Everything in Moderation - Dietary Diversity and Quality, Central Obesity and Risk of Diabetes

Abstract

Diet guidelines recommend increasing dietary diversity. Yet, metrics for dietary diversity have neither been well-defined nor evaluated for impact on metabolic health. Also, whether diversity has effects independent of diet quality is unknown. We characterized and evaluated associations of diet diversity and quality with abdominal obesity and type II diabetes (T2D) in the Multi-Ethnic Study of Atherosclerosis. At baseline (2000–02), diet was assessed among 5,160 Whites, Hispanic, Blacks, and Chinese age 45–84 y and free of T2D, using a validated questionnaire. Three different aspects of diet diversity were characterized including count (number of different food items eaten more than once/week, a broad measure of diversity), evenness (Berry index, a measure of the spread of the diversity), and dissimilarity (Jaccard distance, a measure of the diversity of the attributes of the foods consumed). Diet quality was characterized using aHEI, DASH, and a priori pattern. Count and evenness were weakly positively correlated with diet quality (r with AHEI: 0.20, 0.04), while dissimilarity was moderately inversely correlated (r = -0.34). In multivariate models, neither count nor evenness was associated with change in waist circumference (WC) or incident T2D. Greater food dissimilarity was associated with higher gain in WC (p-trend<0.01), with 120% higher gain in participants in the highest quintile of dissimilarity scores. Diet diversity was not associated with incident T2D. Also, none of the diversity metrics were associated with change in WC or incident T2D when restricted to only healthier or less healthy foods. Higher diet quality was associated with lower risk of T2D. Our findings provide little evidence for benefits of diet diversity for either abdominal obesity or diabetes. Greater dissimilarity among foods was actually associated with gain in WC. These results do not support the notion that “eating everything in moderation” leads to greater diet quality or better metabolic health.

Consumo de grupos de alimentos y factores sociodemográficos en población mexicana

“…1 Esto se refleja en una disminución del gasto per cápita en alimentos recomendables como frutas, verduras, lácteos y carnes, y en un mayor gasto en alimentos densos en energía (como cereales refinados y comida rápida) y bebidas azucaradas. 2 Existe evidencia sobre la asociación del consumo de grupos de alimentos como cereales refinados, dulces, bebidas azucaradas y alimentos procesados de origen animal con la ganancia de peso y enfermedades crónicas; [3][4][5] por ello, se recomienda no consumirlos de forma cotidiana. En México, se ha reportado que los patrones de alimentación basados en este tipo de alimentos se asocian positivamente con el riesgo de presentar sobrepeso u obesidad en escolares y adultos.…”

Mediterranean diet, diet quality, and bone mineral content in adolescents: the HELENA study

“…The Family Affluence Scale (FAS) index was used as an indicator of the adolescents' material affluence (reflecting family expenditure and consumption) [19]. The scale ranged from 0 to 8 and was re-coded and dichotomized into a 2-point scale: Blow familial wealth^(0-4) and Bhigh familial wealth^ (5)(6)(7)(8). Maternal educational level was also recorded (primary education, lower secondary education, higher secondary education, or university degree) and recorded later into a 2-point scale, namely as a low (primary and lower secondary education) and high (higher secondary education and university degree score) education.…”

“…While the MDS is characterized by a high intake of vegetables, legumes, fruits, nuts, and cereal grains, moderate-to-high fish intakes, and high intakes of unsaturated lipids but low intakes of saturated fats, together with low intake of meat products, the DQI is more based upon principles of balance and variation, including considering that all foods and food groups (including dairy and meat products) may contribute to a healthy diet. These indices are indicators of the overall diet and are known to be inversely associated with mortality in adults [5], as well as with a number of chronic diseases including cardiovascular diseases [6,7], obesity, and type 2 diabetes [8].…”

The Relationship Between Dietary Diversity with General and Abdominal Obesity in Female Amateur Athletes of Mazandaran University of Medical Sciences

“…Studies have shown that a healthy lifestyle and nutrition help the physical, intellectual, and social health of the individual, improve the quality of life, and reduce the cost of socio-healthy cares (8). According to the WHO, more than 80% of obesity-related illnesses can be treated by improving the quality of life and physical activity (9).…”