Ecological diversity indices such as Hill numbers have been developed to estimate effective species numbers, yet the ability of Hill numbers to compare food biodiversity across contexts is unclear. Here we computed the between- and within-country variability of similarity-insensitive Hill numbers using dietary intake collected from prospective cohorts in nine European countries and cross-sectional studies in five low- and middle-income countries. We also assessed the relationships between more biodiverse diets, mortality rates and micronutrient adequacy. Only Hill0, better known as dietary species richness (DSR), showed strong heterogeneity between countries and individuals within countries. Higher DSR was most strongly associated with lower mortality rates in Europe as compared to Hill1, Hill2 and Hill∞, whereas relationships with micronutrient adequacy were comparable across Hill numbers in the global south. DSR can be used to assess progress towards more biodiverse diets, while also serving as a marker for the deleterious nutrition and health impacts associated with non-diverse diets.

Alliance of Bioversity International and the International Center for Tropical Agriculture Hanoi Viet Nam

Alliance of Bioversity International and the International Center for Tropical Agriculture Nairobi Kenya

Alliance of Bioversity International and the International Center for Tropical Agriculture Rome Italy

Cancer Epidemiology and Prevention Research Unit School of Public Health Imperial College London London UK

Centre for Biostatistics Epidemiology and Public Health Department of Clinical and Biological Sciences University of Turin Turin Italy

Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública Madrid Spain

Department of Agricultural Biology Faculty of Agriculture University of Ruhuna Matara Sri Lanka

Department of Community Medicine Faculty of Health Sciences UiT The Arctic University of Norway Tromsø Norway

Department of Data Analysis and Mathematical Modelling Faculty of Bioscience Engineering Ghent University Ghent Belgium

Department of Epidemiology and Biostatistics School of Public Health Imperial College London London UK

Department of Food Science Nutrition and Technology Faculty of Agriculture University of Nairobi Nairobi Kenya

Department of Food Technology Safety and Health Faculty of Bioscience Engineering Ghent University Ghent Belgium

Department of Molecular Epidemiology German Institute of Human Nutrition Potsdam Rehbruecke Nuthetal Germany

Department of Nutrition Sports and Exercise University of Copenhagen Frederiksberg Denmark

Department of Public Health Aarhus University Aarhus Denmark

Faculty of Medicine Universidad de Especialidades Espíritu Santo Samborondon Ecuador

Faculty of Tropical AgriSciences Czech University of Life Sciences Prague Czech Republic

Institute of Nutritional Science University of Potsdam Nuthetal Germany

Instituto de Salud Pública y Laboral de Navarra Pamplona Spain

Julius Center for Health Sciences and Primary Care University Medical Center Utrecht Utrecht University Utrecht The Netherlands

Medical Research Council Unit The Gambia London School of Hygiene and Tropical Medicine London UK

MRC Epidemiology Unit University of Cambridge School of Clinical Medicine Cambridge UK

Navarra Institute for Health Research Pamplona Spain

Nutrition and Metabolism Branch International Agency for Research on Cancer Lyon France

Sorbonne Paris Nord University Inserm INRAE Cnam Nutritional Epidemiology Research Team Bobigny France

Steno Diabetes Center Aarhus Aarhus University Hospital Aarhus Denmark

The Alliance of Bioversity International and the International Center for Tropical Agriculture Montpellier France

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