The relation of Dietary diversity score and food insecurity to metabolic syndrome features and glucose level among pre-diabetes subjects

Introduction: Prediabetes is considered as an increased risk factor for cardiovascular disease and overt diabetes and is the precursor stage of diabetes. Dietary Diversity Score (DDS) is recognized as an essential factor of a high-quality diet. However, diets with more varieties of food items might increase calorie intake and body weight. Therefore, this study was carried out to determine the association of DDS with metabolic syndrome features in adults with prediabetes. Methods: Three hundred subjects were randomly selected from participants who were undergone diabetes test screening program. Dietary intake was assessed by using a validated semi-quantitative food frequency questionnaire. DDS was calculated by scoring food intake as nine food groups. The 18-items USDA household food securities and International Physical Activity (IPAQ) were also measured. The metabolic syndrome was defined according to the Adult Treatment Panel III. Results: DDS mean for cases and controls were 4.43 and 4.9, respectively (p<0.005). The prevalence of food insecurity was 67/3% in cases and 55/4% in controls group. The decrease in metabolic syndrome probability was compatible with quartiles of DDS (the quartiles odds ratios: 0.6, 0.5, 0.4, 0.19, P = 0.05). A higher DDS was associated with lower level of fasting blood glucose, HDL-cholesterol, TG and Waist circumference. Conclusion: Lower DDS was associated with high probability of metabolic syndrome and with some features of it, like high fasting blood glucose. Therefore, it seems that increase in dietary diversity scores could prevent the pre diabetes development to overt diabetes. (C) 2018 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.