Dietary diversity helps lower bad cholesterol in women

Adherence to a diet containing a variety of foods may improve serum lipid markers, suggests a study involving Japanese female workers.

“A higher dietary diversity seems to reflect healthy nutritional habits, which have been shown to be related to higher food quality,” according to the investigators. [J Am Diet Assoc 2002;102:1096-1104]

A higher score in dietary diversity among women showed an inverse relationship with serum concentrations of low-density lipoprotein (LDL) cholesterol (p=0.028), triglycerides (p=0.029), and nonhigh-density lipoprotein (non-HDL) cholesterol (p=0.026). [Eur J Clin Nutr 2025;79:273-282]

After additional adjustments for three dietary patterns (ie, healthy, western, and sweetener), these associations remained robust, apart from that with serum triglycerides. The association with serum triglycerides disappeared following the adjustment for a healthy pattern.

On the other hand, no significant association was observed between dietary diversity and dyslipidaemia in men during the follow-up period.

Previous studies

These findings support those of a US study on healthy diets in women, showing that greater adherence to the DASH dietary pattern correlated with increased plasma concentrations of HDL cholesterol and lower concentrations of triglycerides and that greater adherence to the aMed dietary pattern resulted in lower levels of triglycerides. [Am J Clin Nutr 2017;105:432-441]

“Our previous study indicated an inverse association between higher dietary diversity and allergic rhinitis in Japanese female workers,” the investigators said. [Asia Pac J Clin Nutr 2019;28:857-869]

An earlier study involving 38,797 participants aged 45–74 years reported the inverse association of dietary diversity with disabling dementia. Moreover, these results did not change significantly when using disabling dementia with stroke in women. [Clin Nutr 2023;42:541-549]

In another study conducted among Japanese community dwellers, researchers tried to clarify the effects of dietary diversity on a decrease in higher-level functional capacity among middle-aged and older adults in a 14-year follow-up period. They found that a higher score in dietary diversity prevented a decline in cognitive activity among participants. [Nutrition 2016;32:784-789]

Additionally, a previous study that examined dietary diversity and brain morphology reported the association of higher dietary diversity with a slight reduction in hippocampal volume among community-dwelling adults in Japan. [Eur J Clin Nutr 2021;75:946-953]

Survival benefits

Other literature that delved on older populations also found that consumption of a great variety of foods resulted in the diversity of the gut microbiota and in short-chain fatty acid-producing bacteria, which help improve health. In addition, higher dietary diversity also showed beneficial effects on all-cause and cancer-specific mortality in older Japanese adults. [Nutrients 2020;12:1052]

"Our results support the results of previous studies showing adherence to eating diversity is likely to have favourable health outcomes,” the investigators said.

The current study included 745 participants aged 20–60 years in 2012–2013 without dyslipidaemia at baseline who participated at least once from 2013 to 2017. A food frequency questionnaire was used to assess dietary intake, while the Quantitative Index for Dietary Diversity was used to determine the dietary diversity score.

The investigators identified three dietary patterns (ie, healthy, western, and sweetener) using principal component analysis and measured lipid markers, such as total cholesterol, triglycerides, LDL-cholesterol, HDL-cholesterol, and non-HDL-cholesterol. To calculate the cumulative mean of lipid profiles in the follow-up period, generalized estimating equations were used.

“Further studies are needed to confirm such associations in different populations,” they noted.