Dietary diversity score and the incidence of chronic kidney disease in an agricultural Moroccan adults population

Abstract

Background. Healthy diet plays an important role in the management of chronic kidney disease (CKD) and in the prevention of related comorbidities. Dietary diversity score (DDS) is well recognized as an indicator for assessing diet quality and food security. However, its association with CKD has not been investigated. Objective. The aim of this study was to estimate the prevalence of CKD and to evaluate its association with DDS among a Moroccan adults from Sidi Bennour province. Materials and methods. A cross sectional study was conducted among 210 individuals. General information among others was collected. Weight, height and waist circumference were measured and body mass index (BMI) was calculated. Blood samples were collected and the serum creatinine was determined. Subsequent glomerular filtration rate (eGFR) was estimated by the modification of diet in renal disease (MDRD) formula and the chronic kidney disease was defined by an eGFR<60 ml/min/1.73m². Dietary intake was assessed using a 24-hours dietary recall, and DDS was computed according to the FAO guidelines. Results. The participants mean age was 54.18±13.45 years, with a sex ratio of 0.38 and 4.4% as the prevalence of chronic kidney disease. The dietary diversity score was lower than 3 (lowest DDS) in 14.4% of the subjects, between 4 and 5 (medium DDS) in 72.5% and higher than 6 (high DDS) in 13.1% of the subjects. Subjects with higher DDS consistently have a higher level of eGFR compared to those with lower DDS while the DDS was not associated with the incidence of CKD in the present study. Conclusion. Even if no statistically significant association was found between CKD and dietary diversity, there is a relationship of higher eGFR levels among the study participants with higher dietary diversity.

Dietary diversity and possible sarcopenia among older people in China: a nationwide population-based study

“…We also observed some variations in the association between different DDSs and possible sarcopenia, while the associations between DDS (total diet, animal-based diet, and plant-based diet) and possible sarcopenia were more pronounced. When constructing a DDS, the food groups included were different across studies and may contribute to the inconsistent findings, partly due to the study population and purpose ( 21 , 32 , 33 , 37 ). In the literature, the classification of DDS was based on the US Department of Agriculture (USDA) food guide pyramid (five food groups), the Chinese Dietary Guideline (10 food groups), and the Food and Agriculture Organization (FAO) guidelines (9 food groups) ( 32 , 34 , 38 ).…”

“…The National Health and Nutrition Examination Survey (NHANES) concluded that DDS could be viewed as a convenient and fast indicator for assessing dietary diversity and observed that improved diet quality was associated with increased dietary diversity ( 19 , 22 ). Previous studies have additionally demonstrated an association between DDS and chronic diseases, such as cardiovascular diseases, cancer, diabetes, and metabolic syndrome, as well as its correlation with improved health status and prolonged longevity ( 21 – 23 ). According to data from several investigations, higher DDS was also associated with better cognitive function, fewer physical limitations, and lower psychological stress in the elderly ( 24 , 25 ).…”

“…DDS usually entails assigning scores to different food and evaluating dietary diversity based on the sum of those scores, with higher scores indicating dietary variety. An increase in individual DDS is associated with increased dietary intake of macronutrients and micronutrients ( 20 , 21 ). DDS is a well-recognized indicator for evaluating diet quality and nutrition of food security status ( 21 ).…”

“…An increase in individual DDS is associated with increased dietary intake of macronutrients and micronutrients ( 20 , 21 ). DDS is a well-recognized indicator for evaluating diet quality and nutrition of food security status ( 21 ). The DDS can be widely used in large-scale studies and surveys (such as the Demographic and Health Survey) as a convenient and inexpensive index for assessing nutrient adequacy and overall dietary quality ( 19 ).…”