A cross-sectional baseline survey investigating the relationship between dietary diversity and cardiovascular risk factors in women from the Vaal Region, South Africa

Abstract

Objective: Dyslipidaemia, an abnormality in circulating serum cholesterol, triglycerides, high-density and low-density lipoproteins, is one of the risk factors of cardiovascular disease. The role of nutrients is well known in the development of cardiovascular disease, but little emphasis is placed on total diet quality. Food group diversity and food variety scores are often used to reflect diet quality. The objective of this study was to investigate the relationship between dietary diversity and cardiovascular disease risk factors among low-income women in the Vaal Region.

Methods: A cross-sectional, observational baseline survey was undertaken in 722 randomly selected black women in four purposively selected peri-urban settlements in the Vaal Region. Measurements included socio-demographic data, dietary intake (24-hour recall), dietary diversity (food frequency), anthropometric (weight and height), blood pressure and biochemi-
cal indices (lipid profile). Data analyses included descriptive statistics, multivariate analyses of variance, analyses of variance and regression analyses.

Results: The mean individual dietary diversity score±standard deviation (SD) for the total group was 6.4±2.4. Those women in the low dietary diversity category were significantly (p=0.020) younger (45.8±4.4 years) and had a significantly (p=0.002) higher body mass index (30.7±2.8 kg/m²). The mean±SD of body mass index for the low and medium dietary diversity categories respectively indicated obesity (≥30 kg/m²) compared to overweight in the high dietary diversity category (29.3±5.4 kg/m²). The mean±SD systolic blood pressure (134.9±19.5) was significantly (p=0.000) higher in the low dietary diversity category, whereas the medium dietary diversity category showed the highest mean±SD total triglyceride level of 70.3±23.7 mg/dl. The high dietary diversity category was associated with the highest total serum cholesterol (176.4±24.2 mg/dl), low density lipoprotein cholesterol (103.8±28.7 mg/dl) and lowest high density lipoprotein cholesterol (46.1±10.6 mg/dl) levels.

Conclusions: Higher dietary diversity was associated with a healthier diet, not only in terms of nutrient intakes, but also with regard to food group variety across all nine nutritious food groups. Although relationships between dietary diversity and cardiovascular disease risk factors were observed, discrepant findings have been noted.