title: Diet diversity and nutritional status among adults in southwest China.
abstract: BACKGROUND
  With rapid urbanization in the past decades, diet diversity continues to increase in China. The present cross-sectional study aims to explore the association between dietary diversity and nutritional status among adults in southwest China.
  
  
  METHODS
  This study used data from 2011-2012 National Nutritional Survey in Yunnan Province, southwest China (N = 1105).Data of three consecutive 24-hour dietary recalls were used to calculate dietary diversity scores (DDS) and nutrient adequacy ratio (NAR). Body mass index and waist circumference were used to determine nutritional status. Surveylogistic procedure of SAS 9.2 software was used to examine the association between DDS and obesity by estimating odds ratio (OR) and 95% confidence intervals (CI).
  
  
  RESULTS
  The mean DDS was 5.2 (SD 1.1) out of nine points. Being female, younger age, belonging to Han ethnicity, having higher educational level and household income were positively associated with DDS (all P<0.05). As DDS increased, consumption also increased in most food groups except grains and vegetables. People with medium and high DDS (DDS = 5 and DDS ≥6, respectively) ingested more energy than the recommended quantity(NAR = 1.1 and 1.2, respectively). However, the intakes of Calcium and Vitamin A were seriously inadequate even for people with high DDS (NAR≤0.5). With potential confounders adjusted, people with medium and high DDS were at higher risk of general and central obesity than people with DDS ≤4 (OR = 1.4-1.9, P<0.01).
  
  
  CONCLUSIONS
  Our data indicated that high DDS was associated with excessive energy intake and obesity among adults in southwest China. Although dietary diversity is widely recommended, public health messages should give less emphasis on dietary diversity.
authors.affiliation: Department of Nutrition and Food Hygiene, Yunnan Center for Disease Control and Prevention, Kunming, China.|Department of Epidemiology, University of Florida, Gainesville, Florida, United States of America.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Department of Epidemiology, University of Florida, Gainesville, Florida, United States of America.
authors.forename: Xinguang
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Nutrition and Food Hygiene, Yunnan Center for Disease Control and Prevention, Kunming, China.
authors.forename: Zhitao
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Epidemiology, University of Florida, Gainesville, Florida, United States of America.
authors.forename: Deepthi S
authors.initials: DS
authors.lastname: Varma
authors.affiliation: Department of Nutrition and Food Hygiene, Yunnan Center for Disease Control and Prevention, Kunming, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Wan
authors.affiliation: Department of Nutrition and Food Hygiene, Yunnan Center for Disease Control and Prevention, Kunming, China.
authors.forename: Shiwen
authors.identifier: http://orcid.org/0000-0001-9544-1455
authors.initials: S
authors.lastname: Zhao
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004032:Diet / Q000009:adverse effects; D004034:Diet Surveys; D002149:Energy Intake; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D009765:Obesity / Q000453:epidemiology*; D012307:Risk Factors; D012959:Socioeconomic Factors; D055105:Waist Circumference; D055815:Young Adult