Is dietary diversity a proxy measurement of nutrient adequacy in Iranian elderly women?

OBJECTIVES
To investigate whether consumption of more diverse diets would increase the probability of nutrients adequacy among elderly women in Tehran, Iran.

METHODS
This cross-sectional study was conducted on 292 women aged ≥60 years who were randomly selected from 10 public health centers among 31 centers in south area of Tehran. Because of some limitations we randomly chose these 10 centers. The sample sizes provided 80% statistical power to meet the aim of study for test the relationship between Nutrient Adequacy Ratio (NAR), Mean Adequacy Ratio (MAR) as a dependent variable and total Dietary Diversity Score (DDS) as an independent variable. Dietary intakes were assessed by two 24-h recall questionnaires. The mean probability of adequacy across 12 nutrients and energy were calculated using the Dietary Reference Index (DRI). Dietary diversity Score was defined according to diet quality index revised (Haines et al. method). To investigate the relationship between MAR and DDS some demographic and socioeconomic variables were examined.

RESULTS
Mean ± SD of total dietary diversity was 4.22 ± 1.28 (range 1.07-6.93). The Fruit and vegetable groups had the highest (1.27 ± 0.65, range 0-2.0) and the lowest (0.56 ± 0.36, range 0-1.71) diversity score, respectively. We observed that total DDS has significant positive correlation with MAR (r = 0.65, P < 0.001). Total DDS was significantly associated with NAR of all 12 studied nutrients (P < 0.01); probability adequacy of vitamin B2 revealed the strongest (r = 0.63, P < 0.01) and vitamin B12 revealed the weakest (r = 0.28, P < 0.01) relationship with total DDS. When maximizing sensitivity and specificity, the best cut-off point for achieving MAR≥1 was 4.5 for DDS.

CONCLUSION
The results of our study showed that DDS is an appropriate indicator of the probability of nutrient adequacy in Tehranian elderly women.