Vision Bangladesh was implemented in Mymensingh, Sherpur, Rangpur, Dinajpur, Thakurgaon, Panchagar, and Nilphamari districts of Bangladesh between 2014 and 2017. A cross-sectional community household survey was administered between July and October 2014 to collect baseline data to evaluate the Nobokoli programme. A total of 6,468 children between 6–59 months old were included in the final analysis. Anthropometric data was collected following WHO guidelines on using wooden height and digital weight scales. We collected food intake information for the past 24 hours of the survey. The WHO’s child growth standard medians were used to identify the nutritional indices of stunting, wasting, and underweight. Food items consumed were categorized into nine food groups and the DDS was constructed by counting the consumption of food items across these groups during the preceding 24 hour period. The association of DDS and nutritional status (stunting, wasting and underweight) with sociodemographic factors and household food security status were examined using multivariable models; linear regression and logistics regression respectively.ResultsThe prevalence of stunting, wasting and underweight among children aged 6-59months were 36.8%, 18.2% and 37.7% respectively. Our findings revealed that almost all children ate any form of starch followed by consumption of milk or milk products (76%) and fleshy meat /fish (61%) respectively. The mean DDS among children was 3.93(sd 1.47). Forty percent of the children obtained a DDS score less than 4. Multivariable analysis suggested that children whose mothers had higher educational attainment and are skilled workers had higher DDS (15% and 48% respectively) compared to their counterparts. The DDS showed strong positive association with household wealth status. Children from food secure households had 26% higher DDS compared to children from food insecure households. Similarly, increasing maternal education and household wealth were found to be protective against childhood stunting and undernutrition.DiscussionOur findings reiterate the need for improving household socioeconomic factors and household food security status for improving dietary diversity practices and nutritional status of children. Evidence-based solutions are needed to be implemented and expanded at scale to ensure appropriate dietary practices and improve nutritional status of the children in local context.

A case-control study on dietary quality indices and glioma.

No study is available that has assessed the association of dietary diversity score (DDS) and alternative healthy eating index (AHEI) with glioma. The present study aimed to assess this association in Iranian adults. Overall, 128 pathologically confirmed cases of glioma were enrolled from hospitals and 256 age- and sex-matched controls were recruited from other wards of the hospital between 2009 and 2011. Dietary assessment was done using a validated block-format 123-item semi-quantitative FFQ. Dietary indices including DDS and AHEI-2010 were constructed according to standard methods. After controlling for potential confounders, a significant inverse association was found between DDS and risk of glioma (OR 0·42, 95 % CI 0·19, 0·94). Such finding was also seen when further adjustment was made for BMI; such that participants in the highest quartile of DDS were 56 % less likely to have glioma compared with those in the lowest quartile (OR 0·44, 95 % CI, 0·20, 0·97). In addition, a significant inverse association was found between adherence to AHEI and glioma; such that in the fully adjusted model, participants in the fourth quartile of AHEI had 74 % lower risk of glioma compared with those in the first quartile (OR 0·26, 95 % CI 0·12, 0·56). In conclusion, we found that greater adherence to the healthy, as measured by AHEI, and diverse, as measured by DDS, diets was associated with decreased odds of glioma.

Association of Dietary Diversity with Health-related Quality of Life and Osteosarcopenic Obesity in Korean Female Adults (P18-059-19)

ObjectivesThis study was conducted to evaluate the association of dietary diversity score with health-related quality of life and osteosarcopenic obesity in female aged 50 or older using data from the 2008∼2010 National Health and Nutrition Examination Survey (KNHANES). MethodsIn this cross-sectional study, a total of 4276 subjects (50∼64y: n = 2279, ≥65y: n = 1997) were classified according to dietary diversity score (DDS) (≥3 DDS, <3 DDS) using 24 h dietary recalls method. Body composition was evaluated using dual-energy X-ray absorptiometry (DXA) and health-related quality of life was assessed using EQ-5D (EuroQol five-dimension) index. Analysis was conducted by age-stratified groups: 50∼64 (≥3 DDS = 2070, <3 DDS = 209) and 65 (≥3 DDS = 1534, <3 DDS = 463) yrs or older. ResultsThe ≥3 DDS group had a larger proportion of subjects who were highly educated compared to <3 DDS group (P < 0.001). In the 65 yrs or older age group, age-adjusted means of EQ-5D index of ≥3 DDS group and <3 DDS group were 0.84 and 0.74, respectively and there was significant difference (P < 0.0001). However, in the 50∼64 yrs age group, no difference was observed in EQ-5D index according to the dietary diversity. The ≥3 DDS group had a larger proportion of subjects who had no osteosarcopenic obesity compared to <3 DDS group (P < 0.05). ConclusionsThese results suggest that the dietary diversity may be associated with a lower health-related quality of life and osteosarcopenic obesity in Korean female aged 50 years or older. Funding SourcesThis work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIP; Ministry of Science, ICT & Future Planning) (No. 2017R1C1B5017636).

Associations of Dietary Diversity Score, Obesity, and High-sensitivity C-reactive Protein with HbA1c

Background: Associations of dietary diversity score (DDS), obesity and high-sensitivity C-reactive protein (hs-CRP) with glucose metabolism have been reported. Furthermore, DDS may not be associated with healthy weight. However, studies on these topics are limited in general Indonesia population. Methods: A total of 3,825 Indonesia Family Life Survey 2014/2015 participants aged 20-59 years old were included in this study. DDS was measured qualitatively in five food groups: carbohydrates, proteins, dairy products, vegetables, and fruits. Obesity was defined by Body Mass Index (BMI) classification for Indonesians. Blood analyses were performed in dried blood spot specimens. hs-CRP were analyzed using enzyme-linked immunosorbent assay and HbA1c was analyzed using Bio-Rad D10. Results: High DDS group had higher HbA1c than low DDS group (p = 0.030). Furthermore, medium and high DDS group had higher BMI than low DDS group (p = 0.003 and < 0.001). Obese group had higher HbA1c than nonobese group (p < 0.001). hs-CRP was correlated with HbA1c (r = 0.1194; p < 0.001). Multivariate analysis showed that DDS, obesity and hs-CRP were associated with HbA1c (p = 0.030, p < 0.001 and < 0.001). Conclusions: Present study confirmed that obesity and hs-CRP are associated with HbA1c. DDS is positively associated with HbA1c and BMI. Promoting dietary diversity requires careful consideration. Moreover, further studies are warranted.

Association of dietary diversity score with anxiety in women

Evidence suggests that diet plays an important role in the development of mental disorders, especially anxiety. Dietary diversity score is an indicator for assessing diet quality. However, its association with anxiety has not been investigated. The aim of this study was to examine the association of dietary diversity score with anxiety. A cross-sectional study was conducted among 360 women attending health centers in the south of Tehran in 2014. General information among others were collected. Weight, height and waist circumference were measured and body mass index (BMI) was calculated. Dietary intake and anxiety score were assessed using a 24-h dietary recall and Depression, Anxiety, Stress Scales (DASS) questionnaires, respectively. Dietary diversity score was computed according to the guidelines of FAO. About 35% of the participants were found to exhibit anxiety. The dietary diversity score in 12.5% of the subjects were between 1 and 3 (low dietary diversity score) but 87.5% scored between 4 and 7 (high dietary diversity score). The adjusted mean of anxiety score in subjects with high dietary diversity score was significantly lower than those with low dietary diversity score. Dietary diversity score was found to be inversely associated with anxiety. However, the causality between anxiety and dietary diversity could not be determined.