Dietary Pattern and Diversity Analysis Using DietDiveR in R: a Cross-Sectional Evaluation in the National Health and Nutrition Examination Survey

BACKGROUND:There are few resources available for researchers aiming to conduct 24-h dietary record and recall analysis using R. OBJECTIVES:We aimed to develop DietDiveR, which is a toolkit of functions written in R for the analysis of recall or record data collected with the Automated Self-Administered 24-h Dietary Assessment Tool or 2-d 24-h dietary recall data from the National Health and Nutrition Examination Survey (NHANES). The R functions are intended for food and nutrition researchers who are not computational experts. METHODS:DietDiveR provides users with functions to 1) clean dietary data, 2) analyze 24-h dietary intakes in relation to other study-specific metadata variables, 3) visualize percentages of energy intake from macronutrients, 4) perform principal component analysis or k-means clustering to group participants by similar data-driven dietary patterns, 5) generate foodtrees based on the hierarchical food group information for food items consumed, 6) perform principal coordinate analysis taking food grouping information into account, and 7) calculate diversity metrics for overall diet and specific food groups. DietDiveR includes a self-paced tutorial on a website (https://computational-nutrition-lab.github.io/DietDiveR/). As a demonstration, we applied DietDiveR to a demonstration data set and data from NHANES 2015-2016 to derive a dietary diversity measure of nuts, seeds, and legumes consumption. RESULTS:Adult participants in the NHANES 2015-2016 cycle were grouped depending on the diversity in their mean consumption of nuts, seeds, and legumes. The group with the highest diversity in nuts, seeds, and legumes consumption had 3.8 cm lower waist circumference (95% confidence interval: 1.0, 6.5) than those who did not consume nuts, seeds, and legumes. CONCLUSIONS:DietDiveR enables users to visualize dietary data and conduct data-driven dietary pattern analyses using R to answer research questions regarding diet. As a demonstration of this toolkit, we explored the diversity of nuts, seeds, and legumes consumption to highlight some of the ways DietDiveR can be used for analyses of dietary diversity.