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. 2025 Jan 17;24(1):48.
doi: 10.1007/s40200-025-01557-0. eCollection 2025 Jun.

The association between dietary diversity score and food insecurity and novel cardiovascular risk factors in type 2 diabetes mellitus patients: a cross-sectional study

Hanieh Abbasi  1 , Ensieh Nasli-Esfahani  2 , Mobina Zeinalabedini  1   3 , Razieh Tabaei-Fard  1 , Fozhan Javadi  1 , Leila Azadbakht  1   2   4
Affiliations

The association between dietary diversity score and food insecurity and novel cardiovascular risk factors in type 2 diabetes mellitus patients: a cross-sectional study

Hanieh Abbasi et al. J Diabetes Metab Disord. .

Abstract

Objectives: An efficient approach to monitor the risks associated with chronic diseases is to use a dietary diversity score (DDS). To our knowledge, there has been no study conducted on the correlation between DDS and cardiovascular risk factors in individuals with diabetes. Hence, the objective of this study is to ascertain the correlation between these traits.

Methods: In this cross-sectional investigation, 490 individuals with type 2 diabetes were included. The patients' food consumption was assessed using a 168-item food frequency questionnaire (FFQ), and a dietary diversity score (DDS) was computed. Traditional CVD risk variables were used to evaluate cardiovascular risk factors, including Castelli risk index 1 and 2 (CRI-I and II), atherogenic index of plasma (AIP), lipid accumulation product (LAP), and cholesterol index (CI). We evaluated the anthropometric indicators that predict CVD, including the abdominal volume index (AVI), body roundness index (BRI), and body shape index (ABSI).

Results: In the final model adjusted for all the considered confounders, there was a significant association between DDS and LAP (OR: 1.33; 95% CI: 0.61, 0.82; p-trend = 0.03). Moreover, there was a significant association between DDS and AVI (OR: 1.99; 95% CI: 1.17,3.35; p-trend = 0.04). We could not find any association between food security and DDS among the participants of the current study.

Conclusions: In the present study, it was found that DDS may result in higher LAP and AVI which are markers of abdominal obesity and cardiovascular diseases. Therefore, despite the probable positive effect of having a diverse diet on cardiovascular health and wide recommendations for that, using healthier food groups should be considered.

Supplementary information: The online version contains supplementary material available at 10.1007/s40200-025-01557-0.

Keywords: Atherogenic index; CVD risk factors; Diabetes; Dietary diversity score; Food insecurity.

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Conflict of interest statement

Conflict of interestThe authors declare that they have no conflict of interest.

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