title: Dietary diversity and adiposity in Chinese men and women: an analysis of four waves of cross-sectional survey data.
abstract: Increasing dietary diversity is concurrent with an increasing prevalence of adiposity in China, but the association between these variables remains ambiguous. This study reveals an association between dietary diversity and body mass (underweight, overweight and obesity) in Chinese adults.
  
  
  
  Data from 17 825 participants (age, 18-65 years) were pooled from four survey waves (2004, 2006, 2009 and 2011) of the Chinese Health and Nutrition Survey. Anthropometric data and dietary intake information obtained through a 24-h dietary recall for 3 consecutive days were collected. Information on covariates, namely those regarding the socioeconomic status and lifestyle of each participant, were collected. The dietary diversity score (DDS) and entropy were used to represent dietary diversity. The association between dietary diversity and adiposity was analyzed by using multivariable-adjusted multinomial logistic regression.
  
  
  
  A positive association between dietary diversity and overweight was detected only in men (DDS: OR=1.09 (1.03-1.17); entropy: OR=1.60 (1.24-2.07)). The results were confirmed by analyzing the interaction between sex and diversity (DDS: OR=1.27 (1.17-1.37); entropy: OR=2.89 (2.11-3.89)). In contrast, no significant association was detected between dietary diversity and underweight/obesity (all P>0.05). Dietary consumption was compared between sexes to explain the different effects of dietary diversity on body mass in men and women. The results indicated that men typically had a higher consumption of meat (P<0.01).
  
  
  
  Higher dietary diversity is positively associated with overweight in men. Additional preventive strategies that promote a healthy diet should focus on men.
authors.affiliation: College of Economics and Management, China Center for Food Security Studies, Nanjing Agricultural University, Nanjing, China.
authors.forename: X
authors.initials: X
authors.lastname: Tian
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China.
authors.forename: M
authors.initials: M
authors.lastname: Wu
authors.affiliation: Department of Nutrition Hygiene, Division of Health Risk Factor Monitoring and Control, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China.
authors.forename: J
authors.initials: J
authors.lastname: Zang
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China.
authors.forename: H
authors.initials: H
authors.lastname: Wang
mesh_terms: D050154:Adiposity; D000293:Adolescent; D000328:Adult; D000368:Aged; D000886:Anthropometry; D044466:Asian People / Q000706:statistics & numerical data*; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004032:Diet / Q000009:adverse effects / Q000706:statistics & numerical data*; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D009765:Obesity / Q000453:epidemiology* / Q000209:etiology; D050177:Overweight / Q000453:epidemiology* / Q000209:etiology; D012923:Social Class; D013851:Thinness / Q000453:epidemiology* / Q000209:etiology; D055815:Young Adult