Sarrafzadegan Nizal, Azadbakht Leila, Mohammadifard Noushin, Esmaillzadeh Ahmad, Safavi Morteza, Sajadi Firoozeh, Alikhasi Hasan, Maghroun Maryam, Kelishadi Roya
Isfahan Cardiovascular Research Center (WHO Collaborating Center in the Eastern Mediterranean Region), Isfahan University of Medical Sciences, PO Box 81465-1148, Isfahan, Iran.
Public Health Nutr. 2009 Oct;12(10):1924-30. doi: 10.1017/S1368980009004856. Epub 2009 Feb 23.
The dietary diversity score (DDS) is a good indicator of diet quality as well as of diet-disease relationships; therefore, the present study was undertaken to reveal the effect of a lifestyle intervention on this index.
A baseline and three evaluation studies were conducted in two intervention districts (Isfahan and Najaf-Abad) and a reference area (Arak), all located in central Iran. The Isfahan Healthy Hearth Programme (IHHP) targeted the entire population of nearly 2 million in urban and rural areas of the intervention communities. One of the main strategies of the lifestyle intervention phase in the IHHP was healthy nutrition. Usual dietary intake was assessed using a forty-nine-item FFQ. A diversity score for each food group was calculated and the DDS was considered the sum of the diversity scores of the food groups.
There were significant increases in DDS in both intervention areas (P = 0.0001) after controlling for confounding factors. There was a significant interaction between area and evaluation stage with regard to DDS (P = 0.0001). The effect of the intervention on the diversity scores of all food groups was also significant (P = 0.0001 for all) after adjusting for socio-economic status.
The community-based lifestyle intervention in the IHHP was successful in improving DDS which might be related to an increase of diet quality of the population that in turn might decrease the risks of chronic diseases.
饮食多样性评分（DDS）是饮食质量以及饮食与疾病关系的良好指标；因此，本研究旨在揭示生活方式干预对该指标的影响。
在伊朗中部的两个干预区（伊斯法罕和纳贾夫 - 阿巴德）和一个参考地区（阿拉克）进行了一项基线研究和三项评估研究。伊斯法罕健康心脏计划（IHHP）针对干预社区城乡近200万的全部人口。IHHP生活方式干预阶段的主要策略之一是健康营养。使用包含49个条目的食物频率问卷评估通常的饮食摄入量。计算每个食物组的多样性评分，DDS被视为食物组多样性评分的总和。
在控制混杂因素后，两个干预区的DDS均显著增加（P = 0.0001）。在DDS方面，地区与评估阶段之间存在显著交互作用（P = 0.0001）。在调整社会经济地位后，干预对所有食物组多样性评分的影响也具有显著性（所有P = 0.0001）。
IHHP中基于社区的生活方式干预成功提高了DDS，这可能与人群饮食质量的提高有关，进而可能降低慢性病风险。
