Background

Dietary diversity (DD), provided the foods are healthful, should promote optimal health. However, evidence exists that dietary diversity is inversely associated with metabolic syndrome, obesity, and cardiovascular health. Study objectives were to determine the associations of dietary diversity and diet quality with Body Mass Index (BMI) in an urban US sample.

Methods

Participants were from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study, wave 4 (n=2066, 1259 African Americans [AA], 807 Whites [W]). Three DD measures were derived from 2 days of 24-hr recall data collected with USDA automated-multiple-pass-method. Count was based on consumption of at least half an equivalent of food from 21 subgroups per 1000 kcal. Solid fats, added sugar, alcohol, cured and organ meat food groups were eliminated from counts. Evenness was calculated using Berry Index adjusted by health value of food. Dissimilarity was calculated by Mahalanobis Distance. Diet quality was assessed by Dietary Approaches to Stop Hypertension (DASH) scores. BMI was calculated as the ratio of measured weight (kg) to height (m) squared. Associations of DD and DASH with BMI were assessed with multivariable regression. Covariates included income, education, and food security.

Results

There were no significant differences in dissimilarity scores among people with normal, overweight or obese BMI [BMI defined as <25.0, 25.0-29.9, ≥30.0, respectively]. Count and evenness scores for people with a normal BMI were significantly lower than those who were categorized as obese. Count was positively associated (p<0.001), whereas DASH score was negatively associated (p=0.01) with BMI. Neither evenness (p=0.053) nor dissimilarity (p=0.758) were associated with BMI.

Conclusions

The findings are consistent with other researchers who report increased count is associated with greater BMI.