{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T20:06:53Z","timestamp":1791662813154,"version":"4.3.4"},"reference-count":54,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Cardiometabolic risk is increasingly observed in young adults, particularly during university years, and is not limited to individuals with elevated body mass index. Emerging evidence highlights the presence of normal weight obesity\u2014characterized by excess adiposity and unfavorable body composition despite normal BMI\u2014which may confer early metabolic vulnerability. Dietary diversity is often promoted as a marker of dietary adequacy; however, its relationship with adiposity, body composition, and muscular health remains inconsistent, particularly in Latin American populations. Moreover, few studies have directly contrasted dietary diversity indicators with empirically derived dietary patterns in relation to cardiometabolic and functional outcomes. Objective: To examine the associations between dietary diversity, dietary patterns, and indicators of adiposity, muscular strength, and relative muscle mass in Ecuadorian university students. Methods: A cross-sectional study was conducted among 349 undergraduate students aged 18\u201326 years enrolled in health sciences programs in Ecuador. Dietary intake was assessed using a validated food frequency questionnaire. Dietary diversity was quantified using the Food and Agriculture Organization\u2019s Individual Dietary Diversity Score, while dietary patterns were identified through principal component analysis followed by k-means clustering. Outcomes included excess body weight, relative muscle mass assessed by bioelectrical impedance analysis, and handgrip strength. Multivariable Poisson and linear regression models were fitted, adjusting for age, sex, academic program, physical activity level, and pre-existing conditions. Results: Despite their young age and low prevalence of diagnosed disease, approximately one-third of the participants exhibited markers of early cardiometabolic risk, including excess body weight and central adiposity. Higher dietary diversity was independently associated with a higher prevalence of excess body weight (adjusted prevalence ratio per one-unit increase in IDDS: 1.17; 95% CI: 1.06\u20131.30) and with greater relative muscle mass (adjusted \u03b2 = 0.13; 95% CI: 0.05\u20130.22), whereas no association was observed with handgrip strength. In contrast, dietary patterns derived from multivariate analysis showed no significant associations with adiposity, muscular strength, or relative muscle mass after adjustment. Conclusions: In this young adult population, dietary diversity captured aspects of overall dietary exposure associated with both increased adiposity and greater lean mass, but not with muscular strength. Empirically derived dietary patterns demonstrated limited discriminatory capacity, likely reflecting dietary homogeneity within the cohort. These findings indicate that dietary diversity alone does not necessarily reflect diet quality and underscore the importance of interpreting diversity metrics alongside indicators of food quality, energy density, and body composition when evaluating early cardiometabolic risk in contemporary food environments.<\/jats:p>","DOI":"10.3390\/nu18030511","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T15:38:12Z","timestamp":1770046692000},"page":"511","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Dietary Diversity, Dietary Patterns, and Cardiometabolic Health in University Students: A Cross-Sectional Study"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6437-2730","authenticated-orcid":false,"given":"Diana","family":"Fonseca-P\u00e9rez","sequence":"first","affiliation":[{"name":"Carrera de Nutrici\u00f3n y Diet\u00e9tica, Facultad de Ciencias de la Salud, Universidad Cat\u00f3lica de Santiago de Guayaquil, Guayaquil 090615, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6116-6122","authenticated-orcid":false,"given":"Ludwig","family":"\u00c1lvarez-C\u00f3rdova","sequence":"additional","affiliation":[{"name":"Maestr\u00eda de Nutrici\u00f3n y Diet\u00e9tica, Facultad de Ciencias de la Salud, Universidad de Las Am\u00e9ricas (UDLA), Quito 170503, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2472-3820","authenticated-orcid":false,"given":"Cecilia","family":"Arteaga-Pazmi\u00f1o","sequence":"additional","affiliation":[{"name":"Carrera de Nutrici\u00f3n y Diet\u00e9tica, Facultad de Ciencias M\u00e9dicas, Universidad de Guayaquil, Guayaquil 090615, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0052-9209","authenticated-orcid":false,"given":"V\u00edctor","family":"Sierra-Nieto","sequence":"additional","affiliation":[{"name":"Carrera de Fisioterapia, Facultad de Ciencias de la Salud, Universidad Cat\u00f3lica de Santiago de Guayaquil, Guayaquil 090615, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1684-5206","authenticated-orcid":false,"given":"Jaen","family":"Cagua-Ordo\u00f1ez","sequence":"additional","affiliation":[{"name":"Facultad de Ciencias de la Salud y Bienestar Humano, Universidad Tecnol\u00f3gica Indoam\u00e9rica, Quito 170103, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2228-0141","authenticated-orcid":false,"given":"Evelyn","family":"Frias-Toral","sequence":"additional","affiliation":[{"name":"Escuela de Medicina, Universidad Esp\u00edritu Santo, Samborond\u00f3n 0901952, Ecuador"},{"name":"Division of Research, Texas State University, 601 University Dr., San Marcos, TX 78666, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8809-4931","authenticated-orcid":false,"given":"Giovanna","family":"Muscogiuri","sequence":"additional","affiliation":[{"name":"Endocrinology Unit, Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy"},{"name":"Italian Centre for the Care and Wellbeing of Patients with Obesity, Federico II University Hospital, 80131 Naples, Italy"},{"name":"UNESCO Chair on Health Education and Sustainable Development, Federico II University, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4234-5524","authenticated-orcid":false,"given":"Claudia","family":"Reytor-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Facultad de Ciencias de la Salud y Bienestar Humano, Universidad Tecnol\u00f3gica Indoam\u00e9rica, Ambato 180150, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3641-1501","authenticated-orcid":false,"given":"Daniel","family":"Simancas-Racines","sequence":"additional","affiliation":[{"name":"Facultad de Ciencias de la Salud y Bienestar Humano, Universidad Tecnol\u00f3gica Indoam\u00e9rica, Ambato 180150, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.1249\/MSS.0000000000002214","article-title":"Physical Activity and Cardiometabolic Risk Factor Clustering in Young Adults with Obesity","volume":"52","author":"Dipietro","year":"2020","journal-title":"Med. 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