Dietary Diversity and Its Association with Diet Quality and Health Status of European Children, Adolescents, and Adults: Results from the I.Family Study
Marika Dello Russo,
Annarita Formisano,
Fabio Lauria,
Wolfgang Ahrens,
Leonie H. Bogl,
Gabriele Eiben,
Stefaan De Henauw,
Antje Hebestreit,
Timm Intemann,
Monica Hunsberger,
Lauren Lissner,
Denes Molnar,
Valeria Pala,
Stalo Papoutsou,
Alba M. Santaliestra-Pasias,
Toomas Veidebaum,
Maike Wolters,
Alfonso Siani,
Paola Russo
Affiliations
Marika Dello Russo
Institute of Food Sciences, National Research Council, 83100 Avellino, Italy
Annarita Formisano
Institute of Food Sciences, National Research Council, 83100 Avellino, Italy
Fabio Lauria
Institute of Food Sciences, National Research Council, 83100 Avellino, Italy
Wolfgang Ahrens
Leibniz Institute for Prevention Research and Epidemiology—BIPS, 28359 Bremen, Germany
Leonie H. Bogl
School of Health Professions, Bern University of Applied Sciences, 3008 Bern, Switzerland
Gabriele Eiben
Department of Public Health, School of Health Sciences, University of Skövde, 541 28 Skövde, Sweden
Stefaan De Henauw
Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
Antje Hebestreit
Leibniz Institute for Prevention Research and Epidemiology—BIPS, 28359 Bremen, Germany
Timm Intemann
Leibniz Institute for Prevention Research and Epidemiology—BIPS, 28359 Bremen, Germany
Monica Hunsberger
Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 413 90 Gothenburg, Sweden
Lauren Lissner
Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 413 90 Gothenburg, Sweden
Denes Molnar
Department of Pediatrics, Medical School, University of Pécs, 7624 Pécs, Hungary
Valeria Pala
Department of Preventive and Predictive Medicine, Fondazione IRCCS, Istituto Nazionale dei Tumori, 20133 Milan, Italy
Stalo Papoutsou
Research and Education Institute of Child Health, Attikis 8, 2027 Strovolos, Cyprus
Alba M. Santaliestra-Pasias
NUTRI-GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences and Sports, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Universidad de Zaragoza, 50009 Zaragoza, Spain
Toomas Veidebaum
National Institute for Health Development, Center of Health and Behavioral Science, 11619 Tallinn, Estonia
Maike Wolters
Leibniz Institute for Prevention Research and Epidemiology—BIPS, 28359 Bremen, Germany
Alfonso Siani
Institute of Food Sciences, National Research Council, 83100 Avellino, Italy
Paola Russo
Institute of Food Sciences, National Research Council, 83100 Avellino, Italy
Dietary diversity (DD) plays a crucial role in fostering high-quality diets, but its association with health outcomes, particularly body adiposity and non-communicable diseases (NCDs), is inconsistent. This may be due to a lack of a standardized method for estimating DD. Our study investigates the association between two DD indices, namely the dietary diversity score (DDS) and food variety score (FVS), and anthropometric measures, biochemical parameters, and diet quality in a large population sample from the I.Family study across research centers in eight European countries. In our cross-sectional analysis of 3035 participants, DDSs varied among countries, with a higher prevalence in the third DDS tertile among those with higher education. DDS showed a positive association with diet quality across all age groups. Higher DDS tertile individuals showed increased fiber, fruit, and vegetable intake, greater meal frequency, and lower ultra-processed food consumption. No relevant biochemical differences were observed across DDS tertiles, and a higher DDS was associated with lower overweight/obesity prevalence only in adults. No significant associations were found with FVS. Our findings emphasize the need to consider food groups for a more accurate estimation of diet quality. This aligns with studies suggesting DDS alone is not an independent risk factor for obesity in children and adolescents. Public health programs should prioritize food diversity to promote improved nutrition and overall well-being in communities.
