Abstract P195: Dietary Diversity and Quality, Change in Waist Circumference and Risk of Diabetes in the Multi-Ethnic Study of Atherosclerosis
Background: Diet guidelines recommend dietary diversity, but metrics for dietary diversity have not been well defined nor evaluated for impact on metabolic health. Also, whether diversity has effects independent of diet quality is unknown.
Aims: To characterize metrics of dietary diversity and prospectively assess change in waist circumference (WC) and incident diabetes (DM) in a multi-ethnic population; and whether associations were independent of diet quality.
Methods: Among 5,215 Whites, Hispanic, Blacks, and Chinese age 45-84 y and free of DM at baseline (2000-02), diet was assessed using a validated questionnaire, WC was directly measured, and incident DM defined from fasting glucose and medications. Three separate aspects of diet diversity were characterized: count (different food items eaten >once/week), evenness (Berry index) and dissimilarity (Jaccard distance). Diet quality was characterized using DASH, AHEI, and a priori patterns. Diversity metrics were also separately defined based only on generally healthier or less healthy foods. We evaluated associations with 5 y change in WC using linear regression; and incident DM using Cox models.
Results: After multivariable adjustment, neither count nor evenness was associated with WC or DM (Table). Higher dissimilarity was associated with gain in WC in Hispanic, Blacks and Chinese, but not Whites; and higher risk of DM in Chinese and Blacks. Most associations were independent of diet quality. No associations were found for diversity metrics defined on strata of only healthier or less healthy foods. Higher diet quality was associated with less WC gain in Hispanics only, and lower risk of DM in Whites and Chinese only.
Conclusion: Our findings provide little evidence for benefits of dietary diversity for either WC or DM. Greater dissimilarity was actually positively associated with change in WC in most ethnicities. These results support need for greater investigation of role and relevance of diet diversity for metabolic health in diverse populations.
Author Disclosures: M.C. de Oliveira Otto: B. Research Grant; Modest; Dr. Otto was supported by an unrestricted educational grant from Bunge LLC.. N.S. Padhye: None. A. Bertoni: None. D.R. Jacobs: G. Consultant/Advisory Board; Modest; Consultant California Walnut Commission. D. Mozaffarian: B. Research Grant; Significant; Research grants from GlaxoSmithKline, Sigma Tau, Pronova, and the National Institutes of Health for a completed investigator-initiated, not-for-profit, randomized clinical trial of fish oil supplement. E. Honoraria; Modest; Ad hoc travel reimbursement and/or honoraria for one-time scientific presentations or reviews on diet and cardiometabolic diseases from Quaker Oats, Life Sciences Research Organization, Ad hoc travel reimbursement and/or honoraria for one-time scientific presentations or reviews on diet and cardiometabolic diseases from Pollock Institute and Bunge LLC. G. Consultant/Advisory Board; Modest; Ad hoc consulting fees from McKinsey Health Systems Institute (11/11), Foodminds (1/12), Nutrition Impact (10/12), Amarin (9/13), Omthera (9/13), and Winston and Strawn LLP (9/13), Advisory board: Unilever North America Scientific Advisory Board. H. Other; Modest; Royalties from UpToDate, for an online chapter on fish oil, Harvard University has filed a provisional patent application listing Dr. Mozaffarian as a co-inventor to the US Patent and Trademark Office for use of trans-palmitoleic acid to prevent diabetes.
- © 2014 by American Heart Association, Inc.