Diet Variety Based on Macronutrient Intake and Its Relationship With Body Mass Index

Thomas E. Lyles III, BS; Renee Desmond, DVM, PhD; Lori E. Faulk, MS, RD; Suzanne Henson, MS, RD; Kathy Hubbert, MS, RD; Douglas C. Heimburger, MD, MS; Jamy D. Ard, MD

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Abstract

Context: Increased dietary variety has been associated with increased body weight; however, diet variety is not measured using a standardized methodology.
Objective: We developed a new dietary variety score (DVS) based on food macronutrient content, and determined the relationship between DVS and measures of adiposity.
Design: Cross-sectional, observation study.
Setting: University of Alabama at Birmingham (UAB), EatRight Weight Management Program
Patients: Study subjects (n = 74) were former participants of UAB's EatRight Weight Management Program who completed the program at least 1 year ago.
Main Outcome Measures: Unique items from 4-day food records were converted to macronutrient categories using the diabetic exchange. Foods were categorized as a source of carbohydrate if containing ≥ 5 g carbohydrate and ≥ 20 calories; fat if containing ≥ 5g fat; protein if containing ≥ 7g protein. Height and weight were measured; BMI (kg/m2) was calculated. Dual energy X-ray absorptiometry measured body fat. Generalized linear modeling in SAS (Ver.9) determined relationships between adiposity and DVS.
Results: On average, participants weighed 92.7 ± 30.9 kg (BMI = 32.5 kg/m2). Men and women's body fat were 37.4 ± 6.4% and 47.3 ± 6.4%, respectively. Separate linear regression models containing terms for sex and DVS showed significant relationships between macronutrient DVS and BMI. In a multivariate model controlling for each of the macronutrient DVS, BMI was not related to fat DVS, but was found to be positively related to protein DVS (beta = 0.87, P = .04). Sex modified the relationship between carbohydrate DVS and BMI, with an inverse relationship between BMI and carbohydrate DVS among women, and a positive relationship among men. Percent body and trunk fat were not related to DVS for either gender.
Conclusions: The new DVS, based on macronutrient content of foods, had significant associations with BMI. These dietary variety scores may provide another way to evaluate the impact of consuming a variety of food types on energy intake and BMI.
Key Words: Dietary variety, macronutrient, body mass index, obesity, body composition

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