Dietary diversity and metabolic health among people in Västerbotten, Sweden

High dietary diversity is recognized as a crucial element of diet quality because this ensures abundant nutrients. A diverse diet may also provide health benefits beyond nutritional adequacy. Few studies have evaluated associations with lipid profile. The aim of this study was to investigate the association between dietary diversity and metabolic health and common measures of diet quality in a large population-based sample.

This was a cross-sectional analysis within the Västerbotten Intervention Programme (VIP). Participants filled out an extensive health questionnaire including a 66-item semi-quantitative food frequency questionnaire (FFQ). The FFQ was used to create dietary diversity scores (DDS) for 5 major and 13 minor food groups. Associations between DDS and concurrent fasting lipid profile and measured body mass index (BMI) were explored with multivariable linear regression. Correlation analyses were used to explore the relationship between DDS and diet quality.

The mean age of participants was 51 ± 8.3 years, with females comprising 50.8% of the study population (n = 82,171). Higher DDS was associated with decreased total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and triglycerides (all p < 0.01). DDS had no significant association with BMI. DDS had a positive correlation with the Relative Mediterranean Diet Score, the Healthy Nordic Food Index and the Healthy Diet Score, and a negative correlation with the Dietary Inflammatory Index (all p < 0.001).

The results add to the body of research showing metabolic health benefits of dietary diversity. More consistent methods of measuring dietary diversity should be developed, with careful consideration given to the healthfulness of foods included in the definition.