Aims Eating a varied diet promotes adequate micronutrient intake. Poor appetite could decrease the desire to eat a varied dietleading to dietary micronutrient insufficiencies. The interrelationships among appetite, diet variety, and dietary micronutrientintake have not been investigated in patients with heart failure (HF). The purpose of the study was to determine whether therelationship between appetite and micronutrient insufficiency was mediated through diet variety.
Methodsand results A total of 238 patients with HF, mean age 61 ± 12.1; 68% male, and 45% NYHA class III/IV were included in this secondaryanalysis. Data collection consisted of a 4-day food diary and self-reported appetite on a 10-point visual analogue scale.Micronutrient insufficiency was defined as the total number of 17 minerals and vitamins that were insufficient in the diet.Diet variety was calculated as the number of 23 food types consumed over the 4 days. Mediation analysis, controlling for cov-ariates age, gender, NYHA class, and body mass index showed that diet variety mediated the relationship between appetiteand micronutrient insufficiencies [indirect effect = −0.0828, 95% confidence interval (CI): −0.1585 to −0.0150]. There was nodirect effect of appetite on micronutrient insufficiency (c ́ = −0.1802; 95% CI = −0.3715 to.0111).
Conclusions Diet variety played a previously unrecognized role in the relationship between appetite and dietary micronutrient intake inpatients with HF. More research is needed to validate these associations in patients with HF.