Open Access Highly Accessed Research article

High dietary diversity is associated with obesity in Sri Lankan adults: an evaluation of three dietary scores

Ranil Jayawardena12*, Nuala M Byrne1, Mario J Soares3, Prasad Katulanda2, Bijesh Yadav4 and Andrew P Hills5

Author Affiliations

1 Institute of Health and Biomedical Innovation, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia

2 Diabetes Research Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka

3 Curtin Health Innovation Research Institute, School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia

4 Department of Biostatistics, Christian Medical College, Vellore, India

5 Mater Mother’s Hospital, Mater Medical Research Institute and Griffith Health Institute, Griffith University, Brisbane, QLD, Australia

For all author emails, please log on.

BMC Public Health 2013, 13:314  doi:10.1186/1471-2458-13-314

Published: 8 April 2013



Dietary diversity is recognized as a key element of a high quality diet. However, diets that offer a greater variety of energy-dense foods could increase food intake and body weight. The aim of this study was to explore association of diet diversity with obesity in Sri Lankan adults.


Six hundred adults aged > 18 years were randomly selected by using multi-stage stratified sample. Dietary intake assessment was undertaken by a 24 hour dietary recall. Three dietary scores, Dietary Diversity Score (DDS), Dietary Diversity Score with Portions (DDSP) and Food Variety Score (FVS) were calculated. Body mass index (BMI) ≥ 25 kg.m-2 is defined as obese and Asian waist circumference cut-offs were used diagnosed abdominal obesity.


Mean of DDS for men and women were 6.23 and 6.50 (p=0.06), while DDSP was 3.26 and 3.17 respectively (p=0.24). FVS values were significantly different between men and women 9.55 and 10.24 (p=0.002). Dietary diversity among Sri Lankan adults was significantly associated with gender, residency, ethnicity, education level but not with diabetes status. As dietary scores increased, the percentage consumption was increased in most of food groups except starches. Obese and abdominal obese adults had the highest DDS compared to non obese groups (p<0.05). With increased dietary diversity the level of BMI, waist circumference and energy consumption was significantly increased in this population.


Our data suggests that dietary diversity is positively associated with several socio-demographic characteristics and obesity among Sri Lankan adults. Although high dietary diversity is widely recommended, public health messages should emphasize to improve dietary diversity in selective food items.

Diet diversity; Dietary variety; DDS; Sri Lanka; Obesity; Adults