Association between dietary diversity score and anthropometric indices among children and adolescents: the weight disorders survey in the CASPIAN-IV study.

Background: The aim of this study was to determine the association between the dietary diversity score (DDS) and anthropometric indices in a nationally representative sample of Iranian children and adolescents.
Methods: The nationwide cross-sectional study included 5178 students aged 6-18 years. A validated 168-item food frequency questionnaire (FFQ) was used. The DDS was assessed by dividing food items into five groups.
Results: An increase of 1 in the total DDS score was associated with 0.08 increase in the body mass index z-score (BMIz), 0.06 increase in waist circumference z-score (WCz), and 0.07 increase in hip circumference z-score (HCz) (P < 0.05) in girls. An increase of 1 in the DDS score of the dairy group was associated with an 0.11 increases in BMIz (P < 0.05). An increase of 1 in the DDS score of the fruit-vegetable group was associated with 0.09 and 0.08 increase in BMIz and HCz among girls respectively (P < 0.05). The odds of excess weight (overweight or obesity) and abdominal obesity increased with each unit increase in total DDS in girls (odds ratio, OR _{excess weight}  = 1.11 (95% confidence interval, CI: 1.003-1.23), OR _{abdominal obesity}  = 1.11 (95% CI: 1.001-1.23)). The odds of excess weight increased with each unit increase in dairy DDS (OR _{excess weight}  = 1.20 (95% CI: 1.002-1.43) among boys.
Conclusion: Higher DDS was associated with higher anthropometric indices and greater risk of obesity among children and adolescents. Our findings emphasize the importance of increasing the diversity of healthy food items to reduce weight disorders in the pediatric age group. © 2021 Society of Chemical Industry.
(© 2021 Society of Chemical Industry.)