Association Of Dietary Diversity Research Articles

Association of dietary diversity and falls among Chinese people aged 65 years and above in 2018

To estimate the prevalence of falls and examine the association between the dietary diversity and falls among older Chinese adults. We used data from the 2018 Chinese Longitudinal Healthy Longevity Survey(CLHLS), a nationwide survey with 10 698 adults aged ≥65 years old in 23 provinces of China. Dietary diversity score(DDS) was constructed based on 11 items of a food frequency questionnaire. Participants were assigned into 4 groups(Q1, Q2, Q3 and Q4) according to the quartile of DDS. The outcome observed was the incidence of fall in the past year acquired by questionnaire. Multinomial logistic regression was used to examine the association between DDS and the risk of falls in the elderly. Among the 10 698 participants, 4686(43.8%) were male, and 6012(56.2%) were female, with a mean(SD) age of 85.03(11.8).6191(57.9%) of them were came from urban. Fall was reported by 22.9% of the 10698 participants. After adjustment for age, sex, ethnicity, educational background, marital status, residence, sufficient income, smoking, drinking, regular exercise, sleep duration, Precentral obesity and central obesity, vision impairment, disability, nervous system diseases, and arthritis diseases, compared to the Q1 of DDS, OR were 0.83(95% CI 0.74-0.94) for Q2, 0.85(95% CI 0.74-0.97) for Q3, and 0.76(95% CI 0.66-0.81) for Q4(P_(trend)<0.01). In addition, a significant association was observed between higher consumption of fresh vegetables, fresh fruits and beans, with lower risk of falls, OR were 0.76(95% CI 0.66-0.87), 0.81(95% CI 0.73-0.89) and 0.88(95% CI 0.80-0.96), respectively. A higher DDS was associated with a lower risk of falls in the Chinese aged 65 years and above.

Evidence on Milk Consumption and Production Linkages from Rural Bihar, India

BackgroundMilk is an important source of protein for many Indian households. However, milk intake is very low. Hence, it is necessary to examine production–consumption linkages of milk within the paradigm of accessibility, availability, and affordability. ObjectivesThis study examined linkages between milk consumption and production, accounting for sales and factors associated with production investments in rural Bihar, a major milk-producing state of India with very poor nutritional status. MethodsA panel of households from the Gaya and Nalanda districts of Bihar were surveyed: the first round in July and August 2019 (n = 2026 households) and the second round from December 2019 to January 2020 (n = 2001 households). Data were collected on household consumption, production, and sale of milk, as well as other foods. The study examines the consumption–production linkage of milk and the association of dietary diversity with consumption from own production, with households as the unit of analysis. Ordinary least square regression analysis of average monthly household milk consumption was used to identify factors associated with milk consumption, particularly milk production. ResultsThe median (Quartile 1, Quartile 3) per capita milk consumption per day was 83.3 (41.6, 166.6) mL in the milk-consuming households. Average monthly household milk consumption in liters was higher in milk-producing households [β: 7.1; 95% confidence interval (CI): 6.1, 8.1] than households relying on market purchases. Household milk consumption was higher in the third tertile of milk production than the first tertile of production (β: 14.3 L/wk; 95% CI: 12.1, 17.2) and lower in the highest tertile of household sale quantity (β: −8.8 L/wk in tertile 3, 95% CI: −12.7, −5) than the first tertile of household sale quantity of milk. ConclusionsThe study provides evidence that consumption of milk in rural households is associated with own production such that households with higher production consume more. However, sale preferences restrict the quantity of milk consumed in milk-producing households.

The association of the healthy food diversity index with the risk of non-alcoholic fatty liver disease among the adult population

Dietary diversity index is a useful evaluation index for examining the role of dietary pattern in predicting chronic diseases risk, including non-alcoholic fatty liver disease(NAFLD). In the present study, we aimed to examine the possible association of dietary diversity using US Healthy Food Diversity(US HFD) index and the NAFLD risk in Iranian adults. A total of 675 individuals (225 patients with NAFLD and 450 controls) aged 20-60 years were recruited for the current case-control study. Data on dietary intakes were determined using a validated food frequency questionnaire, and dietary diversity was calculated using the US HFD index. In patients with NAFLD, an ultrasound scan of the liver was used to detect NAFLD. Logistic regression models were used to estimate the odds ratios(ORs) and 95% confidence interval(CI) of NAFLD across tertiles of the US HFD index. Mean±SD age of the study population were 38.13±8.85 years. The median (interquartile) score of the US HFD index in patients with NAFLD and healthy subjects was 0.08(0.07-0.09) and 0.09(0.08-0.10), respectively. In the age and sex-adjusted model, the odds of NAFLD were considerably reduced across tertiles of the US HFD index (OR:0.48; 95%CI:0.32-0.72, Ptrend<0.001). Also, in the final model, after adjusting for age, sex, waist-to-hip ratio, smoking, physical activity, marital status, socioeconomic status, and energy intake, the odds of NAFLD were significantly reduced across tertiles US HFD index (OR:0.55; 95%CI:0.31-0.97, Ptrend<0.001). Furthermore, for each SD increase in the US HFD index, the odds of NAFLD are reduced by 23% (OR:0.77;95%CI:0.60-0.97,P-Value<0.001). Our findings revealed that greater adherence to dietary pattern with a high US HFD score, defined by higher intakes of fruits, vegetables, whole grains, legumes, nuts, low-fat dairy, seeds, soya products, and plant oils may be related to reducing the odds of NAFLD.

An Association of Dietary Diversity with the Nutritional Status of Cardiovascular Diseased Patients in the Private Tertiary Care Unit of District Peshawar

OBJECTIVES The aim of this study was to analyze the effect of socio-demographic and dietary intake patterns on the nutritional status of cardiovascular disease (CVD) patients and to determine the dietary diversity of the households. METHODOLOGY This cross-sectional study was conducted from May 2018 to June 2018 at the Rehman Medical Institute, Peshawar. Based on written consent, a sample of 250 adult CVD patients was selected through a convenient sampling method. The data was collected through a structured questionnaire containing demographic, anthropometry, biochemical, clinical data, and a dietary record. RESULTS In a sample of 250 patients mean age was 55.41±12.558. On the basis of BMI, almost 52.8% were overweight and 0.8% of the patients were obese. Overweight was the major trend among the patients where this tendency was more common in males (57.5%) as compared to females (41%). Diabetes and hypertension were the major complications among these patients. Daily and per week food frequency and dietary diversity scores showed high intake of meat, milk, saturated fats, high glycemic index fruits, intake of processed foods along with goodconsumption of vegetables. The regression coefficient of DDI showed whole milk, cream, meat and processed meat as a strong predictor of obesity, overweight and CVD. CONCLUSION The overall dietary diversity of the patients showed a trend toward western dietary patterns with a focus on meat, whole milk, and processed foods. Among the financially stable families of Khyber Pakhtunkhwa, this dietary trend may pose a serious health concern in the context of non -communicable diseases in this region and demand for nutrition education at all levels of the society.

Association of dietary diversity with all-cause mortality by body mass index in Japanese older adults: An age-specific prospective cohort study (NISSIN project).

Dietary diversity might reduce the risk of malnutrition, although it is also linked to obesity. We examined whether dietary diversity is associated with all-cause mortality in Japanese older adults based on their body mass index (BMI). The current study included 2944 people aged 64-65 years who participated in the New Integrated Suburban Seniority Investigation (NISSIN) project from 1996 to 2005. Dietary diversity was measured using the Food Variety Score (FVS), which calculates the frequency of all food items consumed daily using a self-administered food frequency questionnaire. Participants were divided into tertiles according to their FVS (first: low, second: middle, third: high). Multivariate adjusted hazard ratios with 95% confidence intervals were calculated using the Cox proportional hazard regression model. For the stratified analysis, BMI was used to divide the participants into three groups - lean (BMI <20), normal (BMI 20-24.9) and overweight/obese (BMI ≥25). Overall, 454 (30.7%) men and 222 (15.2%) women died over a median follow-up period of 16.6 years. No significant association was observed between FVS and all-cause mortality. However, when grouped by BMI, for the participants in the lean group, the multivariate adjusted hazard ratios were 0.56 (95% confidence interval 0.32-0.96) for the middle FVS and 0.50 (95% confidence interval 0.25-1.02) for the high FVS, compared with the low FVS (P for trend=0.059). In overweight/obese women, although not significant, total mortality was higher in the middle and high FVS. These findings show that dietary diversity should be promoted in lean older Japanese adults. Geriatr Gerontol Int 2022; 22: 736-744.

Association of Dietary Diversity With Growth Outcomes in Infants and Children Aged Under 5 Years: A Systematic Review

ObjectiveThis study aimed to present an overview of the association between dietary diversity (DDiv) and growth outcomes (stunting, wasting, and underweight) in children aged < 5 years. DesignThis systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Setting and ParticipantsPubMed, Scopus, Embase, Cochrane library, and Google Scholar databases were searched up to February, 2021, using relevant keywords as follows: “Dietary diversity or diet diversity or food diversity or diet variety or dietary variety or food variety,” “under-nutrition or stunting or wasting or underweight or nutritional status,” and “children or infants.” Original articles published in English were eligible for this review. Newcastle-Ottawa scales and the Cochrane Collaboration's tool were used to assess the quality and risk of bias of the articles. Main Outcome Measures, Analysis, and ResultsTotally, 81 articles (70 cross-sectional, 4 longitudinal cohort, 5 case-control, and 2 randomized controlled trials) were included in this review. Of the studies, 45 focused on infants and 36 on children aged < 5 years. The reviewed articles had good quality and low risk of bias (scores > 6). In infants, low DDiv was associated with stunting, wasting, and being underweight (79%, 57%, and 68% of the studies, respectively). Among children aged < 5 years, the association was observed in 75%, 56%, and 57% of the studies, respectively, for stunting, wasting, and underweight. Conclusions and ImplicationsThe findings indicate a possible association between low DDiv of infants and children aged < 5 years with stunting. However, this association remained uncertain with wasting and being underweight.

Association of dietary diversity and cognition in preschoolers in rural China

ObjectivesWe sought to investigate the cognition of preschoolers in rural China and examine the relationship between dietary diversity and cognition. MethodsWe performed a cross-sectional survey analysis. In 1334 preschoolers ages 3 to 5, from 26 preschools in two nationally designated poverty counties in Hunan Province in China, we calculated the dietary diversity score (DDS) using a 24-h recall method. To measure children's cognitive ability, we assessed the Working Memory Index and Verbal Comprehension Index on the Mandarin-language version of the Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition. Multiple linear regression models were used to estimate the association between DDS and cognitive test scores. ResultsA total of 22% of children had a Working Memory Index that was either extremely low or borderline, and 31% of children had a Verbal Comprehension Index that was either extremely low or borderline. The mean (± SD) DDS was 5.65 ± 1.30. Those preschoolers with medium DDS (5 or 6) or high DDS (7 to 9) scored higher on both Working Memory Index—respectively, mean difference (MD), 1.327; 95% confidence interval (CI), 0.246–3.901; and MD, 2.067, 95% CI, 0.261–4.641—and Verbal Comprehension Index—MD, 0.168; 95% CI, 0.072–2.135; and MD, 0.398; 95% CI, 0.032–2.137—than did those with low DDS (0 to 4). ConclusionsConsuming a more diverse diet may contribute to better cognition in preschoolers. Future research is needed to better understand the possible causal effect of dietary diversity on cognitive development.

Association of dietary diversity with uterine fibroids among urban premenopausal women in Shijiazhuang, China: A cross-sectional study.

Uterine fibroids (UFs) are the most common neoplasm affecting reproductive-age women. The purpose of the present study is to explore the association between dietary diversity and risk of UFs in a cross-sectional study of urban premenopausal women. A total of 248 urban premenopausal women with age of 20-45 were recruited in 3 randomly chosen hospitals in Shijiazhuang, China. Dietary diversity was assessed from food frequency intake data using dietary diversity score (DDS), Prime Diet Quality Score (PDQS) and food variety score (FVS). UFs were diagnosed by the methods of ultrasound, pelvic exam, or surgery. Binary logistic regression was used to estimate the relationship between dietary diversity and risk of UFs. 37 of the study subjects (14.9%) had UFs. Participants with a low education level and single marital status participants had a lower DDS and PDQS, respectively. After adjustment for confounding factors, a higher DDS 24 was associated with decreased UF risk (OR=0.22, 95% CI=0.05-1.01). Similar trends were observed for the plantbased FVS (ptrend=0.025). Carrot (OR=0.04, 95% CI=0.00-0.48) and kiwi fruit (OR=0.03, 95% CI=0.00-0.47) were also inversely associated with risk of UFs after adjustment for confounding factors. Multifarious food groups and the increase of variety of plant-based food, especially carrot and kiwi fruit, may be associated with the lower risk of UFs; they may play an important role in inhibiting the formation of UFs.

Association of dietary diversity with total mortality and major causes of mortality in the Japanese population: JPHC study.

Eating a variety of foods has been recommended in the dietary guidelines of many developed nations, as well as global dietary guidelines. We investigated the potential effect of dietary diversity on the risk of total mortality and major causes of mortality in a large-scale cohort study involving the Japanese population. From 1995 to 2012, 79,904 participants (37,240 men and 42,664 women) aged 45 to 74 years, without histories of ischemic heart disease, stroke, or cancer were followed-up for a median of 14.9 years. We used 133 food and beverage items listed on a 5-year follow-up food frequency questionnaire, and the daily frequency of consumption for each item (excluding five alcoholic beverages) was counted. Multivariable-adjusted Cox proportional hazards regression models were used to calculate hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) to compare the highest and lowest quintiles. An inverse association was identified between total dietary diversity and mortality rates in women (highest quintile HR: 0.81; 95% CI: 0.71, 0.92; p for trend = 0.002) but the same trend was not observed in men (highest quintile HR: 0.96; 95% CI: 0.87, 1.10; p for trend = 0.266). In addition, fruit diversity was associated with lower mortality rates in men (highest quintile HR: 0.87; 95% CI: 0.79, 0.95; p for trend = 0.006), whereas soy diversity was associated with lower mortality rates in women (highest quintile HR: 0.89; 95% CI: 0.79, 1.00; p for trend = 0.004). With regard to men, meat and fish diversity were associated with higher mortality rates (highest quintiles of meat and fish diversity HR: 1.15 [95% CI: 1.06, 1.25] and 1.12 [95% CI: 1.02, 1.22], respectively). These findings indicate that consuming a greater diversity of total foods and increasing the diversity of fruit and soy consumed have considerable public health implications.

The relationship of dietary diversity score with depression and anxiety among prenatal and post-partum women.

The objective of the study is to explore the relationship between the dietary diversity score (DDS) and anxiety and depression of perinatal women. The Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS) and the dietary recall questionnaire were used to measure the status of depression, anxiety and dietary diversity at T1 (first trimester), T2 (second trimester), T3 (third trimester) and T4 (post-partum). The association of dietary diversity and food groups with depression and anxiety status were estimated by linear and logistic regression models. The prevalence of depression and anxiety status were the highest at T1, which were 35.58% and 22.57%, respectively. Cross-sectional and longitudinal association of DDS with SDS and SAS was estimated by ordinary or multilevel linear or logistic model. In the cross-sectional analysis, high dietary status (>6) was negatively associated with depression status [T1: OR (95% CI) = 0.56 (0.46, 0.69); T2: 0.55 (0.36, 0.84); T3: 0.45 (0.31, 0.65); T4: 0.58 (0.34, 0.99)] and anxiety status [T1: OR (95% CI) = 0.70 (0.56, 0.88); T2: 0.42 (0.27, 0.65)]. In the longitudinal analysis, it was demonstrated that the DDS level was negatively associated with SDS [β(se) = -0.99 (0.09), P = <0.0001] and SAS scores [β(se) = -0.37 (0.08), P = <0.0001] throughout pregnancy. There was a negative relationship between some food groups and SDS or SAS scores at different periods. A negative relationship between DDS and depression as well as anxiety was found among prenatal and post-partum women.