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At least 19 recordsLinked to original sources
PubMed2006

New Quantitative Index for Dietary Diversity (QUANTIDD) and its annual changes in the Japanese.

OBJECTIVE: A diverse diet is recommended in many dietary guidelines. However, because there are no unified standards for measurement methods, objective comparisons across different populations or time points is difficult. This report proposes a new dietary diversity index based on quantitative distribution of consumed foods to allow objective measurement of dietary diversity. METHODS: A Quantitative Index for Dietary Diversity (QUANTIDD) is proposed: QUANTIDD=(1-summation operatorjn prop[j]2)/(1-1/n), where prop(j) is the proportion of food group(s) j that contributes to total energy or nutrient intake, n is the number of food groups, and j = 1,2,...,n. The numerator is the probability that the two foods taken out of an aggregation of consumed foods belong to different food groups. The denominator is its maximum value. The index ranges from 0 to 1. By using the officially released average data from the National Nutrition Survey in Japan from 1957 to 2000, we investigated annual changes in the QUANTIDD. We also investigated the distribution of the index by using individual data from the National Nutrition Survey in Japan in 1996. RESULTS: The QUANTIDD increased from the 1960s to the 1970s. This was the era of rapid economic growth in Japan, during which the dietary habits of the Japanese underwent rapid changes. The distribution of the QUANTIDD was skewed to the left, but logit-transformation decreased this asymmetry and made it similar to a normal distribution. CONCLUSION: Because this index can measure dietary diversity objectively and is suitable for statistical handling, it is useful as a method to compare dietary patterns across different populations or time points.

Databases, Factual↗
PubMed2004

Dietary diversity is associated with child nutritional status: evidence from 11 demographic and health surveys.

Simple indicators reflecting diet quality for young children are needed both for programs and in some research contexts. Measures of dietary diversity are relatively simple and were shown to be associated with nutrient adequacy and nutritional status. However, dietary diversity also tends to increase with income and wealth; thus, the association between dietary diversity and child nutrition may be confounded by socioeconomic factors. We used data from 11 recent Demographic and Health Surveys (DHS) to examine the association between dietary diversity and height-for-age Z-scores (HAZ) for children 6-23 mo old, while controlling for household wealth/welfare and several other potentially confounding factors. Bivariate associations between dietary diversity and HAZ were observed in 9 of the 11 countries. Dietary diversity remained significant as a main effect in 7 countries in multivariate models, and interacted significantly with other factors (e.g., child age, breast-feeding status, urban/rural location) in 3 of the 4 remaining countries. Thus, dietary diversity was significantly associated with HAZ, either as a main effect or in an interaction, in all but one of the countries analyzed. These findings suggest that there is an association between child dietary diversity and nutritional status that is independent of socioeconomic factors, and that dietary diversity may indeed reflect diet quality. Before dietary diversity can be recommended for widespread use as an indicator of diet quality, additional research is required to confirm and clarify relations between various dietary diversity indicators and nutrient intake, adequacy, and density, for children with differing dietary patterns.

Africa↗
PubMed2006

Food variety and dietary diversity scores in children: are they good indicators of dietary adequacy?

OBJECTIVE: To assess whether a food variety score (FVS) and/or a dietary diversity score (DDS) are good indicators of nutrient adequacy of the diet of South African children. METHODS: Secondary data analyses were undertaken with nationally representative data of 1-8-year-old children (n = 2200) studied in the National Food Consumption Study in 1999. An average FVS (mean number of different food items consumed from all possible items eaten) and DDS (mean number of food groups out of nine possible groups) were calculated. A nutrient adequacy ratio (NAR) is the ratio of a subject's nutrient intake to the estimated average requirement calculated using the Food and Agriculture Organization/World Health Organization (2002) recommended nutrient intakes for children. The mean adequacy ratio (MAR) was calculated as the sum of NARs for all evaluated nutrients divided by the number of nutrients evaluated, expressed as a percentage. MAR was used as a composite indicator for micronutrient adequacy. Pearson correlation coefficients between FVS, DDS and MAR were calculated and also evaluated for sensitivity and specificity, with MAR taken as the ideal standard of adequate intake. The relationships between MAR and DDS and between anthropometric Z-scores and DDS were also evaluated. RESULTS: The children had a mean FVS of 5.5 (standard deviation (SD) 2.5) and a mean DDS of 3.6 (SD 1.4). The mean MAR (ideal = 100%) was 50%, and was lowest (45%) in the 7-8-year-old group. The items with the highest frequency of consumption were from the cereal, roots and tuber group (99.6%), followed by the 'other group' (87.6%) comprising items such as tea, sugar, jam and sweets. The dairy group was consumed by 55.8%, meat group by 54.1%, fats by 38.9%, other vegetables by 30.8%, vitamin-A-rich by 23.8%, other fruit by 22%, legumes and nuts by 19.7% and eggs by 13.3%. There was a high correlation between MAR and both FVS (r = 0.726; P < 0.0001) and DDS (r = 0.657; P < 0.0001), indicating that either FVS or DDS can be used as an indicator of the micronutrient adequacy of the diet. Furthermore, MAR, DDS and FVS showed significant correlations with height-for-age and weight-for-age Z-scores, indicating a strong relationship between dietary diversity and indicators of child growth. A DDS of 4 and an FVS of 6 were shown to be the best indicators of MAR less than 50%, since they provided the best sensitivity and specificity. CONCLUSION: Either FVS or DDS can be used as a simple and quick indicator of the micronutrient adequacy of the diet.

Age Distribution↗
PubMed2006

Dietary diversity within food groups: an indicator of specific nutrient adequacy in Tehranian women.

OBJECTIVE: To determine the relationship between dietary diversity within food groups and dietary diversity score and the probability of nutrient adequacy in Tehranian women. DESIGN: Cross-sectional study assessing food intake by two 24-hour recalls questionnaires on two different occasions. Dietary diversity was defined according to diet quality index revised. The mean probability of adequacy across 14 nutrients was calculated using the Dietary Reference Intakes. SETTING: District 13 of Tehran, Iran. SUBJECTS: 286 females aged 18-80 years. RESULTS: Whole grain diversity score mostly correlated with protein and vitamin B2 (r = 0.35, p < 0.05). Fruit diversity score was correlated with vitamin C (r = 0.44, p < 0.05). Dairy diversity score was correlated with calcium intake (r = 0.54, p < 0.05). Meat diversity score was correlated with protein intake (r = 0.34, p < 0.05). Most subjects failed to meet vitamin B6, zinc, magnesium, calcium, copper, and vitamin B12 adequacy. Energy intake was a strong predictor of the mean probability of adequacy in models controlled for age, BMI, education level and job status (model R2 = 0.53). Adding the number of servings from each of the food group to the models significantly improved the model fit (model R(2) = 0.59). Adding the dietary diversity score improved the model fit significantly (model R2 = 0.64). Dairy diversity score had the strongest association with improved nutrient adequacy. CONCLUSION: Dietary diversity score is a useful indicator of specific nutrient adequacy in Tehranian women. However, to determine the adequacy of a specific nutrient, the diversity scores of specific food groups might be taken into account.

Adolescent↗
PubMed2003

[Dietary diversity and associated factors among beneficiaries of 77 child care centers: Central Regional, Venezuela].

The aim of this study was to estimate household measure diet quality, using a dietary diversity score, and its associated demographic and socio-economic factors. One hundred fifty three households representatives of the Capital District and Miranda State belonging of seventy seven day care children centers were studied. To gather data on dietary diversity, we used the food register method, collecting data on household food availability during a month. Dietary diversity at day care centers of the Capital District was 46 foods differed from that found, in Miranda State was 39 foods (p = 0.005). Likewise it differed in beneficiaries' households of the Capital District was 33 foods compared to those in Miranda State was 25 foods (p = 0.000). There were 13 and 14 foods more between day care centers and the households in both states. State (Capital District or Miranda), money spent on food per person, households size and social level were variables that explained 28.9% of dietary diversity variation in households studied. Households in the Capital District had less members, spent more money on food, and a greater proportion were non-poor compared to those in Miranda. These factors could partially explain differences in diet quality among households in the two States. Whatever perspective studied indicates that the dietary diversity had a statistically significant difference between day care centers and households in states studied. Miranda State was more deficiency than Capital District. Higher dietary diversity reflects a better quality diet at day care centers compared to households studied.

Child↗
PubMed2004

Dietary diversity score in adolescents - a good indicator of the nutritional adequacy of diets: Tehran lipid and glucose study.

The purpose of this study was to determine dietary diversity and its relation to dietary adequacy in 10-18 year-old adolescents of district 13 of Tehran during the period 1999-2001. After excluding for over and under reporters, dietary intake assessment was conducted on 304, 10-18 year old individuals, participants of Tehran Lipid and Glucose Study. A dietary diversity score was calculated as part of the pyramid serving database that is categorized into 23 broad food groups. Each of the 5 broad food categories received a maximum diversity score of 2 of the 10 possible score points. To be counted as a "consumer " for any of the food groups categories, a respondent needed to consume one-half serving, as defined by Food Guide Pyramid quantity criteria, at any time during a 2-day survey period. The nutrient adequacy ratio for a given nutrient is the ratio of a subject's intake to the current recommended allowance for the subject's sex and age category. Weight and height were measured and BMI was calculated. Student's t-test was used to compare the means. Those variables which had normal distribution were tested by Pearson correlation coefficient and the others were tested by the Spearman correlation coefficient. Mean +/-SD of dietary diversity score (DDS) was 6.25 +/- 1.08 (range 0-10). The maximum and minimum scores of dietary diversity were related to the fruit (1.46+/-0.61) and bread-grain (0.95+/-0.27) groups, respectively. Significant positive correlation was observed between DDS and the mean adequacy ratio (MAR) (r =0.42, P <0.001). Fifty percent of people had DDS >or = 6. In people with a DDS of six or over, BMI was higher (19.81 +/- 4.08vs18.95+/- 3.30 Kg/m(2), P<0.01) than others. There was a significant and positive correlation between DDS and most of the nutrient adequacy ratios (NARs). It is concluded that DDS is an appropriate method to evaluate nutrient intake adequacy in this group of adolescents.

Adolescent↗
PubMed2004

Nutrient adequacy and dietary diversity in rural Mali: association and determinants.

OBJECTIVE: To examine the association between nutrient adequacy and dietary diversity, and to assess and compare the determinants for the two constructs in an adult population in rural Mali. DESIGN: Cross-sectional study assessing food intake by a validated 7-day quantitative food frequency questionnaire. Two different dietary diversity indexes were created: food variety score (FVS), a simple count of food items, and diet diversity score (DDS) a count of food groups. Mean adequacy ratio, the mean ratio of intake to recommended intake (each truncated at one) of energy and nine nutrients, was calculated as an indicator of nutrient adequacy. Information on household and individual characteristics, including demography, socioeconomic conditions and food production strategies was obtained using precoded questionnaires. SETTING: Bafoulabé district, Kayes region, Western Mali. SUBJECTS: In total, 502 subjects (55% women) aged 15-45 y from 319 different households. RESULTS: Both FVS and DDS had a positive correlation with mean adequacy ratio (MAR). Multivariate analysis (linear regression) showed that the most important factors explaining MAR was the number of milk products, vegetables and green leaves consumed, as well as sex and the number of crops produced in the household. Dietary diversity was associated with socioeconomic status, residence and age. CONCLUSION: Dietary diversity is useful as an indicator of nutrient adequacy. It is important to examine how various food groups contribute to the nutrient adequacy of the diet in an area.

Adolescent↗
PubMed2007

Measuring dietary diversity in rural Burkina Faso: comparison of a 1-day and a 3-day dietary recall.

OBJECTIVES: To compare dietary diversity scores measured over a 1-day and a 3-day period, and to assess their relationships with socio-economic characteristics and the nutritional status of rural African women. DESIGN: A qualitative dietary recall allowed calculation of a dietary diversity score (DDS; number of food groups consumed out of a total of nine). Body mass index (BMI) and body fat percentage (BFP) were used to assess the nutritional status of women. SETTING AND SUBJECTS: A representative sample of 550 mothers in north-east Burkina Faso. RESULTS: The DDS increased from 3.5 to 4.4 when calculated from a 1-day or a 3-day recall (P < 0.0001), although for the latter the DDS was affected by memory bias. The DDS calculated from a 1-day recall was higher when a market day occurred during the recall period. Both scores were linked to the sociodemographic and economic characteristics of the women. Women in the lowest DDS tertile calculated from the 1-day recall had a mean BMI of 20.5 kg m-(2) and 17.7% of them were underweight, versus 21.6 kg m (-2) and 3.5% for those in the highest tertile (P = 0.0003 and 0.0007, respectively). The DDS calculated from the 1-day recall was also linked to mean BFP; all these links remained significant after adjustment for confounders. For the 3-day period, no such relationships were found to be significant after adjustment. CONCLUSION: The DDS calculated from a 1-day dietary recall was sufficient to predict the women's nutritional status. In such a context attention should be paid to market days.

Adolescent↗
PubMed2003

Operationalizing dietary diversity: a review of measurement issues and research priorities.

Dietary diversity (DD) is universally recognized as a key component of healthy diets. There is still, however, a lack of consensus on how to measure and operationalize DD. This article reviews published literature on DD, with a focus on the conceptual and operational issues related to its measurement in developing countries. Findings from studies of the association between DD and individual nutrient adequacy, child growth and/or household socioeconomic factors are summarized. DD is usually measured using a simple count of foods or food groups over a given reference period, but a number of different groupings, classification systems and reference periods have been used. This limits comparability and generalizability of findings. The few studies that have validated DD against nutrient adequacy in developing countries confirm the well-documented positive association observed in developed countries. A consistent positive association between dietary diversity and child growth is also found in a number of countries. Evidence from a multicountry analysis suggests that household-level DD diversity is strongly associated with household per capita income and energy availability, suggesting that DD could be a useful indicator of food security. The nutritional contribution of animal foods to nutrient adequacy is indisputable, but the independent role of animal foods relative to overall dietary quality for child growth and nutrition remains poorly understood. DD is clearly a promising measurement tool, but additional research is required to improve and harmonize measurement approaches and indicators. Validation studies are also needed to test the usefulness of DD indicators for various purposes and in different contexts.

Cultural Diversity↗
PubMed2006

Dietary diversity scores and nutritional status of women change during the seasonal food shortage in rural Burkina Faso.

In developing countries, dietary diversity is usually assessed during a single yearly period and the effects of seasonal variations remain unknown. We studied these variations in women living in a Sahelian rural area (Burkina Faso). A representative sample of 550 women was surveyed at the beginning and at the end of the seasonal cereal shortage in April and September 2003, respectively. For each season, a dietary diversity score (DDS) representing the number of food groups consumed over a 24-h period, was computed and nutritional status was assessed by the BMI. The DDS increased from 3.4 +/- 1.1 to 3.8 +/- 1.5 food groups between the beginning and the end of the shortage season (P < 0.0001), and the proportion of women exhibiting low DDS decreased from 31.6 to 8.1%. This was due to the consumption of foods available during the cereal shortage season and despite the decrease in the consumption of some purchased foods. The increase in DDS was lower in women for whom DDS was already high in April and vice versa. Over the same period, the percentage of underweight women (BMI <18.5 kg/m(2)) increased from 11.1 to 17.1%. The relation between DDS and the women's socioeconomic characteristics or nutritional status was weakened in September. Thus, in April, fewer women were underweight when their DDS was high than when it was medium or low [odds ratio = 0.3 (0.2; 0.6)], but not in September [odds ratio = 0.6 (0.3; 1.0)]. In such a context, it would be useful to measure dietary diversity at the beginning of the cereal shortage season, when many women exhibit low DDS.

Adult↗
PubMed2006

Dietary diversity score and cardiovascular risk factors in Tehranian adults.

AIM: To evaluate the relationship between dietary diversity score (DDS) and cardiovascular risk factors in Tehranian adults. METHODS: In this population-based cross-sectional study, a representative sample of 581 subjects (295 males and 286 females) aged over 18 years, residents of Tehran, participated. Hypercholesterolaemia, hypertriglyceridaemia and low high-density lipoprotein cholesterol were defined according to the Adult Treatment Panel III guidelines of the National Cholesterol Education Program. Diabetes was defined as fasting plasma glucose concentration > or = 126 mg dl(-1) or 2-h post challenge glucose concentration > or = 200 mg dl(-1). Hypertension was defined on the basis of the sixth report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. Dietary diversity was defined according to the Diet Quality Index revised. RESULTS: Mean (+/- standard deviation) DDS was 6.15 +/- 1.02. The probability of having diabetes (odds ratio (OR) among quartiles: 1.45, 1.26, 1.11 and 1.00, respectively; P for trend = 0.04) and hypertriglyceridaemia (OR = 1.41, 1.23, 1.05 and 1.00, respectively; P for trend=0.04) decreased with increasing quartile of the diversity score for whole grains. The probability of having obesity (OR among quartiles: 1.39, 1.06, 1.03 and 1.00, respectively; P for trend = 0.03), hypercholesterolaemia (OR = 1.46, 1.28, 1.11 and 1.00, respectively; P for trend = 0.03), hypertension (OR = 1.32, 1.17, 1.13 and 1.00, respectively; P for trend = 0.03) and high low-density lipoprotein cholesterol (LDL-C) (OR = 1.25, 1.12, 1.07 and 1.00, respectively; P for trend = 0.04) decreased with increasing quartile of the diversity score for vegetables. The probability of having hypercholesterolaemia, high LDL-C, hypertension and diabetes decreased with quartile of the DDS. But the probability of being obese increased with quartile of the DDS (P for trend = 0.03). CONCLUSION: DDS was inversely associated with cardiovascular risk factors in this cross-sectional study. Increased diversity scores of diets, to increase the variety score for vegetables, may be emphasised in programmes attempting to bring about changes in lifestyle.

Adult↗
PubMed1996

Diet quality and dietary diversity in France: implications for the French paradox.

OBJECTIVES: Assessing the quality of the total diet is a relatively new focus of studies in nutritional epidemiology. New indexes of healthful eating patterns have been largely limited to US populations. This study used evaluative criteria developed in the United States to assess diet quality and dietary diversity of French adults. METHODS: Habitual dietary intakes of a representative sample of 837 adults (361 men and 476 women) in the Val-de-Marne Dèpartement were evaluated. Evaluative measures of diet quality included a modified diet quality index (DQI), a dietary diversity (DD) score, and a dietary variety score (DVS). The 5-point DQI assessed compliance with the key guidelines of the US Department of Agriculture (USDA) for healthy people. The DD score counted the number of major food groups consumed whereas the DVS counted the total number of foods consumed on a regular basis. RESULTS: Few French adults consumed diets consistent with the USDA dietary recommendations. Only 14% of respondents derived less than 30% of energy from fat and only 4% derived less than 10% of energy from saturated fat. As a result, 63% of the sample had DQI scores of either 0 or I. In contrast, close to 90% of respondents scored a maximum of 5 in DD. Persons whose diets met US dietary recommendations also had the lowest DVSs. CONCLUSIONS: Methodologic factors and cultural biases may account for some of the observed differences between French and US data. Nevertheless, studies of diet quality and diversity are a promising new approach to the study of the total diet and associated health outcomes and may provide new insight into the French paradox.

Adolescent↗
PubMed1993

Dietary diversity and subsequent mortality in the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study.

We examined the relation of dietary diversity to subsequent all-cause mortality by using data from the First National Health and Nutrition Examination Survey (NHANES I) Epidemiologic Follow-up Study, 1982-1987. The analytic cohort consisted of 4160 men and 6264 women (including 2556 deaths), 25-74 y at baseline (1971-1975). Twenty-four-hour dietary recalls were evaluated for variety among the five major food groups: dairy, meat, grain, fruit, and vegetable, with a dietary diversity score (DDS); consumption of each food group contributed 1 point to a maximum possible DDS of 5. Age-adjusted risk of mortality was inversely related to DDS (P < or = 0.0009) in men and women. The inverse diversity-mortality association was adjusted for potential confounders: education, race, smoking status, and dietary fiber intake; the relative risk of mortality in men and women consuming two or fewer food groups was 1.5 (95% CI 1.2-1.8) and 1.4 (95% CI 1.1-1.9), respectively. In conclusion, diets that omitted several food groups were associated with an increased risk of mortality.

Adult↗
PubMed2005

Dietary diversity score is favorably associated with the metabolic syndrome in Tehranian adults.

OBJECTIVE: Assessing overall diet instead of the effects of a single nutrient on diet-disease relations may be more informative. This study was conducted to evaluate the relationship between dietary diversity score (DDS) and metabolic syndrome in Tehranian adults. DESIGN: Cross-sectional study. SUBJECTS: A representative sample of 581 healthy subjects aged over 18 y selected randomly from among participants of the Tehran Lipid and Glucose Study. MEASUREMENTS: Usual dietary intake was assessed using a validated semi quantitative food frequency questionnaire. DDS was calculated based on scoring to the five-food group. The DDS range was 0-10. Weight and height were measured according to standard protocols and body mass index (BMI) was calculated. Fasting blood samples were taken for biochemical measurements and blood pressure was assessed according to standard methods. Metabolic syndrome was defined according to ATPIII. Subjects were categorized based on quartile cut-points of DDS. RESULTS: Means (+/-s.d.) of age and BMI were 37+/-12 y and 25.7+/-4.3 kg/m(2), respectively. Mean (+/-s.d.) of DDS was 6.15+/-1.02. The probability of having metabolic syndrome decreased with quartiles of DDS (odds ratios among quartiles: 1.00, 0.82, 0.76, 0.70, P<0.05, and odds ratios among quartiles after further adjustment for BMI: 1.00, 0.88, 0.80, 0.77, P<0.05). After controlling for confounders, a significantly decreasing trend was observed for the risk of having high blood pressure, impaired glucose homeostasis and high triglyceride levels. CONCLUSION: DDS had inverse association with metabolic syndrome and some of its features in this cross-sectional study. A higher dietary diversity, therefore, might be associated with lower possibility of having some metabolic disorders.

Adult↗
PubMed1995

Dietary diversity and subsequent cause-specific mortality in the NHANES I epidemiologic follow-up study.

OBJECTIVES: Human diets tend to be complex mixtures of foods and nutrients. Therefore, we examined the relation of a measure of overall diet quality (independent of intake of individual foods or nutrients) with mortality from cardiovascular disease (CVD), cancer, and non-CVD, non-cancer (other) causes. METHODS: We used data from the NHANES I Epidemiologic follow-up study (n = 10,337; median follow-up time = 14 years; age 25-74 years at baseline), and included 988 CVD, 571 cancer, and 910 other cases. The 24-hour dietary recalls obtained at baseline were scored for quality using a dietary diversity score (DDS). The DDS (range 0-5) counts the number of major food groups--dairy, meat, grain, fruit, and vegetable consumed daily. RESULTS: Age-adjusted risk of mortality from all three causes (except cancer in women) was inversely related with DDS in both men and women. Adjustment for multiple covariates attenuated the relative risk estimates slightly for CVD and cancer mortality, but markedly for other mortality. CONCLUSIONS: The results are suggestive of an increased risk of CVD and cancer mortality associated with diets characterized by omission of several major food groups.

Adult↗
PubMed2005

Predictors of food variety and dietary diversity among older persons in Botswana.

OBJECTIVE: We investigated whether food variety and diversity are associated with physical and cognitive functioning in older adults in Botswana and designed a simple set of screening questions that predict food variety in this population. METHODS: Data were collected (1998) as a national household survey of 1085 subjects 60 y and older. A food variety score, based on a food frequency checklist, was calculated by summing the frequency of weekly intakes of 16 food items (0 to 66). A dietary diversity score was calculated as the number of food groups consumed weekly (0 to 5). A representative subsample (n = 393) was randomly selected for the clinical component of the survey, and measurements on dependency and cognitive function were conducted. RESULTS: Low food variety was found: 35.2%, 59.3%, and 22.4% of subjects consumed no dairy products, fruits, and vegetables, respectively. A higher food variety score was associated with urban residence, ownership of cattle, higher education, and more frequent meals, and these indicators were used to construct a nutritional risk indicator. Higher food variety score was associated with better self-reported health and better cognitive function. Similarly, a higher score on the nutritional risk indicator screening tool was associated with desirable health outcomes. CONCLUSION: A limited number of foods is consumed, leading to an overall pattern of poor food variety. Higher food variety was associated with improved physical and cognitive functions. A screening tool that predicts food variety in this population has been developed and is recommended to be incorporated at a primary care level to identify older adults most at risk of a poor quality diet.

Aged↗