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J Nutr. 2015 Mar;145(3):555-63. doi: 10.3945/jn.114.199067. Epub 2014 Dec 31.

Dietary variety is inversely associated with body adiposity among US adults using a novel food diversity index.

Author information

Department of Nutrition, Harvard School of Public Health, Boston, MA;
Department of Public Health, Food Studies, and Nutrition, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY; and.
Department of Humanities and Social Sciences in the Professions, Steinhardt School of Culture, Education, and Human Development.
Department of Population Health, NYU School of Medicine, NYU Robert F. Wagner Graduate School of Public Service, and.
Department of Population Health, NYU School of Medicine, Department of Nutrition, Food Studies, and Public Health, New York University, New York, NY



Consuming a variety (vs. monotony) of energy-poor, nutrient-dense foods may help individuals adhere to dietary patterns favorably associated with weight control.


The objective of this study was to examine whether greater healthful food variety quantified using the US Healthy Food Diversity (HFD) index favorably influenced body adiposity.


Men and nonpregnant, nonlactating women aged ≥20 y with two 24-h recalls from the cross-sectional NHANES 2003-2006 (n = 7470) were included in this study. Dietary recalls were merged with the MyPyramid Equivalent database to generate the US HFD index, which ranges from 0 to ∼1, with higher scores indicative of diets with a higher number and proportion of healthful foods. Multiple indicators of adiposity including BMI, waist-to-height ratio, android-to-gynoid fat ratio, fat mass index (FMI), and percentage body fat were assessed across US HFD index quintiles. ORs and 95% CIs were computed with use of multivariable logistic regression (SAS v. 9.3).


The US HFD index was inversely associated with most adiposity indicators in both sexes. After multivariable adjustment, the odds of obesity, android-to-gynoid ratio >1, and high FMI were 31-55% lower (P-trend < 0.01) among women in quintile 5 vs. quintile 1 of the US HFD index. Among men, the odds of obesity, waist-to-height ratio ≥0.5, and android-to-gynoid ratio >1 were 40-48% lower (P-trend ≤ 0.01) in quintile 5 vs. quintile 1 of the US HFD index.


Higher US HFD index values were inversely associated with indicators of body adiposity in both sexes, indicating that greater healthful food variety may protect against excess adiposity. This study explicitly recognizes the potential benefits of dietary variety in obesity management and provides the foundation to support its ongoing evaluation.


body adiposity; dietary diversity; dietary variety; healthy food diversity; healthy variety; obesity

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