Study On Associations Of Dietary Diversity With Nutrients Adequacy And Nutrition Related Chronic Disease In Chinese Adults

Dietary diversity plays a key role in improving diet quality and promoting nutrition status. Studies show that dietary diversity is associated with nutrients adequacy, BMI, and nutrition related chronic disease such as hypertention, diabetes and hyperlipidemia. So it's important and more practical to guide people have a diversified diet, promote the diet quality, prevent nutritional related chronic disease and relieve double-burden of China by understanding the dietary diversity status. Researches are limited in this area and no effective evaluation system developed in China. This study developed an effective dietary diversity evaluation system for further assessment on its relationships with nutrients adequacy and chronic disease. This scoring system may help us to find the defects in current diet patterns and may also help to find most optimal diet pattern for Chinese people.The study analyzed 3 day 24h diet recall data of 2002 China National Nutrition and Health Survey, subjects aged from 18-59. Dietary Diversity Scores for 5 food groups,9 food groups and 28 food groups, and also Food Variety Score were calculated and evaluated by assessing their effectivities. The choosed optimal scoring system will be used for further analysis on relationships with nutrients adequacy ratio (NAR) and mean adequacy ratio (MAR), and relationships with BMI. hypertension, diabetes, hyperlipidamia.Coefficients of dietary diversity scores with MAR were 0.2261,0.2719,0.2799, 0.2716 respectively for DDS5,DDS9,DDS28, and FVS. Among the max coefficients of NAR with DDS,6 comes from DDS9, DDS9>DDS5>FVS>DDS28. DDS9 system was proved to be the most effective index among these 4 dietary diversity evaluation systems.DDS was less in rural than in urban, more than 50% people in urban scored≥6 while more than 75% people in rural scored only≤4. Rural residents consumed more diversified cereals and vegetables while less diversified fish, egg, dairy and fruits than their urban counterparts. The most frequently missed foods were dairy, fruit and fish in Chinese diet.MAR increased with DDS, MAR of rural (0.78) is higher than urban (0.75). DDS was positively related with MAR (r=0.27～0.43). All foods intra-group diversity scores were positively related with MAR, score of Meat contributed the most for MAR, the coefficients were 0.30,0.25 and 0.22 respectively for Meat, Vegetable and Soy. DDS also corelated with the numbers of adequate nutrients NAR-N positively. The dietary diversity score increased as the income and education grades increased.BMI increased as DDS increased, the correlation was found not significant after controlling the confounding factors. Foods other than Vegetable and Soy were found have positive correlations with BMI. The sequence was fish> vegetable> cereal> meat >egg according to their contribution to BMI. The overweight & obesity OR of moderate and diversified diet with less diversified diet were 1.02 and 0.84 respectively.DDS correlated with SBP & DBP negatively whie correlated with fast blood glucose, cholesterol, triglyceride and low high-density lipoprotein positively. Vegetable diversity score had negative correlation with SBP, DPB and cholesterol; Fish diversity score correlated with SBP, DBP, fast blood glucose and trglyceride negatively; while Egg had positive correlation with all above indexs; Cereal correlated with SBP DBP positively while it's negative for cholesterol and high-density lipoprotein, the Meat diversity score was exactly on the contraray. For people with moderate and adequate diversity score, the hypertension OR were 1.0 and 0.89 respectively and the diabetes OR were 1.29 and 1.19. hyperlipidamia OR were 1.07 and 0.96 respectively.Conclude from above, DDS9 scoring system can effectively assess the dietary diversity status, and effective in evaluating relationships with nutrients adequacy, BMI and chronic disease factors. Urban residents consumed more diversified diet than rural counterparts, especially in fish, egg, meat, dairy and fruits diversities. Dietary diversity related with nutrients adequacy status positively; the risk of hypertension, diabetes and hyperlipidamia increased first then decrease when DDS increased.