A pilot study of the Nutrient Composition Diversity Index in a sample of healthy United States adults shows positive associations with adherence to the Dietary Guidelines for Americans and micronutrient adequacy

Authors: Gersten, Zachary; WILSON, STEPHANIE - University Of California, Davis; Larke, Jules; Lemay, Danielle; Caswell, Bess

Submitted to: Current Developments in Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 10/7/2025
Publication Date: 11/20/2025
Citation: Gersten, Z.P., Wilson, S.M., Larke, J.A., Lemay, D.G., Caswell, B.L. 2025. A pilot study of the Nutrient Composition Diversity Index in a sample of healthy United States adults shows positive associations with adherence to the Dietary Guidelines for Americans and micronutrient adequacy. Current Developments in Nutrition. 9(11). Article 107576. https://doi.org/10.1016/j.cdnut.2025.107576.
DOI: https://doi.org/10.1016/j.cdnut.2025.107576

Interpretive Summary: Food dendrograms, which are food trees that contain quantitative information, offer new ways to measure the quality of diets. In this study, we built a food dendrogram that arranged over 5,600 foods based on similarities in their content of 30 nutrients. We used this food dendrogram to score one such new metric, nutrient diversity, for the diets of 377 healthy US adults, where higher nutrient diversity means that a person eats foods with more variety in their nutrient contents. We found that higher nutrient diversity was associated with two existing ways to measure dietary quality: the 2015 Healthy Eating Index, which measures how closely a person's diet adheres to the 2015 US Dietary Guidelines for Americans, and Mean Probability of Adequacy, which measures the likelihood that a person's diet contains adequate amounts of 17 vitamins and minerals. We found that people with higher nutrient diversity tended to have higher HEI-2015 and MPA scores. Our findings will benefit researchers interested in using food dendrograms and nutrient diversity as a new metric of dietary quality, as well as policymakers who need information on how to characterize what people eat.

Technical Abstract: Background: Nutrient diversity is an emerging dietary metric that uses a food dendrogram to describe food dissimilarities based on nutrient content. Research has yet to assess nutrient diversity using repeat 24-hour dietary intake data or assess its convergent validity with dietary quality metrics in the same sample. Objectives: This study aimed to describe nutrient diversity constructed from dietary data collected over two 24-hour recalls in sample of healthy US adults and assess its convergent validity with two existing dietary quality metrics. Methods: We analyzed cross-sectional dietary data collected by two 24-hour recalls in 377 healthy adult participants (strata balanced for sex, age, and BMI). Daily nutrient diversity was computed using a food dendrogram of 5,628 foods and 30 nutrients in the USDA Food and Nutrient Database for Dietary Studies. We calculated best linear unbiased predictors of usual nutrient diversity to account for within-person variability of diet. Usual nutrient diversity was compared with the 2015 Healthy Eating Index (HEI-2015) and the Mean Probability of Adequacy (MPA) for 17 vitamins and minerals. Results: Mean usual nutrient diversity for the sample was 2.10 (SD 0.60) with a range of 0.81 to 4.01. In linear regression models, standardized usual nutrient diversity was positively associated with HEI-2015 (ß = 0.03, p < 0.001) and MPA (ß = 0.03, p < 0.001). Adjusting for usual energy intake slightly attenuated the association between standardized individual usual ND and MPA (ß = 0.02, p < 0.001). Conclusions: Nutrient diversity exhibits convergent validity with two dietary quality metrics, the HEI-2015 and the MPA for 17 vitamins and minerals.