Public Health Nutrition

Assessment and methodology

Dietary diversity score is related to obesity and abdominal adiposity among Iranian female youth

Leila Azadbakhta1 c1 and Ahmad Esmaillzadeha2

a1 Department of Nutrition, School of Public Health, Isfahan University of Medical Sciences, Isfahan PO Box 81745, Islamic Republic of Iran

a2 Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Islamic Republic of Iran


Objective To assess the relationship between diet and disease, consideration of whole-diet indices may be more informative than single-nutrient intake. The present study was conducted to report the relationship among dietary diversity score (DDS), obesity and abdominal adiposity among female university students.

Design Cross-sectional study.

Setting Isfahan, Iran.

Subjects A representative sample of 289 healthy female students aged 18–28 years was selected randomly from Isfahan University of Medical Sciences, Iran. Usual dietary intake was assessed using a validated semi-quantitative FFQ. DDS was calculated according to the scoring of the five food groups based on the US Department of Agriculture Food Guide Pyramid. This is a score of diet variety, and shows the diversity of the consumed diet. Participants were categorised on the basis of quartile cut-off points of DDS. Potential confounders such as age, total energy intake and physical activity were considered in all the analyses.

Results The means (sd) of BMI and waist circumference were 25·9 (sd 5·1) kg/m2 and 85·5 (sd 14) cm, respectively. The probability of obesity decreased with quartiles of DDS (OR among quartiles: 1·00, 0·41, 0·31 and 0·21, P = 0·03; this was the same for abdominal adiposity: 1·00, 0·55, 0·36 and 0·21, P = 0·02). Those in the lowest quartile of the DDS had the highest risk for being overweight.

Conclusions There were inverse associations among DDS, obesity and abdominal adiposity among the female students of Isfahan University. Further prospective investigations are needed to confirm this finding.

(Received August 25 2009)

(Accepted February 10 2010)

(Online publication March 31 2010)


c1 Corresponding author: Email