title: High dietary diversity is associated with obesity in Sri Lankan adults: an evaluation of three dietary scores.
abstract: BACKGROUND
  Dietary diversity is recognized as a key element of a high quality diet. However, diets that offer a greater variety of energy-dense foods could increase food intake and body weight. The aim of this study was to explore association of diet diversity with obesity in Sri Lankan adults.
  
  
  METHODS
  Six hundred adults aged > 18 years were randomly selected by using multi-stage stratified sample. Dietary intake assessment was undertaken by a 24 hour dietary recall. Three dietary scores, Dietary Diversity Score (DDS), Dietary Diversity Score with Portions (DDSP) and Food Variety Score (FVS) were calculated. Body mass index (BMI) ≥ 25 kg.m⁻² is defined as obese and Asian waist circumference cut-offs were used diagnosed abdominal obesity.
  
  
  RESULTS
  Mean of DDS for men and women were 6.23 and 6.50 (p=0.06), while DDSP was 3.26 and 3.17 respectively (p=0.24). FVS values were significantly different between men and women 9.55 and 10.24 (p=0.002). Dietary diversity among Sri Lankan adults was significantly associated with gender, residency, ethnicity, education level but not with diabetes status. As dietary scores increased, the percentage consumption was increased in most of food groups except starches. Obese and abdominal obese adults had the highest DDS compared to non obese groups (p<0.05). With increased dietary diversity the level of BMI, waist circumference and energy consumption was significantly increased in this population.
  
  
  CONCLUSIONS
  Our data suggests that dietary diversity is positively associated with several socio-demographic characteristics and obesity among Sri Lankan adults. Although high dietary diversity is widely recommended, public health messages should emphasize to improve dietary diversity in selective food items.
authors.affiliation: Faculty of Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia. ranil7@gmail.com
authors.forename: Ranil
authors.initials: R
authors.lastname: Jayawardena
authors.forename: Nuala M
authors.initials: NM
authors.lastname: Byrne
authors.forename: Mario J
authors.initials: MJ
authors.lastname: Soares
authors.forename: Prasad
authors.initials: P
authors.lastname: Katulanda
authors.forename: Bijesh
authors.initials: B
authors.lastname: Yadav
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Hills
mesh_terms: D000293:Adolescent; D000328:Adult; D004032:Diet / Q000706:statistics & numerical data*; D004034:Diet Surveys; D002149:Energy Intake; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D013188:Sri Lanka / Q000453:epidemiology; D055815:Young Adult