Dietary patterns and acculturation - Dietary Habits in the US

Nutrition Research Newsletter, Feb, 2004

Migration and acculturation are associated with changes in chronic disease risk. Epidemiologic studies consistently show that people who migrate from one part of the world to another quickly adopt the chronic disease patterns of their new host country. For example, Japanese immigrants to Hawaii experience a 50% decrease in stomach cancer risk, but a three-fold increase in breast cancer risk after just one generation. Japanese and Mexican immigrants living in the United States have higher rates of cardiovascular disease compared with those living in their home countries. The prevalence of hypertension is higher among African-Americans who have lived in the United States for several generations compared with first-generation immigrants. An important ethnic group in which to examine migration-related changes in diet and other lifestyle habits is Hispanics, because they are the fastest growing ethnic group in the United States. The objective of the present study was to examine the associations of acculturation with diet in a homogeneous sample of Hispanics, and to investigate whether acculturation is an independent predictor of fruit, vegetable and fat intake among Hispanics living in Washington State.

Data are from Celebrating Health!, a community intervention trial in the Yakima Valley of central Washington state. The overall objective of the trial is to assess the effectiveness of a comprehensive cancer prevention program, including a dietary intervention. Approximately 50% of the Yakima Valley Population is Hispanic, 90% of whom are from Michoacan, Mexico. Residents were recruited for an in-person baseline survey to obtain information about health beliefs and practices, diet, acculturation, and demographics. From a sample of 2,862 addresses, 2,345 were approached for study participation. There were 1,795 interviews completed.

Usual fruit and vegetable consumption during the previous month was assessed with a modified version of the instruments used in the Behavioral Risk Factor Surveillance System and the National 5-A-Day for Better Health program. These questionnaires contain six items that estimate the frequency of consumption of fruit, 100% fruit juice, and vegetables. Fat intake was assessed with the Fat-Related Diet Habits questionnaire. This 12-item questionnaire asks about diet over the previous month and assesses avoiding fat as flavoring, substituting specially flavored manufactured low-fat foods, modifying meals to be lower in fat, replacing high-fat foods with fruits and vegetables, and avoiding fried foods.

Dietary patterns varied by ethnicity and acculturation status. On average, compared with non-Hispanic white residents, Hispanics consumed one more serving of fruits and vegetables per day. Dietary habits changed as Hispanics acculturated to the United States. Highly acculturated Hispanics ate fewer servings of fruits and vegetables per day, compared with those not highly acculturated. Highly acculturated Hispanics had slightly higher--but not statistically significant--scores on the Fat-Related Diet Habits questionnaire, which corresponds to a higher fat intake, compared with low-acculturated Hispanics. The early dietary changes made on acculturation included adding fat at the table to breads and potatoes.

The findings of this study support the hypothesis that acculturation is an independent predictor of diet. Nutrition professionals should encourage their Hispanic clients to maintain their traditional dietary practices, such as the high intakes of fruits and vegetables, and to eat bread and potatoes without added fat. Dietitians can provide information about fat reduction behaviors that may be novel to recent immigrants, such as the use of reduced-fat milk or other lower-fat items.

M. Neuhouser, B. Thompson, G. Coronado, et al. Higher fat intake and lower fruit and vegetables intakes are associated with greater acculturation among Mexicans living in Washington state. JADA 104:51-57 (January 2004) [Correspondence: Marian L. Neuhouser, PhD, RD, Cancer Prevention, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue N, M4-B402, PO Box 19024, Seattle, WA 98109-1024. E-mail: mneuhous@fhcrc.org.]