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Weisberg-Shapiro P, Devine C. "Men like to Eat More Rice and Beans and Things like That": The Influence of Childhood Experience and Life Course Events on Dietary Acculturation. Ecol Food Nutr 2019; 58:413-429. [PMID: 31035772 DOI: 10.1080/03670244.2019.1606805] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Life course perspective provides a framework for examining the immigrant experience within the context of globalization and transnationalism. Life course perspective states that individuals develop food choice trajectories based on childhood experiences with food. This study examined the influence of childhood experiences and life events on eating behaviors of Dominican born women in Santo Domingo, Dominican Republic, and New York City. Findings revealed that women developed traditional or non-traditional food choice trajectories. These food choice trajectories remained stable through transition points, such as immigration, marriage, and divorce. Women discussed changes in the amount of food that was eaten, which may explain weight gain after immigration. These findings highlight the limitations of acculturation theory in understanding the eating behaviors of immigrants and provide an alternative explanation for weight gain after immigration.
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Affiliation(s)
| | - Carol Devine
- Division of Nutritional Sciences, Cornell University , Ithaca, NY , USA
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52
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Estrada Del Campo Y, Cubillos L, Vu MB, Aguirre A, Reuland DS, Keyserling TC. Feasibility and acceptability of a Mediterranean-style diet intervention to reduce cardiovascular risk for low income Hispanic American women. ETHNICITY & HEALTH 2019; 24:415-431. [PMID: 28670906 PMCID: PMC5821604 DOI: 10.1080/13557858.2017.1346784] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Accepted: 05/18/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Evidence for the cardioprotective effects of a Mediterranean-style (Med-style) diet is strong, however few Med-style dietary interventions have been developed for and tested among Hispanic Americans (HAs), especially younger HAs of reproductive age whose dietary habits may strongly influence dietary intake for all family members. DESIGN We adapted a previously tested and evidence-informed lifestyle intervention to reduce CVD risk and evaluated its feasibility, acceptability, and effects on self-reported lifestyle behaviors in this study enrolling low-income HA women attending a Title X family planning clinic in eastern North Carolina. The 3-month long intervention, given to all participants, promoted a Med-style dietary pattern with a focus on increasing consumption of foods commonly consumed by HA that have high quality dietary fats (polyunsaturated and monounsaturated fats primarily from plant sources and fish) and carbohydrates (fruits, vegetables, and whole grains). The intervention also recommended increasing physical activity and was given during 2 face-to-face counseling sessions and 2 telephone counseling sessions. Major outcomes were engagement with study activities and intervention acceptability; lifestyle behavior change at 3-month follow-up is also reported. RESULTS Baseline characteristics (n = 36) were: mean age 33 years, 35 (97%) without health insurance, 32 (89%) born in Mexico, and mean BMI 30 kg/m2. Engagement was high among the 36 participants with 33 (92%) completing the intervention and follow-up measures. At follow-up, most participants thought the intervention was helpful (range: 85-100%) and acceptable (100% agreed 'I would recommend the program to others'). The mean dietary fat quality score improved by 0.5 units (95% CI: 0.0-1.1) and the mean fruit-vegetable servings/day improved by 0.7/day (95% CI: 0.1-1.3). CONCLUSION Intervention engagement and acceptability were high and there was improvement in self-reported dietary behaviors. This type of Med-style dietary pattern intervention should be evaluated in randomized trials enrolling HAs at risk for CVD.
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Affiliation(s)
- Yaniré Estrada Del Campo
- a Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
| | - Laura Cubillos
- b Cecil G. Sheps Center for Health Services Research , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
| | - Maihan B Vu
- a Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
| | - Aurelia Aguirre
- a Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
| | - Daniel S Reuland
- c Department of Medicine , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
| | - Thomas C Keyserling
- a Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
- c Department of Medicine , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
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53
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Fuster M, Colón-Ramos U. Changing Places, Changing Plates? A Binational Comparison of Barriers and Facilitators to Healthful Eating Among Central American Communities. J Immigr Minor Health 2019; 20:705-710. [PMID: 28424997 DOI: 10.1007/s10903-017-0588-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
To understand the process by which immigrants adopt dietary practices, this study offers a binational comparison of factors that predispose, enable, and reinforce healthful eating in the sending and receiving countries. Data are from two qualitative studies that examined barriers and facilitators to healthful eating in El Salvador (four focus groups, n = 28 adults) and in the US (30 in-depth interviews n = 15 mothers recently migrated from Central America). There was a strong emphasis on hygiene and vitamin-content of foods among participants in El Salvador. In both settings, participants perceived that their respective community food environments (schools, food stores) exposed their families to highly processed, unhealthful foods. In both settings, they described similar struggles to encourage their families to eat foods healthfully (traditional, home-made foods). These results underscore the importance of acknowledging the changing food environment in sending countries where people may already be exposed to processed foods.
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Affiliation(s)
- Melissa Fuster
- City University of New York - Brooklyn College, 2900 Bedford Ave., Brooklyn, NY, 11210, USA.
| | - Uriyoán Colón-Ramos
- George Washington University Milken Institute School of Public Health, Washington, DC, 20052, USA
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Pineros-Leano M, Tabb K, Liechty J, Castañeda Y, Williams M. Feeding decision-making among first generation Latinas living in non-metropolitan and small metro areas. PLoS One 2019; 14:e0213442. [PMID: 30883597 PMCID: PMC6422285 DOI: 10.1371/journal.pone.0213442] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 02/21/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Worldwide, overweight and obesity rates have more than tripled over the past three decades. Overweight and obesity rates are particularly high among Latinos. In order to determine some of the potential reasons, it is imperative to investigate how first-generation Latina mothers living in non-metropolitan and small metro areas decide how and what to feed their children. Using the Socio-Ecological Model, this study aimed to understand how Latina immigrant mothers make feeding decisions for their children. METHODS A total of 29 semi-structured interviews were conducted with a purposive sample of immigrant mothers from Latin American countries whose preschoolers were enrolled in a Women, Infant, and Children supplemental nutrition program located in non-metropolitan and small metro areas. All interviews were recorded and transcribed verbatim in Spanish, and analyzed by a bilingual team. RESULTS Multi-stage qualitative analysis was employed to analyze the data. Nineteen participants originated from Mexico, four from Central America, and six from South America. Five themes emerged that helped illuminate mother's decision-making around feeding choices: 1) culture as all-encompassing, 2) location and access to fresh and traditional foods, 3) disjunction between health provider advice and cultural knowledge 4) responsiveness to family needs and wants as determinants of food choices, 5) intrapersonal conflict stemming from childhood poverty and food insufficiency. CONCLUSION Findings suggest that Latina immigrant mothers engage in a difficult and even conflicting process when deciding how to feed their children. Future interventions should focus on implementing hands-on activities that can help consolidate, promote, and encourage healthy feeding choices.
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Affiliation(s)
- Maria Pineros-Leano
- School of Social Work, Boston College, Boston, Massachusetts, United States of America
- Illinois Transdisciplinary Obesity Prevention Program (I-TOPP), Urbana, Illinois, United States of America
| | - Karen Tabb
- School of Social Work, University of Illinois, Urbana, Illinois, United States of America
| | - Janet Liechty
- Illinois Transdisciplinary Obesity Prevention Program (I-TOPP), Urbana, Illinois, United States of America
- School of Social Work, University of Illinois, Urbana, Illinois, United States of America
- College of Medicine at Urbana, University of Illinois, Urbana, Illinois, United States of America
- Carle-Illinois College of Medicine, University of Illinois, Urbana, Illinois, United States of America
| | - Yvette Castañeda
- Department of Kinesiology and Community Health, University of Illinois, Urbana, Illinois, United States of America
| | - Melissa Williams
- Office of Minority Student Affairs, University of Illinois, Champaign, Illinois, United States of America
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Soto SH, Arredondo EM, Shakya HB, Roesch S, Marcus B, Parada H, Ayala GX. Family environment, children's acculturation and mothers' dietary intake and behaviors among Latinas: An autoregressive cross-lagged study. Soc Sci Med 2019; 228:93-102. [PMID: 30897499 DOI: 10.1016/j.socscimed.2019.03.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 02/12/2019] [Accepted: 03/10/2019] [Indexed: 01/17/2023]
Abstract
BACKGROUND Many Latinos in the U.S. do not meet dietary recommendations for healthy eating. Family systems theory posits that the family environment affects family members' dietary behaviors. Moreover, research suggests that children's acculturation is associated with Latina mothers' dietary intake and behaviors. PURPOSE This longitudinal study examined the effect of the family environment on Latina mothers' dietary intake and behaviors. Further, we examined whether these effects differed between mothers of assimilated versus bicultural children. METHODS Secondary data were collected at three time points (baseline, and four and 10 months' post-baseline) from 162 culturally traditional and bicultural Latina mothers residing in Imperial County, California, U.S. Participants were enrolled in the delayed treatment group of a randomized controlled trial. Mothers' daily fruit, vegetable, and sugary beverages intake, percent of calories from fat, weekly away-from-home eating, and percent of weekly grocery dollars spent on fruits and vegetables were examined. The family environment was measured by family expressiveness and family interactions around food. Separate autoregressive cross-lagged models examined the effects of the family environment on dietary outcomes, adjusting for sociodemographic variables. Interactions between the family environment and children's acculturation were also tested. RESULTS Less positive family interactions around food at baseline predicted more frequent away-from-home eating four months later among mothers of assimilated children. More family expressiveness at four months predicted more grocery dollars spent on fruits and vegetables at ten months among mothers of bicultural children. CONCLUSIONS Findings suggest the importance of a positive family environment on socially-bound dietary behaviors (e.g., away-from-home eating) exhibited by the mother. Family interventions aimed at improving dietary intake and associated behaviors should promote a positive family environment around food and consider the moderating role of children's acculturation.
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Affiliation(s)
- Sandra H Soto
- University of North Carolina, Chapel Hill, School of Nursing, Carrington Hall, Campus Box #7460 Chapel Hill, NC, 27599, USA.
| | - Elva M Arredondo
- Institute for Behavioral and Community Health, 9245 Sky Park Court, Suite 221, San Diego, CA, 92123, USA; San Diego State University, College of Health and Human Services, Graduate School of Public Health, Division of Health Promotion and Behavioral Science, 5500 Campanile Drive, San Diego, CA, 92182, USA.
| | - Holly B Shakya
- University of California, San Diego, USA; Department of Medicine, Division of Global Health, 9500 Gilman Drive, La Jolla, CA, 92093, USA.
| | - Scott Roesch
- San Diego State University, College of Sciences, Department of Psychology, 5500 Campanile Drive, San Diego, CA, 92182, USA.
| | - Bess Marcus
- Brown University, School of Public Health, 121 S Main St, Providence, RI, 02903, USA.
| | - Humberto Parada
- San Diego State University, College of Health and Human Services, Graduate School of Public Health, Division of Health Promotion and Behavioral Science, 5500 Campanile Drive, San Diego, CA, 92182, USA.
| | - Guadalupe X Ayala
- Institute for Behavioral and Community Health, 9245 Sky Park Court, Suite 221, San Diego, CA, 92123, USA; San Diego State University, College of Health and Human Services, Graduate School of Public Health, Division of Health Promotion and Behavioral Science, 5500 Campanile Drive, San Diego, CA, 92182, USA.
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Johansen CM, Reynolds KD, Xie B, Unger JB, Ames SL. Acculturation and sugar-sweetened beverage consumption among Hispanic adolescents: The moderating effect of impulsivity. Appetite 2019; 134:142-147. [PMID: 30578800 DOI: 10.1016/j.appet.2018.12.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 10/09/2018] [Accepted: 12/19/2018] [Indexed: 12/25/2022]
Abstract
Consumption of sugar-sweetened beverages is a risk factor for obesity. Acculturation to the United States (US) might increase sugar-sweetened beverage consumption among Hispanic adolescents, but few moderators of this relationship have been examined. This study examined the moderating influence of impulsivity on the association between acculturation and sugar-sweetened beverages. Hispanic adolescents (n = 154), 14-17 years, were identified and screened for eligibility through low-SES high schools and parents provided consent. Adolescents completed measures of acculturation using Unger's 8-item acculturation scale, impulsivity, and diet. Multiple linear regression was used to examine the main effect of acculturation and the interaction of acculturation with impulsivity on the diet outcomes: sugar-sweetened beverage consumption and percent of calories from sugar. Acculturation was positively associated with sugar-sweetened beverages (β = 0.43; p < .05). The interaction of acculturation x impulsivity was significant (β = 0.42, p < .05). Among youth who were more acculturated, those who were more impulsive consumed more sugar-sweetened beverages. Youth who were more acculturated, but less impulsive consumed less sugar-sweetened beverages. Neurocognitive variables such as impulsivity may be important moderators of the influence of acculturation on dietary behavior. Targeted messaging strategies based on levels of acculturation and impulsivity might enhance the effectiveness of interventions designed to reduce the intake of sugar-sweetened beverages among Hispanic adolescents.
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Affiliation(s)
- Christopher M Johansen
- School of Community and Global Health, Claremont Graduate University, 675 W. Foothill Blvd, Suite 310, Claremont, CA, 91711, USA.
| | - Kim D Reynolds
- School of Community and Global Health, Claremont Graduate University, 675 W. Foothill Blvd, Suite 310, Claremont, CA, 91711, USA.
| | - Bin Xie
- School of Community and Global Health, Claremont Graduate University, 675 W. Foothill Blvd, Suite 310, Claremont, CA, 91711, USA.
| | - Jennifer B Unger
- University of Southern California, Department of Preventive Medicine, 2001 N. Soto St., SSB 302, Los Angeles, CA, 90089, USA.
| | - Susan L Ames
- School of Community and Global Health, Claremont Graduate University, 675 W. Foothill Blvd, Suite 310, Claremont, CA, 91711, USA.
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Vercammen KA, McClain AC, Tucker KL, Falcón LM, Mattei J. The association between baseline acculturation level and 5-year change in adiposity among Puerto Ricans living on the mainland United States. Prev Med Rep 2019; 13:314-320. [PMID: 30792946 PMCID: PMC6369330 DOI: 10.1016/j.pmedr.2019.01.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 01/21/2019] [Accepted: 01/23/2019] [Indexed: 10/28/2022] Open
Abstract
While it is recognized that acculturation influences adiposity risk, the direction and magnitude of this relationship remain unclear. Previous studies' use of proxy acculturation measures and exclusively cross-sectional study designs have limited understanding of this research question. The aim of this study was to examine associations between acculturation and adiposity among Puerto Ricans (45-75 years) living on the mainland United States. We analyzed data from the longitudinal (baseline, 2-year, 5-year) Boston Puerto Rican Health Study (n = 1114). Language-based and psychological-based acculturations were assessed at baseline using questionnaires. Acculturation scores were divided into tertile categories; higher tertiles indicate greater English- and U.S.-based acculturation. Adiposity was assessed using BMI and waist circumference at baseline and each follow-up. Linear mixed effects regression models were fit with baseline acculturation tertile as the predictor and baseline or change in adiposity as the outcome. When examining baseline associations with language acculturation tertiles, participants in the middle acculturation tertile (bilingual) had 2.48 cm (95%CI: -4.64, -0.31) lower waist circumference compared to the more Spanish-based acculturation tertile. When examining the associations between baseline language acculturation tertiles and change in adiposity, those in the more English-based acculturation tertile had higher annual gains in BMI (0.13 kg/m2 (95%CI: 0.01, 0.25)) and waist circumference (0.44 cm (95%CI: 0.01, 0.88)) over 5-years compared to those in the more Spanish-based acculturation tertile. No significant differences in adiposity were found across psychological-based acculturation tertiles. In conclusion, English language-based acculturation at baseline influences long-term adiposity. Psychological-based acculturation may capture distinct acculturation processes from the language-based construct.
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Affiliation(s)
- Kelsey A Vercammen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Amanda C McClain
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Katherine L Tucker
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, MA, USA
| | - Luis M Falcón
- College of Fine Arts, Humanities & Social Sciences, University of Massachusetts Lowell, MA, USA
| | - Josiemer Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Aguayo-Mazzucato C, Diaque P, Hernandez S, Rosas S, Kostic A, Caballero AE. Understanding the growing epidemic of type 2 diabetes in the Hispanic population living in the United States. Diabetes Metab Res Rev 2019; 35:e3097. [PMID: 30445663 PMCID: PMC6953173 DOI: 10.1002/dmrr.3097] [Citation(s) in RCA: 109] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 11/12/2018] [Accepted: 11/13/2018] [Indexed: 12/15/2022]
Abstract
The prevalence and incidence of type 2 diabetes (T2D) among the Hispanic population in the United States are higher than the national average. This is partly due to sociocultural factors, such as lower income and decreased access to education and health care, as well as a genetic susceptibility to obesity and higher insulin resistance. This review focuses on understanding the Hispanic population living in the United States from a multidisciplinary approach and underlines the importance of cultural, social, and biological factors in determining the increased risk of T2D in this population. An overview of the acute and chronic complications of T2D upon this population is included, which is of paramount importance to understand the toll that diabetes has upon this population, the health system, and society as a whole. Specific interventions directed to the Hispanic populations are needed to prevent and alleviate some of the burdens of T2D. Different prevention strategies based on medications, lifestyle modifications, and educational programmes are discussed herein. Diabetes self-management education (DSME) is a critical element of care of all people with diabetes and is considered necessary to improve patient outcomes. To be more effective, programmes should take into consideration cultural factors that influence the development and progression of diabetes. These interventions aim to enhance long-term effects by reducing the incidence, morbidity, and mortality of T2D in the Hispanic population of the United States.
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Affiliation(s)
| | - Paula Diaque
- Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Sonia Hernandez
- Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, USA
- Surgery Department, University of Chicago, Chicago, Illinois, USA
| | - Silvia Rosas
- Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Aleksandar Kostic
- Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, USA
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Haire-Joshu D, Hill-Briggs F. The Next Generation of Diabetes Translation: A Path to Health Equity. Annu Rev Public Health 2019; 40:391-410. [PMID: 30601723 DOI: 10.1146/annurev-publhealth-040218-044158] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Disparities in diabetes burden exist in large part because of the social determinants of health (SDOH). Translation research and practice addressing health equity in diabetes have generally focused on changing individual behavior or providing supportive approaches to compensate for, rather than directly target, SDOH. The purpose of this article is to propose a pathway for addressing SDOH as root causes of diabetes disparities and as an essential target for the next generation of interventions needed to achieve health equity in diabetes prevention and treatment. This review describes ( a) the current burden of diabetes disparities, ( b) the influence of SDOH on diabetes disparities, ( c) gaps in and implications of current translation research, and ( d) approaches to achieving health equity in the next generation of diabetes translation.
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Affiliation(s)
- Debra Haire-Joshu
- Public Health and Medicine, Brown School, Washington University in St. Louis, St. Louis, Missouri 63130, USA;
| | - Felicia Hill-Briggs
- Departments of Medicine; Health, Behavior and Society; and Acute and Chronic Care; and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA;
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Gibbs HD, Camargo JMTB, Owens S, Gajewski B, Cupertino AP. Measuring Nutrition Literacy in Spanish-Speaking Latinos: An Exploratory Validation Study. J Immigr Minor Health 2018; 20:1508-1515. [PMID: 29164448 PMCID: PMC5962388 DOI: 10.1007/s10903-017-0678-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Nutrition is important for preventing and treating chronic diseases highly prevalent among Latinos, yet no tool exists for measuring nutrition literacy among Spanish speakers. This study aimed to adapt the validated Nutrition Literacy Assessment Instrument for Spanish-speaking Latinos. This study was developed in two phases: adaptation and validity testing. Adaptation included translation, expert item content review, and interviews with Spanish speakers. For validity testing, 51 participants completed the Short Assessment of Health Literacy-Spanish (SAHL-S), the Nutrition Literacy Assessment Instrument in Spanish (NLit-S), and socio-demographic questionnaire. Validity and reliability statistics were analyzed. Content validity was confirmed with a Scale Content Validity Index of 0.96. Validity testing demonstrated NLit-S scores were strongly correlated with SAHL-S scores (r = 0.52, p < 0.001). Entire reliability was substantial at 0.994 (CI 0.992-0.996) and internal consistency was excellent (Cronbach's α = 0.92). The NLit-S demonstrates validity and reliability for measuring nutrition literacy among Spanish-speakers.
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Affiliation(s)
- Heather D Gibbs
- Department of Dietetics & Nutrition, University of Kansas Medical Center, Mail Stop 4013, Kansas City, KS, 66160, USA.
| | - Juliana M T B Camargo
- Department of Dietetics & Nutrition, University of Kansas Medical Center, Mail Stop 4013, Kansas City, KS, 66160, USA
| | - Sarah Owens
- Department of Dietetics & Nutrition, University of Kansas Medical Center, Mail Stop 4013, Kansas City, KS, 66160, USA
| | - Byron Gajewski
- Department of Biostatistics, University of Kansas Medical Center, Kansas City, KS, USA
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Ramírez AS, Arellano Carmona K. Beyond fatalism: Information overload as a mechanism to understand health disparities. Soc Sci Med 2018; 219:11-18. [PMID: 30342382 PMCID: PMC6240483 DOI: 10.1016/j.socscimed.2018.10.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 10/03/2018] [Accepted: 10/12/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Fatalism - beliefs about the causes and controllability of disease - has been negatively associated with prevention behaviors. Fatalism has been suggested as a mechanism for health disparities because ethnic minorities are especially likely to hold fatalistic beliefs. However, the construct has been criticized: Fatalism fails to account for structural barriers to health faced by vulnerable populations that also score highly on measures of fatalism. Another critique suggests that operationalizations of fatalism expose communication failures: "Fatalism" rather reflects information overload from an environment riddled with misinformation and contradictions. This study aimed to expand understanding of one mechanism through which communication may contribute to disparities by considering the context of nutrition among bicultural Latinas, who face increased risk from dietary acculturation. METHOD Mixed-methods (semi-structured in-depth interview, survey) with Mexican-American women ages 18-29 (n = 24) in rural California. RESULTS Contrary to previous studies, the majority of this sample of Mexican-American women did not endorse fatalistic beliefs; most demonstrated clear understanding of the link between diet and risk of diseases: Diabetes and heart disease were understood to result from behaviors within one's control. Yet despite articulating links between diet and disease, participants felt overloaded and confused about conflicting information from public and interpersonal sources. Moreover, despite reporting feeling inundated with information, participants noted critical information gaps, distinguishing between information available and information needed. CONCLUSIONS We found minimal support for fatalistic beliefs among a sample of Mexican-American women, but considerable information overload and confusion, together with a desire for specific knowledge and skills. Results extend understanding of how communication may influence disparities: Information overload may be conflated with fatalism, challenging the notion that fatalism is a cultural belief. Moreover, inequalities in access to and ability to process information compound overload effects. We discuss opportunities to improve the clarity of communication about nutrition science and dietary recommendations.
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Affiliation(s)
- A Susana Ramírez
- School of Social Sciences, Humanities, and Arts, University of California, Merced 5200 North Lake Road, Merced, CA, 95343, USA.
| | - Kimberly Arellano Carmona
- School of Social Sciences, Humanities, and Arts, University of California, Merced 5200 North Lake Road, Merced, CA, 95343, USA.
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Padilla ME, Frietze G, Shenberger-Trujillo JM, Carrillo M, Loya AM. Influenza and Intentions to Vaccinate in an Underserved Hispanic Population: The Role of Theoretically Derived Constructs. J Pharm Pract 2018; 33:326-333. [DOI: 10.1177/0897190018810595] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Past research has focused on understanding influenza vaccine acceptance in non-Hispanic white populations; however, research on the social causes of influenza vaccine acceptance rates in Hispanic populations is slowly developing. Objective: The purpose of this study was to assess theoretically driven predictors (i.e. attitudes, perceptions, behaviors, etc.) on influenza and the intention to vaccinate. Methods: A survey was administered to assess predictors of intentions to receive the influenza vaccine. The survey included items adapted from the National Flu Survey. Results: Key constructs common in models of health behaviors emerged as predictors of behavioral intentions to receive the flu vaccine. Recent vaccination within the past year ( P < 0.001), perceived effectiveness of the flu vaccine ( P < 0.004), and perceived safety of the flu vaccine ( P = 0.009) were predictors of intentions to vaccinate. Exploratory analyses revealed that government distrust was a statistically significant predictor of intentions to vaccinate ( P = 0.044). Conclusion: The above results have important implications for health-care providers and public health educators. The better we understand the relationship between theoretically driven predictors and vaccine behaviors, the more educators and health-care providers can focus on meaningful, culturally sensitive, targeted-vaccine education.
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Affiliation(s)
| | - Gabriel Frietze
- University of Texas at El Paso School of Pharmacy, El Paso, TX, USA
| | | | | | - Amanda M. Loya
- University of Texas at El Paso School of Pharmacy, El Paso, TX, USA
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Mattei J, McClain AC, Falcón LM, Noel SE, Tucker KL. Dietary Acculturation among Puerto Rican Adults Varies by Acculturation Construct and Dietary Measure. J Nutr 2018; 148:1804-1813. [PMID: 30383277 PMCID: PMC6669953 DOI: 10.1093/jn/nxy174] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Accepted: 07/10/2018] [Indexed: 01/14/2023] Open
Abstract
Background The role of acculturation in dietary behaviors among Hispanics/Latinos in the United States remains unclear. Discrepancies may be explained by variations in acculturation constructs or ethnicity-specific dynamics. Objective We aimed to compare relations between 3 different acculturation constructs with dietary quality and patterns among Puerto Ricans in the mainland United States. Methods We analyzed cross-sectional data with 1194-1380 Puerto Ricans, aged 45-75 y. Acculturation was measured with the use of a language-based scale (0-100; higher score denotes more English use), a psychological-based scale (0-50; higher score denotes stronger US orientation), and years living in the mainland United States. Diet quality scores (higher scores denote healthier diet) were defined with the use of the Alternate Healthy Eating Index-2010 (AHEI) and the Mediterranean Diet Score (MeDS). Three dietary patterns were previously derived with the use of principal components analysis. Adjusted multivariable regression models tested the association of each acculturation construct with diet quality score or pattern. Interaction terms were included for income or education status. Results Psychological-based acculturation, but not the other constructs, was positively associated with AHEI (β ± SE: 0.013 ± 0.004; P = 0.002) and MeDS (0.009 ± 0.005; P = 0.041). Income, but not education, moderated this association (P = 0.03), with higher diet quality observed with higher income (>$25,000) and stronger US orientation. All constructs were inversely associated with a traditional dietary pattern, with the language-based scale being stronger (z score β ± SE: -0.160 ± 0.032; P < 0.0001) than the psychological-based scale (-0.097 ± 0.028; P = 0.001) or years living in the mainland United States (-0.058 ± 0.028; P = 0.041). No associations were observed for the Western or sweets/desserts patterns. Conclusions In Puerto Rican adults, stronger psychological US orientation was associated with higher diet quality, particularly with higher income. More Spanish use, stronger psychological Puerto Rican orientation, and shorter length of mainland-US residency were associated with traditional dietary patterns. Appropriate diet-related acculturation constructs should be carefully considered among Hispanics/Latinos. This trial was registered at clinicaltrials.gov as NCT01231958.
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Affiliation(s)
- Josiemer Mattei
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA,Address correspondence to JM (e-mail: )
| | - Amanda C McClain
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA
| | - Luis M Falcón
- College of Fine Arts, Humanities & Social Sciences, University of Massachusetts, Lowell, MA
| | - Sabrina E Noel
- Department of Biomedical and Nutritional Sciences, University of Massachusetts, Lowell, MA
| | - Katherine L Tucker
- Department of Biomedical and Nutritional Sciences, University of Massachusetts, Lowell, MA
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64
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Measures of Acculturation and Relations to zBMI among Mexican-Origin Youth. J Racial Ethn Health Disparities 2018; 6:364-370. [PMID: 30367361 DOI: 10.1007/s40615-018-00533-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 09/22/2018] [Accepted: 10/04/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Risk for obesity increases for Mexican-origin immigrants and their children upon arrival in the USA. Acculturative factors have been shown to play a role, but the significance and directionality of this relation may differ based on the method used to measure acculturation. METHOD This study examines the cross-sectional relations between several measures of acculturation and child zBMI, as well as the 12-month longitudinal relations between these measures and child BMI (adjusted for age and gender), in a sample of 102 6- to 11-year-old, Mexican-origin youth. RESULTS Cross-sectional results indicated that two measures, greater preference for English and higher Anglo Orientation, were positively associated cross-sectionally with higher zBMI (p = 0.002 and p = 0.011, respectively). Only English language preference remained significant in longitudinal analyses (p = 0.047). Parental duration of residence and the child's number of immigrant parents were not significantly associated with zBMI cross-sectionally or BMI longitudinally. DISCUSSION These findings suggest that language proxy measures of acculturation present similar findings to multidimensional measures when assessing child weight and support the idea that behavioral or emotional changes that accompany integration into US culture may contribute to obesity development.
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65
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Soto S, Arredondo EM, Ayala GX, Marcus BH, Shakya HB. Exploring how bicultural and assimilated children of Mexican origin influence their Latina mothers' diet: Perspectives from mothers and children. Appetite 2018; 129:217-227. [PMID: 30037770 PMCID: PMC6632078 DOI: 10.1016/j.appet.2018.06.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 05/02/2018] [Accepted: 06/30/2018] [Indexed: 10/28/2022]
Abstract
Social and cultural factors influence dietary intake and behaviors. Research shows that mothers consume a lower quality diet when they have a child who is assimilated to the US culture versus bicultural. The purpose of this study was to qualitatively compare how bicultural and assimilated children influenced their culturally traditional mothers' dietary intake/behaviors. Separate one-on-one interviews with 21 Mexican-origin mothers and their bicultural (n = 11) or assimilated (n = 10) children (10-13 years old) were conducted. We used framework analysis to reduce qualitative data to themes and subthemes. Data were analyzed separately and then compared between mothers of bicultural versus assimilated children. Mothers of bicultural children reported typically having an easier time consuming a better quality diet than mothers of assimilated children. For example, although all children requested non-traditional foods, bicultural children were typically more accepting of their mothers preparing traditional healthier foods than assimilated children. Furthermore, mothers believed their children's food preferences both influenced and were influenced by their own feeding styles. Mothers of bicultural children described using more "Mexican" (i.e., authoritative) feeding styles that they believed shaped their children's palate into preferring traditional foods. Mothers of assimilated children explained that their children's preference for non-traditional foods resulted in their use of more permissive or indulgent feeding styles. Longitudinal research is needed to test and confirm the directionality between feeding styles and child's food preferences. Interventions may need to consider the reciprocal influences between mothers' feeding styles, children's food preferences, and how children influence their mothers' dietary intake/behavior.
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Affiliation(s)
- Sandra Soto
- University of North Carolina at Chapel Hill, Carrington Hall, Campus Box #7460, Chapel Hill, NC, 27599, USA.
| | - Elva M Arredondo
- Institute for Behavioral and Community Health, 9245 Sky Park Court, Suite 221, San Diego, CA, 92123, USA; San Diego State University, Graduate School of Public Health, Division of Health Promotion and Behavioral Science, 5500 Campanile Drive, San Diego, CA, 92182, USA
| | - Guadalupe X Ayala
- Institute for Behavioral and Community Health, 9245 Sky Park Court, Suite 221, San Diego, CA, 92123, USA; San Diego State University, College of Health and Human Services, 5500 Campanile Drive, San Diego, CA, 92182, USA
| | - Bess H Marcus
- Brown University School of Public Health, Department of Behavioral and Social Sciences, 121 S Main St, Providence, RI, 02903, USA
| | - Holly B Shakya
- University of California, San Diego, Department of Medicine, Division of Global Health, 9500 Gilman Drive, La Jolla, CA, 92093, USA
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66
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Wilson MD, Ramírez AS, Arsenault JE, Miller LMS. Nutrition Label Use and Its Association With Dietary Quality Among Latinos: The Roles of Poverty and Acculturation. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2018; 50:876-887. [PMID: 30297015 PMCID: PMC6181580 DOI: 10.1016/j.jneb.2018.05.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 05/18/2018] [Accepted: 05/29/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To investigate how acculturation and poverty are independently and jointly associated with the use of the Nutrition Facts panel (nutrition label) and to examine the extent to which nutrition label use moderates the association of poverty and acculturation on dietary quality among Latinos. DESIGN Cross-sectional analysis of the 2007/2008 and 2009/2010 waves of the National Health and Nutrition Examination Survey. PARTICIPANTS A total of 3,696 adults (aged >19 years) self-identified as Latino/Hispanic with food label use data from the most recent Consumer Behavior Phone Follow-Up Modules. MAIN OUTCOME MEASURE(S) Nutrition label use and dietary quality. ANALYSIS Logistic regression. RESULTS Acculturation moderated the association of income on the likelihood of using nutrition labels, such that lower-income English-speaking Latinos were half as likely as higher-income English-speakers to use nutrition labels (P = .01, odds ratio [OR] = 0.44, 95% confidence interval [CI], 0.24-0.81); however, Spanish speakers were equally likely to use nutrition labels across income levels (P = .99; OR = 1.00; 95% CI, 0.77-1.31). Nutrition label use moderated the association of acculturation on diet. Among English-speaking Latinos, those who read nutrition labels had less than half the risk for poor diet (P =.001; OR = 0.43; 95% CI, 0.26-0.69); however, label use was not significantly associated with the diet quality of Spanish speakers (P = .07; OR = 0.82; 95% CI, 0.67-1.02). Nutrition label use decreased the risk for poor dietary quality regardless of poverty status. CONCLUSIONS AND IMPLICATIONS Overall, results demonstrated a positive association between the use of the Nutrition Facts panel for Latinos and dietary quality. An important nutrition education strategy among bicultural Latinos at risk for a poor diet as a result of acculturation may include label reading comprehension. This approach may also address the low rates of label use. The study provides evidence of segmented assimilation in which low-income, bicultural Latinos follow an underclass pattern of acculturation demonstrated by a lower likelihood of reading nutrition labels and higher-income, bicultural Latinos follow the more successful selective pattern.
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Affiliation(s)
- Machelle D Wilson
- Department of Public Health Sciences, Division of Biostatistics, University of California, Davis, Davis, CA.
| | - A Susana Ramírez
- Department of Public Health, University of California, Merced, Merced, CA
| | - Joanne E Arsenault
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, Davis, CA
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Jang M, Jeon S, Nam S, Song HJ, Whittemore R. Relationships of Obesity-Related Behavior Patterns With Socioeconomic Status and Acculturation in Korean American Women. Clin Nurs Res 2018; 29:440-447. [PMID: 29932007 DOI: 10.1177/1054773818783467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There is limited understanding about the obesity-related behaviors of diet, physical activity, and sedentary behavior in Korean American women. The purpose of this study was to cluster obesity-related behavior patterns of Korean American women and to examine group differences in acculturation, socioeconomic status (SES), and body mass index (BMI). A secondary analysis from a cross-sectional study was conducted using two-step cluster analysis for clustering groups. A total of 137 Korean American women (M age = 42.7 years, SD = 3.9 years; M BMI = 23.1 kg/m2, SD = 3.1 kg/m2; 47.7% BMI ⩾ 23 kg/m2) participated. Three clusters were identified: healthy lifestyle, unhealthy lifestyle, and low physical activity but healthy diet group. The unhealthy lifestyle group was more likely to have high acculturation compared with other groups (p = .03). SES and BMI were not significantly different between groups. Further intervention is needed to improve obesity-related behaviors of acculturated Korean American women.
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68
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Davis TME, Mulder H, Lokhnygina Y, Aschner P, Chuang LM, Raffo Grado CA, Standl E, Peterson ED, Holman RR. Effect of race on the glycaemic response to sitagliptin: Insights from the Trial Evaluating Cardiovascular Outcomes with Sitagliptin (TECOS). Diabetes Obes Metab 2018; 20:1427-1434. [PMID: 29405540 DOI: 10.1111/dom.13242] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 01/22/2018] [Accepted: 02/01/2018] [Indexed: 01/04/2023]
Abstract
AIM Pooled efficacy studies suggest that glycaemic responses to dipeptidyl-peptidase 4 inhibitors in type 2 diabetes are greatest in Asians, who may also respond better to alpha-glucosidase inhibitors. We assessed the glycaemic impact of sitagliptin by race in the Trial Evaluating Cardiovascular Outcomes with Sitagliptin (TECOS), and whether this was enhanced in Asians with concomitant acarbose therapy. MATERIALS AND METHODS TECOS enrolled 14 671 patients with type 2 diabetes, cardiovascular disease and HbA1c of 48-64 mmol/mol (6.5%-8.0%), and randomized them, double-blind, to sitagliptin or placebo. There were 3265 patients (22.3%) from Asian countries. Background glucose-lowering therapies were unaltered for the first 4 months post randomization unless clinically essential, facilitating comparison of sitagliptin-associated effects in self-identified East Asian, Other (South) Asian, White Caucasian, Hispanic, Black and Indigenous groups. RESULTS Median baseline HbA1c by race was 54 to 57 mmol/mol (7.1%-7.4%). Mean 4-month reduction in placebo-adjusted HbA1c was greatest in East Asians (-6.6 mmol/mol [-0.60%] vs ≤6.0 mmol/mol [≤0.55%] in other groups), with significantly greater reduction vs the 2 largest groups (White Caucasians, Other Asians; P < .0001) after adjustment for covariates. After the first 4 months, East and Other Asians were more likely to initiate additional oral therapy (metformin and/or sulfonylureas) than insulin vs White Caucasians (P < .0001). Acarbose use increased in the Asian patients, but no glycaemic interaction with allocated study medication was observed (adjusted P = .12). CONCLUSIONS The greatest initial reduction in HbA1c with sitagliptin in the TECOS population was in East Asians. No enhanced glycaemic effect was seen when sitagliptin was given with acarbose.
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Affiliation(s)
- Timothy M E Davis
- Medical School, University of Western Australia, Fremantle Hospital, Fremantle, Western Australia, Australia
| | - Hillary Mulder
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina
| | - Yuliya Lokhnygina
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina
| | - Pablo Aschner
- School of Medicine, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Lee-Ming Chuang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | | | | | - Eric D Peterson
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina
| | - Rury R Holman
- Diabetes Trials Unit, University of Oxford, Oxford, UK
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69
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Bojorquez I, Rosales C, Angulo A, de Zapien J, Denman C, Madanat H. International migration and dietary change in Mexican women from a social practice framework. Appetite 2018; 125:72-80. [PMID: 29409770 DOI: 10.1016/j.appet.2018.01.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 11/27/2017] [Accepted: 01/22/2018] [Indexed: 10/18/2022]
Abstract
Migration from lower- and middle-income to high-income countries is associated with dietary change, and especially with the adoption of a modern, less healthy diet. In this article we analyze the dietary changes experienced by Mexican migrants, employing as a theoretical framework the concept of social practice. According to this framework, practices integrate material elements, meanings and competences that provide their conditions of possibility. Practices are shared by members of social groups, and interact with other competing or reinforcing practices. Between 2014 and 2015, we conducted semi-structured interviews with 27 women, international return migrants living in Tijuana, Mexico. The interview guide asked about history of migration and dietary change. We found three main areas of dietary change: from subsistence farming to ready meals, abundance vs. restriction, and adoption of new food items. The first one was associated with changes in food procurement and female work: when moving from rural to urban areas, participants substituted self-produced for purchased food; and as migrant women joined the labor force, consumption of ready meals increased. The second was the result of changes in income: participants of lower socioeconomic position modified the logic of food acquisition from restriction to abundance and back, depending on the available resources. The third change was relatively minor, with occasional consumption of new dishes or food items, and was associated with exposure to different cuisines and with learning how to cook them. Public health efforts to improve the migrants' diets should take into account the constitutive elements of dietary practices, instead of isolating individuals from their social contexts.
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Affiliation(s)
- Ietza Bojorquez
- El Colegio de la Frontera Norte, Carretera Escénica Tijuana-Ensenada Km. 18.5, San Antonio del Mar, Tijuana CP 22560, B.C., Mexico.
| | - Cecilia Rosales
- University of Arizona, 714 E. Van Buren Street, Suite 119, Phoenix 85006, AZ, USA.
| | | | - Jill de Zapien
- University of Arizona, 714 E. Van Buren Street, Suite 119, Phoenix 85006, AZ, USA.
| | - Catalina Denman
- El Colegio de Sonora, México, Garmendia 187, Centro, Hermosillo CP 83150, Son., Mexico.
| | - Hala Madanat
- San Diego State University, 5500 Campanile Dr, San Diego, CA, USA 92182.
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70
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Vintimilla RM, Large SE, Gamboa A, Rohlfing GD, O'Jile JR, Hall JR, O'Bryant SE, Johnson LA. The Link between Potassium and Mild Cognitive Impairment in Mexican-Americans. Dement Geriatr Cogn Dis Extra 2018; 8:151-157. [PMID: 29805381 PMCID: PMC5968281 DOI: 10.1159/000488483] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 03/12/2018] [Indexed: 12/16/2022] Open
Abstract
Background Recent evidence suggests that increasing dietary intake of minerals reduces the risk of dementia. This study aimed to examine the relationship between potassium and diagnosis of mild cognitive impairment (MCI) in a sample of older Mexican-Americans from rural and urban populations. Methods The sample was formed of a total of 139 participants with MCI and 371 normal controls from two independent cohorts: a rural cohort (Facing Rural Obstacles to Healthcare Now through Intervention, Education and Research [Project FRONTIER]) and an urban cohort (the Health and Aging Brain among Latino Elders [HABLE] study). Serum electrolytes examined were sodium and potassium. Age and education were entered in the model as covariates. Results Across both cohorts, the Project FRONTIER (OR = 3.1; p = 0.01) and the HABLE Project (OR = 2.0; p = 0.04), the results indicated that serum potassium levels significantly increased the risk of diagnosis of MCI. Conclusion Our finding suggested a link between serum potassium levels and a diagnosis of MCI in Mexican-Americans. The results of this study support a previous research which has suggested that the risk factors for MCI may vary by ethnicity.
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Affiliation(s)
- Raul M Vintimilla
- Institute for Healthy Aging, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Stephanie E Large
- Department of Family Practice, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Adriana Gamboa
- Institute for Healthy Aging, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Geoffrey D Rohlfing
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Judith R O'Jile
- Institute for Healthy Aging, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - James R Hall
- Institute for Healthy Aging, University of North Texas Health Science Center, Fort Worth, Texas, USA.,Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, Texas, USA.,Department of Psychiatry, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Sid E O'Bryant
- Institute for Healthy Aging, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Leigh A Johnson
- Institute for Healthy Aging, University of North Texas Health Science Center, Fort Worth, Texas, USA
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71
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Vega-López S, Lindberg NM, Eckert GJ, Nicholson EL, Maupomé G. Association of added sugar intake and caries-related experiences among individuals of Mexican origin. Community Dent Oral Epidemiol 2018; 46:376-384. [PMID: 29659041 PMCID: PMC10389538 DOI: 10.1111/cdoe.12378] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 03/08/2018] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Determine the association between key dental outcomes and added sugar intake using a survey instrument to assess added sugars, which was specifically tailored to immigrant and US-born adults of Mexican origin. METHODS Hispanic adults of Mexican origin (n = 326; 36.2 ± 12.1 years) completed a self-administered survey to gather acculturation, self-reported dental experiences and self-care practices (eg brushing, flossing, pain, bleeding gums), and socio-demographic information. The survey included a culturally tailored 22-item Added Sugar Intake Estimate (ASIE) that assessed added sugar intake from processed foods and sugar-sweetened beverages in a semiquantitative food frequency questionnaire format. Linear regression, 2-sample t test, and ANOVA were used to evaluate associations of demographic and dental outcomes with daily added sugar intake. RESULTS Of the mean total daily added sugar intake (99.6 ± 94.6 g), 36.5 ± 44.4 g was derived from sugar-containing foods and snacks, and 63.1 ± 68.2 g from beverages. Participants who reported greater added sugar intake were more likely to have reported the presence of a toothache in the preceding 12 months, having been prescribed antibiotics for dental reasons, being less likely to floss daily, have reported eating or drinking within 1 hour before bed and have lower psychological acculturation (P < .05 for all). Results were comparable when assessing intake from sugar-containing foods/snacks and sugar-sweetened beverages. CONCLUSIONS This study confirmed the association between added sugar intake and self-reported dental outcomes among adults of Mexican origin and points to an urgent need to improve dietary behaviours in this population.
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Affiliation(s)
- S. Vega-López
- College of Health Solutions and Southwest Interdisciplinary Research Center; Arizona State University; Phoenix AZ USA
| | - N. M. Lindberg
- Kaiser Permanente Center for Health Research; Portland OR USA
| | - G. J. Eckert
- School of Medicine; Indiana University/Purdue University in Indianapolis; Indianapolis IN USA
| | - E. L. Nicholson
- Richard M. Fairbanks School of Public Health; Indiana University/Purdue University in Indianapolis; Indianapolis IN USA
| | - G. Maupomé
- Richard M. Fairbanks School of Public Health; Indiana University/Purdue University in Indianapolis; Indianapolis IN USA
- Indiana University Network Science Institute; Bloomington IN USA
- School of Dentistry; Indiana University/Purdue University in Indianapolis; Indianapolis IN USA
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McClain AC, Ayala GX, Sotres-Alvarez D, Siega-Riz AM, Kaplan RC, Gellman MD, Gallo LC, Van Horn L, Daviglus ML, Perera MJ, Mattei J. Frequency of Intake and Type of Away-from- Home Foods Consumed Are Associated with Diet Quality in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). J Nutr 2018; 148:453-463. [PMID: 29546313 PMCID: PMC6251533 DOI: 10.1093/jn/nxx067] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 08/03/2017] [Accepted: 12/11/2017] [Indexed: 12/16/2022] Open
Abstract
Background Away-from-home foods (AFHFs) influence diet quality, a modifiable obesity risk factor, with limited generalizable evidence in Hispanic/Latino adults. Objective We investigated associations between AFHF intake with diet quality and overweight or obesity among US Hispanic/Latino adults. Methods Cross-sectional baseline (2008-2011) analyses included adults (n = 16,045) aged 18-74 y in the national Hispanic Community Health Study/Study of Latinos. Participants self-reported AFHF consumption frequency from 10 different settings and dietary intake (2-d 24-h recall). The Alternate Healthy Eating Index-2010 (AHEI-2010) was used to measure diet quality; higher scores indicated a healthier diet and scores were categorized into tertiles. WHO classifications categorized overweight [body mass index (BMI; kg/m2): 25.0-29.9] and obesity (BMI ≥30). Multivariate-adjusted associations of AFHF frequency or type with AHEI-2010, overweight, or obesity were assessed by using complex survey logistic regression (ORs and 95% CIs). Results Almost half of participants (47.1%) reported eating AFHFs ≥5 times/wk. The mean ± SE AHEI-2010 score was 47.5 ± 0.2. More than one-third (37.2%) were classified as overweight and 39.6% classified as obese. Compared with consuming AFHFs ≥5 times/wk, consuming AFHFs <1 time/wk or 1-2 times/wk was associated with greater odds of being in higher AHEI-2010 tertiles, indicating a healthier diet [<1 time/wk-tertile 2: OR (95% CI): 1.6 (1.4, 1.9); tertile 3: 2.5 (2.1, 3.1); 1-2 times/wk-tertile 2: OR (95% CI): 1.4 (1.2, 1.6); tertile 3: 1.5 (1.2, 1.8)]. Consumption of AFHFs ≥1 time/wk from each AFHF setting, compared with consumption of any AFHFs <1 time/wk was associated with lower odds of being in higher AHEI-2010 tertiles. Increasing AFHF intake frequency was not associated with odds of overweight or obesity. Eating from on-street vendors ≥1 time/wk was associated with obesity (OR: 1.5; 95% CI: 1.1, 2.0). Conclusions Consumption of AFHFs was prevalent among Hispanic/Latino adults and was associated with poorer diet quality. Findings may help to identify dietary targets to improve diet quality and prevent obesity in US Hispanics/Latinos.
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Affiliation(s)
- Amanda C McClain
- Department of Nutrition, Harvard TH Chan School of Public Health, Harvard
University, Boston, MA
| | - Guadalupe X Ayala
- College of Health and Human Services and Institute for Behavioral and Community
Health, and Department of Psychology, San Diego State University, San Diego, CA
| | - Daniela Sotres-Alvarez
- Collaborative Studies Coordinating Center, Department of Biostatistics,
University of North Carolina, Chapel Hill, NC
| | - Anna Maria Siega-Riz
- Department of Public Health Sciences, University of Virginia, Charlottesville,
VA
| | - Robert C Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of
Medicine, New York, NY
| | - Marc D Gellman
- Department of Psychology, University of Miami, Miami, FL
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA
| | - Linda Van Horn
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern
University, Chicago, IL
| | - Martha L Daviglus
- Institute for Minority Health Research, College of Medicine, University of
Illinois, Chicago, IL
| | | | - Josiemer Mattei
- Department of Nutrition, Harvard TH Chan School of Public Health, Harvard
University, Boston, MA
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73
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Oladele CR, Pathak EB, Yang J, Nembhard WN, Sharma S, Himmelgreen D, Dagne G, Mason T. Acculturation and dietary intake pattern among Jamaican immigrants in the US. Prev Med Rep 2018; 9:80-85. [PMID: 29348996 PMCID: PMC5767562 DOI: 10.1016/j.pmedr.2017.12.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 12/04/2017] [Accepted: 12/18/2017] [Indexed: 11/30/2022] Open
Abstract
Information on dietary intakes of Jamaican immigrants in the United States is sparse. Understanding factors that influence diet is important since diet is associated with chronic diseases. This study examined the association between acculturation, socio-cultural factors, and dietary pattern among Jamaican immigrants in Florida. Jamaican persons 25–64 years who resided in two South Florida counties were recruited for participation. A health questionnaire that assessed acculturation, dietary pattern, and risk factors for cardiovascular disease was administered to participants. Generalized Estimating Equations were used to determine associations. Acculturation score was not significantly associated with dietary intake pattern (β = − 0.02 p = 0.07). Age at migration was positively associated with traditional dietary pattern (β = 0.02 p < 0.01). Persons with 12 or fewer years of education (β = − 0.55 p < 0.001), divorced (β = − 0.26 p = 0.001), or engaged in less physical activity (β = − 0.07 p = 0.01) were more likely to adhere to a traditional diet. Although acculturation was not a statistically significant predictor of dietary intake, findings show the role of demographic and lifestyle characteristics in understanding factors associated with dietary patterns among Jamaicans. Findings point to the need to measure traditional dietary intakes among Jamaicans and other immigrant groups. Accurate assessment of disease risk among immigrant groups will lead to more accurate diet-disease risk assessment and development of effective intervention programs. Age at migration was associated with traditional diet among Jamaican immigrants. Persons with lower educational attainment were more likely to eat traditional foods. Residing in an ethnic enclave was not associated with having a traditional diet.
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Affiliation(s)
- Carol R Oladele
- Equity Research and Innovation Center, Yale School of Medicine, P.O. Box 208093, New Haven, CT, United States
| | - Elizabeth B Pathak
- University of South Florida, Morsani College of Medicine, Tampa, FL, United States
| | - Jimin Yang
- University of South Florida, Health Informatics Institute, Tampa, FL, United States
| | - Wendy N Nembhard
- University of Arkansas for Medical Sciences, Department of Pediatrics and Arkansas Children's Hospital Research Institute, Little Rock, AR, United States
| | - Sangita Sharma
- University of Alberta, Department of Medicine, Edmonton, Alberta, Canada
| | - David Himmelgreen
- University of South Florida, Department of Anthropology, Tampa, FL, United States
| | - Getachew Dagne
- University of South Florida, Department of Epidemiology and Biostatistics, Tampa, FL, United States
| | - Thomas Mason
- University of South Florida, Department of Environmental and Occupational Health, Tampa, FL, United States
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Needham BL, Mukherjee B, Bagchi P, Kim C, Mukherjea A, Kandula NR, Kanaya AM. Acculturation Strategies Among South Asian Immigrants: The Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study. J Immigr Minor Health 2018; 19:373-380. [PMID: 26928020 DOI: 10.1007/s10903-016-0372-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In the past, epidemiologic research on acculturation and health has been criticized for its conceptual ambiguity and simplistic measurement approaches. This study applied a widely-used theoretical framework from cross-cultural psychology to identify acculturation strategies among South Asian immigrants in the US and to examine sociodemographic correlates of acculturation strategies. Data were from the Mediators of Atherosclerosis in South Asians Living in America study. We used latent class analysis to identify groups of individuals that were similar based on cultural attitudes and behaviors. We used latent class regression analysis to examine sociodemographic correlates of acculturation strategies. We found that South Asian immigrants employed three acculturation strategies, including separation (characterized by a relatively high degree of preference for South Asian culture over US culture), assimilation (characterized by a relatively high degree of preference for US culture over South Asian culture), and integration (characterized by a similar level of preference for South Asian and US cultures). Respondents with no religious affiliation, those with higher levels of income, those who lived a greater percentage of their lives in the US, and those who spoke English well or very well were less likely to use the separation strategy than the assimilation or integration strategies. Using epidemiologic cohort data, this study illustrated a conceptual and methodological approach that addresses limitations of previous research on acculturation and health. More work is needed to understand how the acculturation strategies identified in this study affect the health of South Asian immigrants in the US.
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Affiliation(s)
- Belinda L Needham
- Department of Epidemiology and Center for Social Epidemiology and Population Health, University of Michigan, 1415 Washington Heights, 2649A SPH Tower, Ann Arbor, MI, 48109-2029, USA.
| | - Bhramar Mukherjee
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Pramita Bagchi
- Department of Statistics, University of Michigan, Ann Arbor, MI, USA
| | - Catherine Kim
- Departments of Medicine and Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - Arnab Mukherjea
- Department of Health Science, California State University, East Bay, Hayward, CA, USA
| | | | - Alka M Kanaya
- Departments of Medicine and Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
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Martin CL, Haan MN, Fernandez-Rhodes L, Lee A, Aiello AE. Association Between Immigration History and Inflammatory Marker Profiles Among Older Adult Mexican Americans. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2018; 64:30-42. [PMID: 29741413 PMCID: PMC6075719 DOI: 10.1080/19485565.2018.1449631] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Foreign-born Hispanics have better cardiometabolic health upon arrival in the US than their US-born counterparts, yet this advantage diminishes as duration of residence in the US increases. Underlying mechanisms explaining this paradox have been understudied. Using data from the Sacramento Area Latino Study on Aging (SALSA), this study examined immigration history (immigrant generation and duration of US residence) in relation to biomarkers of inflammation (interleukin-6 (IL-6), soluble forms of type 1 and 2 receptors of tumor necrosis factor-alpha (sTNF-R1 and sTNF-R2), C-reactive protein (CRP), leptin, adiponectin) in a sample of 1,290 predominantly Mexican-origin immigrants. Second and ≥3rd generation immigrants had higher IL-6 and leptin levels than 1st generation immigrants living in the US for less than 15 years (2nd generation percent difference = 45.9; 95% CI: 24.7, 70.7 and 3rd generation percent difference = 41.8; 95% CI: 17.7, 70.4). CRP and sTNF-R1 levels were higher among ≥3rd generation immigrants than 1st generation immigrants with less than 15 years of US residency. Worse inflammatory profiles were observed among Mexican-origin immigrants with longer US immigration histories, independent of health, and behavioral factors. Additional research is warranted to understand the factors that shape trajectories of biological risk across generations of Hispanics.
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Affiliation(s)
- Chantel L. Martin
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive CB#7400, Chapel Hill, NC 27599 United States
| | - Mary N. Haan
- Department of Epidemiology and Biostatistics, University of California San Francisco, 550 15 Street, San Francisco, CA 94158 United States
| | - Lindsay Fernandez-Rhodes
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive CB#7400, Chapel Hill, NC 27599 United States
| | - Anne Lee
- Department of Epidemiology and Biostatistics, University of California San Francisco, 550 15 Street, San Francisco, CA 94158 United States
| | - Allison E. Aiello
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive CB#7400, Chapel Hill, NC 27599 United States
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Damas OM, Estes D, Avalos D, Quintero MA, Morillo D, Caraballo F, Lopez J, Deshpande AR, Kerman D, McCauley JL, Palacio A, Abreu MT, Schwartz SJ. Hispanics Coming to the US Adopt US Cultural Behaviors and Eat Less Healthy: Implications for Development of Inflammatory Bowel Disease. Dig Dis Sci 2018; 63:3058-3066. [PMID: 29982988 PMCID: PMC6182439 DOI: 10.1007/s10620-018-5185-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 06/25/2018] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The incidence of inflammatory bowel disease (IBD) among US Hispanics is rising. Adoption of an American diet and/or US acculturation may help explain this rise. AIMS To measure changes in diet occurring with immigration to the USA in IBD patients and controls, and to compare US acculturation between Hispanics with versus without IBD. Last, we examine the current diet of Hispanics with IBD compared to the diet of Hispanic controls. METHODS This was a cross-sectional study of Hispanic immigrants with and without IBD. Participants were recruited from a university-based GI clinic. All participants completed an abbreviated version of the Stephenson Multi-Group Acculturation Scale and a 24-h diet recall (the ASA-24). Diet quality was calculated using the Healthy Eating Index (HEI-2010). RESULTS We included 58 participants: 29 controls and 29 IBD patients. Most participants were Cuban or Colombian. Most participants, particularly those with IBD, reported changing their diet after immigration (72% of IBD and 57% of controls). IBD participants and controls scored similarly on US and Hispanic acculturation measures. IBD patients and controls scored equally poorly on the HEI-2010, although they differed on specific measures of poor intake. IBD patients reported a higher intake of refined grains and lower consumption of fruits, whereas controls reported higher intake of empty calories (derived from fat and alcohol). CONCLUSION The majority of Hispanics change their diet upon immigration to the USA and eat poorly irrespective of the presence of IBD. Future studies should examine gene-diet interactions to better understand underlying causes of IBD in Hispanics.
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Affiliation(s)
- Oriana M. Damas
- 0000 0004 1936 8606grid.26790.3aDivision of Gastroenterology, Department of Medicine, University of Miami Miller School of Medicine, Miami, USA
| | - Derek Estes
- 0000 0004 1936 8606grid.26790.3aDepartment of Internal Medicine, University of Miami Miller School of Medicine, Miami, USA
| | - Danny Avalos
- grid.449768.0Division of Gastroenterology, Texas Tech University Health Sciences Center El Paso, El Paso, USA
| | - Maria A. Quintero
- 0000 0004 1936 8606grid.26790.3aDivision of Gastroenterology, Department of Medicine, University of Miami Miller School of Medicine, Miami, USA
| | - Diana Morillo
- 0000 0004 1936 8606grid.26790.3aDivision of Gastroenterology, Department of Medicine, University of Miami Miller School of Medicine, Miami, USA
| | - Francia Caraballo
- 0000 0004 1936 8606grid.26790.3aDivision of Gastroenterology, Department of Medicine, University of Miami Miller School of Medicine, Miami, USA
| | - Johanna Lopez
- 0000 0004 1936 8606grid.26790.3aDivision of Gastroenterology, Department of Medicine, University of Miami Miller School of Medicine, Miami, USA
| | - Amar R. Deshpande
- 0000 0004 1936 8606grid.26790.3aDivision of Gastroenterology, Department of Medicine, University of Miami Miller School of Medicine, Miami, USA
| | - David Kerman
- 0000 0004 1936 8606grid.26790.3aDivision of Gastroenterology, Department of Medicine, University of Miami Miller School of Medicine, Miami, USA
| | - Jacob L. McCauley
- 0000 0004 1936 8606grid.26790.3aJohn P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, USA
| | - Ana Palacio
- 0000 0004 1936 8606grid.26790.3aDivision of Computational Medicine, Department of Public Health, University of Miami Miller School of Medicine, Miami, USA
| | - Maria T. Abreu
- 0000 0004 1936 8606grid.26790.3aDivision of Gastroenterology, Department of Medicine, University of Miami Miller School of Medicine, Miami, USA
| | - Seth J. Schwartz
- 0000 0004 1936 8606grid.26790.3aDepartment of Public Health Sciences, University of Miami Miller School of Medicine, Miami, USA
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Foster BA, Aquino CA, Mejia S, Turner BJ, Singhal A. Identification and Characterization of Families That Are Positively Deviant for Childhood Obesity in a Latino Population: A Case-Control Study. J Obes 2018; 2018:9285164. [PMID: 30018820 PMCID: PMC6029506 DOI: 10.1155/2018/9285164] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 04/16/2018] [Accepted: 05/06/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Childhood obesity is a complex public health challenge that requires innovative, sustainable solutions. Positive deviance, inspired by the science of complexity, is an approach that examines what allows certain individuals to succeed despite being predicted to fail. This study is aimed at identifying and defining positive deviants for early childhood obesity. METHODS This case-control study used medical record data to identify Latino children aged 2-5 and classify them using their longitudinal weight change. Parents of children with trajectories toward a healthy weight from an obese weight (cases) and parents of children with stable obese weight trajectories over time (controls) were recruited. Mixed-methods analyses were used including a semistructured interview and quantitative surveys evaluating diet, physical activity, sleep, feeding practices, and self-efficacy. Qualitative description was applied to the qualitative data; quantitative data were analyzed using descriptive statistics and logistic regression modeling. RESULTS Of eligible Latino children identified from the overall data set (n=1,621), 257 (16%) had trajectories toward a healthy weight, and among these, 21 positively deviant cases completed the study with 23 matched controls. Positive deviant families were characterized by lower education, higher self-efficacy, and a more Mexican cultural orientation. Findings suggest that effective engagement of other caregivers and creating healthy food environments were important determinants of healthy weight outcomes. CONCLUSIONS Positive deviants (cases) were distinct from controls in several parenting strategies such as creating healthy food environments and engaging caregivers. They had higher self-efficacy despite lower education. There were fewer differences in diet and physical activity than expected.
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Affiliation(s)
- Byron A. Foster
- Departments of Dermatology and Pediatrics, Oregon Health & Science University, Portland, OR, USA
- Center for Research to Advance Community Health, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Christian A. Aquino
- School of Medicine, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Sharol Mejia
- School of Medicine, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Barbara J. Turner
- Center for Research to Advance Community Health, University of Texas Health San Antonio, San Antonio, TX, USA
- School of Medicine, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Arvind Singhal
- Department of Communication, The University of Texas at El Paso, El Paso, TX, USA
- Inland University of Applied Sciences, Elverum, Norway
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Questioning the Dietary Acculturation Paradox: A Mixed-Methods Study of the Relationship between Food and Ethnic Identity in a Group of Mexican-American Women. J Acad Nutr Diet 2017; 118:431-439. [PMID: 29289549 DOI: 10.1016/j.jand.2017.10.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 10/11/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND Epidemiological studies have described an "acculturation paradox." Increased acculturation to the United States is associated with increased consumption of dietary fat and decreased consumption of fruits/vegetables. OBJECTIVE To expand understanding of the dietary acculturation paradox, this study examined how bicultural Mexican-American women construct ethnic identity and how these identities and identity-making processes relate to perceptions of health and nutrition. DESIGN We utilized embedded mixed methods (in-depth interviews; survey). PARTICIPANTS/SETTING We analyzed a purposive sample of English-speaking Mexican-American women aged 18 to 29 years (n=24) in rural California to assess ethnic identity and diet beliefs. RESULTS Participants described food as central to expressing cultural identity, usually in terms of family interactions. Mexican food traditions were characterized as unhealthy; many preferred American foods, which were seen as healthier. Specifically, Mexican-American women perceived Mexican patterns of food preparation and consumption as unhealthy. In addition, traditional Mexican foods described as unhealthy were once considered special-occasion foods. Among the participants who expressed a desire to eat healthfully, to do so meant to reject Mexican ways of eating. CONCLUSIONS This study raises questions about the nature of the "dietary acculturation paradox." While food-the eating of Mexican foods-is central to the maintenance of ethnic identity throughout acculturation, negative perceptions about the healthfulness of Mexican foods introduce tension into Mexican-American women's self-identification. This study suggests a subtle contradiction that may help to explain the dietary acculturation paradox: While previous research has suggested that as Mexicans acculturate to the United States they adopt unhealthy diets, this study finds evidence that they do so at least in part due to perceptions that American diets are healthier than Mexican diets. Implications for interventions to improve Latinos' diets include an emphasis on the family and use of Spanish linguistic cues. Finally, messages that simply advocate for "traditional" diets should be reconsidered because that message is discordant with perceptions of the healthfulness of such foods.
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79
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Martin CL, Tate DF, Schaffner A, Brannen A, Hatley KE, Diamond M, Munoz-Christian K, Pomeroy J, Sanchez T, Mercado A, Hagobian T, Phelan S. Acculturation Influences Postpartum Eating, Activity, and Weight Retention in Low-Income Hispanic Women. J Womens Health (Larchmt) 2017; 26:1333-1339. [PMID: 28816589 PMCID: PMC5733667 DOI: 10.1089/jwh.2016.6154] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Low-income Hispanic women experience elevated rates of high postpartum weight retention (PPWR), which is an independent risk factor for lifetime obesity. Sociocultural factors might play an important role among Hispanic women; however, very few studies have examined this association. OBJECTIVE The purpose of our study was to examine the associations between acculturation and maternal diet, physical activity, and PPWR. DESIGN This is a cross-sectional study of baseline data from 282 Hispanic women participating in the FitMoms/Mamás Activas study, a randomized controlled trial examining the impact of primarily an internet-based weight control program, in reducing PPWR among low-income women. We performed multivariable linear regression to examine the association of acculturation with diet quality, physical activity, and PPWR at study entry. RESULTS A total of 213 (76%) women had acculturation scores reflecting Mexican orientation or bicultural orientation, whereas 69 (24%) had scores that represented assimilation to Anglo culture. Women who were more acculturated had lower intakes of fruits and vegetables, lower HEI scores, and lower physical activity levels than women who were less acculturated (p < 0.05). We found an association between acculturation and PPWR in that for every 1-unit increase in acculturation score, PPWR increased, on average, by 0.80 kg. CONCLUSION Higher acculturation was associated with poorer diet and physical activity behaviors and greater PPWR.
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Affiliation(s)
- Chantel L. Martin
- Department of Health Behavior, UNC Chapel Hill, Chapel Hill, North Carolina
| | - Deborah F. Tate
- Department of Health Behavior, UNC Chapel Hill, Chapel Hill, North Carolina
- Department of Nutrition, UNC Chapel Hill, Chapel Hill, North Carolina
| | - Andrew Schaffner
- Statistics Department, California Polytechnic State University, San Luis Obispo, California
| | - Anna Brannen
- Kinesiology Department, California Polytechnic State University, San Luis Obispo, California
| | | | - Molly Diamond
- Department of Health Behavior, UNC Chapel Hill, Chapel Hill, North Carolina
| | - Karen Munoz-Christian
- Department of Modern Languages, California Polytechnic State University, San Luis Obispo, California
| | - Jeremy Pomeroy
- Marshfield Clinic Research Foundation, Marshfield Clinic Health System, Marshfield, Wisconsin
| | - Teresa Sanchez
- Kinesiology Department, California Polytechnic State University, San Luis Obispo, California
| | - Adrian Mercado
- Kinesiology Department, California Polytechnic State University, San Luis Obispo, California
| | - Todd Hagobian
- Kinesiology Department, California Polytechnic State University, San Luis Obispo, California
| | - Suzanne Phelan
- Kinesiology Department, California Polytechnic State University, San Luis Obispo, California
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Flórez KR, Abraído-Lanza A. Segmented Assimilation: An Approach to Studying Acculturation and Obesity Among Latino Adults in the United States. FAMILY & COMMUNITY HEALTH 2017; 40:132-138. [PMID: 28207676 PMCID: PMC5319712 DOI: 10.1097/fch.0000000000000143] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Segmented assimilation theory posits that immigrants experience distinct paths of assimilation. Using cluster analysis and data from the National Latino and Asian American Survey, this study sought to apply this theory in relation to obesity among Latinos. Four clusters emerged: a "second-generation classic," a "third-generation classic," an "underclass," and a "segmented assimilation" pattern. In analyses controlling for sociodemographic confounders (eg, age), second-generation classic individuals had higher odds of obesity (odds ratio = 2.70, 95% confidence interval = 1.47-4.93) relative to the segmented pattern. Similarly, third-generation classic individuals had higher odds of obesity (odds ratio = 3.23, 95% confidence interval = 1.74-6.01) compared with segmented assimilation individuals.
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Soto SH, Arredondo EM, Marcus B, Shakya HB, Roesch S, Ayala GX. Effects of Latino children on their mothers' dietary intake and dietary behaviors: The role of children's acculturation and the mother-child acculturation gap. Soc Sci Med 2017; 191:125-133. [PMID: 28917621 DOI: 10.1016/j.socscimed.2017.09.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 08/24/2017] [Accepted: 09/03/2017] [Indexed: 10/18/2022]
Abstract
RATIONALE Research shows that acculturation is important to Latinas' dietary intake and related behaviors. Although evidence suggests children may also play a role, it remains unclear whether children's acculturation is related to mothers' dietary intake/behaviors. OBJECTIVES We examined the relationship between Latino children's acculturation and mothers' dietary intake/behaviors. We also examined the mother-child acculturation gap to identify dyad characteristics associated with mothers' diet. METHODS Baseline surveys were collected in 2010 from 314 Latino mother-child (7-13 years old) dyads of Mexican-origin enrolled in a family-based dietary intervention in Southern California, USA. Mother's daily intake of fruits, vegetables, and sugary beverages, percent of calories from fat, weekly away-from-home eating, and percent of weekly grocery dollars spent on fruits and vegetables were assessed via self-report. Mothers' and children's bidimensional acculturation were examined using acculturation groups (e.g., assimilated, bicultural) derived from Hispanic and non-Hispanic dimensions of language. We also assessed the acculturation gap between mothers and children with the a) difference in acculturation between mothers' and children's continuous acculturation scores and b) mother-child acculturation gap typologies (e.g., traditional mothers of assimilated children). RESULTS Findings show that having an assimilated versus a bicultural child was negatively associated with mothers' vegetable intake and positively associated with mothers' sugary beverage intake, percent of calories from fat, and frequency of away-from-home eating, regardless of mothers' acculturation. Traditional mothers of assimilated children reported more sugary beverage intake, calories from fat, and more frequent away-from-home eating than traditional mothers of bicultural children. CONCLUSION Results suggest that children's acculturation is associated with their mothers' dietary intake/behaviors and traditional mothers of assimilated children require more attention in future research.
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Affiliation(s)
- Sandra H Soto
- San Diego State University (SDSU)/University of California, San Diego (UCSD) Joint Doctoral Program in Public Health (Health Behavior), 5500 Campanile Drive, San Diego, CA 92182, USA (SDSU) and 9500 Gilman Drive, La Jolla, CA 92093, USA (UCSD); Institute for Behavioral and Community Health, 9245 Sky Park Court, Suite 221, San Diego, CA 92123, USA.
| | - Elva M Arredondo
- Institute for Behavioral and Community Health, 9245 Sky Park Court, Suite 221, San Diego, CA 92123, USA; San Diego State University, College of Health and Human Services, Graduate School of Public Health, Division of Health Promotion and Behavioral Science, 5500 Campanile Drive, San Diego, CA 92182, USA.
| | - Bess Marcus
- University of California, San Diego, Department of Family Medicine and Public Health, Division of Behavioral Medicine, 9500 Gilman Drive, La Jolla, CA 92093, USA.
| | - Holly B Shakya
- University of California, San Diego, Department of Medicine, Division of Global Health, 9500 Gilman Drive, La Jolla, CA 92093, USA.
| | - Scott Roesch
- San Diego State University, College of Sciences, Department of Psychology, 5500 Campanile Drive, San Diego, CA 92182, USA.
| | - Guadalupe X Ayala
- Institute for Behavioral and Community Health, 9245 Sky Park Court, Suite 221, San Diego, CA 92123, USA; San Diego State University, College of Health and Human Services, 5500 Campanile Drive, San Diego, CA 92182, USA.
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Extracting Country-of-Origin from Electronic Health Records for Gene- Environment Studies as Part of the Epidemiologic Architecture for Genes Linked to Environment (EAGLE) Study. AMIA JOINT SUMMITS ON TRANSLATIONAL SCIENCE PROCEEDINGS. AMIA JOINT SUMMITS ON TRANSLATIONAL SCIENCE 2017; 2017:50-57. [PMID: 28815105 PMCID: PMC5543359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We describe here the extraction of country-of-origin, an acculturation variable relevant for gene-environment studies, in a biorepository linked to de-identified electronic health records (EHRs) assessed by the Epidemiologic Architecture for Genes Linked to Environment (EAGLE), a study site of the Population Architecture using Genomics and Epidemiology (PAGE) I study. We extracted country-of-origin from the unstructured clinical free text using regular expressions within the MySQL relational database system in a cohort of 15,863 subjects of mostly non-European descent (including 11,519 African Americans, 1,702 Hispanics, and 1,118 Asians). We performed searches for 231 world countries (including independent sovereign states, dependent areas, and disputed territories) and common misspellings in >14 gigabytes of data including >13 billion characters of clinical text. Manual review of a fraction of the initial country-of-origin assignments established rules for data cleaning and quality control to achieve final country-of-origin status for each subject. After data cleaning, a total of 1,911/15,893 (12.02%) subjects were assigned to a country-of-origin outside of the United States. Mexico was the most commonly assigned country outside of the United States (264 subjects; 13.8% of subjects with a foreign country-of-origin assignment). The distribution of the countries assigned followed expectations based on known migration patterns to the United States with an emphasis on the southeastern region. These data suggest country-of-origin can be successfully extracted from unstructured clinical text for downstream genetic association studies.
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Di Noia J, Monica D, Sikorskii A, Cullen KW. Outcomes of a randomized controlled trial of nutrition education to promote farmers' market fruit and vegetable purchases and consumption among women enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). BMC Nutr 2017; 3:48. [PMID: 32153828 PMCID: PMC7050835 DOI: 10.1186/s40795-017-0172-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Accepted: 06/14/2017] [Indexed: 11/26/2022] Open
Abstract
Background The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides participants seasonal Farmers’ Market Nutrition Program (FMNP) vouchers to purchase fruits and vegetables (FV) at farmers’ markets and monthly cash value vouchers (CVV) redeemable at farmers’ markets. Despite the promise of FMNP vouchers and CVV for improving FV access among WIC participants, voucher redemption rates are low. This study evaluated WIC Fresh Start (WFS), a theory-driven, web-based lesson to promote FV intake, the redemption of CVV at farmers’ markets, FMNP voucher redemption, and farmers’ market-related knowledge, attitudes, and skills among women enrolled in WIC. Methods The lesson was evaluated in a four-arm randomized controlled trial. The setting was a large New Jersey-based WIC agency located in a densely populated, urban area. Participants (N = 744) were stratified based on FMNP voucher receipt and randomized to receive the WFS lesson or WIC online existing health education. Lesson effects on targeted outcomes were examined at posttest (2 weeks after the lesson) and 3 and 6 months after posttesting. Results Receipt of the WFS lesson was associated with FMNP voucher redemption (in the subset of participants preferring to speak Spanish); improvements in knowledge of the FMNP, locally grown seasonal items, seasonal items found at farmers’ markets in July, WIC-authorized farmers’ markets and food- and farmers’ market-specific knowledge; ever having purchased and intentions to purchase FV at a farmers’ market; FV food safety and preparation skills; and modest gains in the redemption of CVV at farmers’ markets. FV intake did not differ over time by trial arm. Conclusions Findings aid understanding of effective approaches to promote farmers’ market use and farmers’ market-related knowledge and skills among WIC participants. Further research is needed to explore factors that may explain the lack of lesson effects on FV intake. Trial registration NCT02565706
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Affiliation(s)
- Jennifer Di Noia
- 1Department of Sociology, William Paterson University, 300 Pompton Road, Wayne, NJ 07460 USA
| | - Dorothy Monica
- Saint Joseph's WIC Program, 185 6th Avenue, Paterson, NJ 07524 USA
| | - Alla Sikorskii
- 3College of Nursing, University of Arizona, 1305 North Martin Avenue, Room 419, PO Box 210203, Tucson, AZ 85721 USA
| | - Karen Weber Cullen
- 4USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030 USA
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Grey M. Lifestyle determinants of health: Isn't it all about genetics and environment? Nurs Outlook 2017; 65:501-505. [PMID: 28601253 DOI: 10.1016/j.outlook.2017.04.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 04/14/2017] [Accepted: 04/21/2017] [Indexed: 11/20/2022]
Abstract
PURPOSE Drawn from one of the keynote addresses at the State of the Science Conference held by the Council for the Advancement of Nursing Science (CANS), the purpose of this paper is to review the evidence from clinical trials about the importance of lifestyle behaviors in human health. METHODS Evidence from trials on the impact of lifestyle interventions on outcomes in diabetes and prediabetes are presented. RESULTS These findings suggest that lifestyle behaviors are important to diabetes prevention and outcomes in youth and adults. IMPLICATIONS More research is needed on the factors that predict these outcomes, especially genetics and environment.
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Cubillos L, Estrada Del Campo Y, Harbi K, Keyserling T, Samuel-Hodge C, Reuland DS. Feasibility and Acceptability of a Clinic-based Mediterranean-style Diet Intervention to Reduce Cardiovascular Risk for Hispanic Americans With Type 2 Diabetes. THE DIABETES EDUCATOR 2017; 43:286-296. [PMID: 28427311 PMCID: PMC5800306 DOI: 10.1177/0145721717706030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Purpose The purpose of the study was to modify a previously tested Spanish language version of a Mediterranean (Med)-style dietary intervention so that the dietary recommendations align with the cultural and social needs of Hispanic Americans (HAs) with type 2 diabetes (T2D) and evaluate the modified intervention's feasibility and acceptability. Methods In phase I (formative), semi-structured interviews and focus groups were used to refine the intervention content and format for delivery to HAs with T2D receiving care at a large primary care practice. In phase II (clinical pilot), the 2-month intervention that promoted a Med-style dietary pattern was given to all participants via 2 face-to-face counseling sessions and 2 telephone counseling sessions. Major outcomes were engagement with study activities and intervention acceptability; dietary behavior change at 2 months using the PREDIMED Med-diet score (range, 0-14, higher indicating better dietary pattern) is also reported. Results From clinic records, we identified 86 potentially eligible participants and enrolled 21. Baseline characteristics were: mean age = 52 years, 12 (57%) female, 15 (71%) from Mexico, mean years in the US = 19, low acculturation scores for all, and mean BMI = 33.7 kg/m2. Engagement and acceptability were high, with 19 (90%) completing all intervention visits and follow-up measures, all of whom would recommend the program to others. Mean Med-diet score improved from 5.7 to 7.9 (difference = 2.3; 95% CI, 1.0-3.5; P = .001). Conclusions Intervention engagement and acceptability were high, and there was improvement in self-reported dietary behaviors. This type of intervention should be evaluated in randomized trials enrolling HAs with diabetes.
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Affiliation(s)
- Laura Cubillos
- Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, North Carolina (Ms Cubillos, Mr Harbi, Dr Reuland)
| | - Yanire Estrada Del Campo
- UNC Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, North Carolina (Ms Estrada Del Campo, Dr Keyserling, Dr Samuel-Hodge)
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA (Ms Estrada Del Campo, Dr Samuel-Hodge)
| | - Khalil Harbi
- Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, North Carolina (Ms Cubillos, Mr Harbi, Dr Reuland)
| | - Thomas Keyserling
- UNC Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, North Carolina (Ms Estrada Del Campo, Dr Keyserling, Dr Samuel-Hodge)
- Department of Medicine, UNC School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA (Dr Keyserling, Dr Reuland)
| | - Carmen Samuel-Hodge
- UNC Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, North Carolina (Ms Estrada Del Campo, Dr Keyserling, Dr Samuel-Hodge)
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA (Ms Estrada Del Campo, Dr Samuel-Hodge)
| | - Daniel S Reuland
- Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, North Carolina (Ms Cubillos, Mr Harbi, Dr Reuland)
- Department of Medicine, UNC School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA (Dr Keyserling, Dr Reuland)
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Koksal E, Karacil Ermumcu MS, Mortas H. Description of the healthy eating indices-based diet quality in Turkish adults: a cross-sectional study. Environ Health Prev Med 2017; 22:12. [PMID: 29165107 PMCID: PMC5664443 DOI: 10.1186/s12199-017-0613-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 03/04/2017] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES This study aims to describe the dietary status of Turkish adults using two different versions of the Healthy Eating Index (HEI). METHODS In this cross sectional study, 494 healthy participants (311 females) with randomly selected and living in Ankara were included between September 2013 and March 2014. A questionnaire was completed and anthropometric measurements (weight and height) were performed. The 24-h dietary recall of individuals was collected. Diet quality was measured through HEI-2005 and HEI-2010 scores. RESULTS The mean age, body mass index (BMI), HEI-2005 and HEI-2010 scores of individuals were 32.9 ± 10.8 years; 25.0 ± 4.8 kg/m2; 56.1 ± 13.9 and 41.5 ± 13.7 points, respectively. Significant differences were found between mean HEI-2005 and HEI-2010 scores (p < 0.05). The individual's whose diet quality needs to be improved according to mean HEI-2005 score, had poorer diet based on mean HEI-2010 scores. The highest mean HEI-2005 and HEI-2010 scores were stated in female, in subjects had low education levels, aged 51 years or older and in overweight groups (p <0.05). Both versions of healthy eating indices were correlated positively with BMI and age CONCLUSION: Diet qualities of the individuals are associated with age, gender, education and BMI. Although the components and scores in HEI-2010 version were changed from the version of HEI-2005, the changes may encourage healthy choices of some food group. HEI-2010 gives more attention to food quality than HEI-2005. Thus, in the present study it was concluded that HEI-2010 provided more precise results about diet quality.
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Affiliation(s)
- Eda Koksal
- Faculty of Health Sciences, Department of Nutrition and Dietetics, Gazi University, Ankara, Turkey
| | | | - Hande Mortas
- Faculty of Health Sciences, Department of Nutrition and Dietetics, Gazi University, Ankara, Turkey.
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Acculturation inclinations and subjective health status of internal migrants in James Town, an urban slum settlement in Accra. JOURNAL OF POPULATION RESEARCH 2016. [DOI: 10.1007/s12546-016-9182-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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88
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Diet quality and its relationship with central obesity among Mexican Americans: findings from National Health and Nutrition Examination Survey (NHANES) 1999-2012. Public Health Nutr 2016; 20:1193-1202. [PMID: 27974064 DOI: 10.1017/s1368980016003190] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Using the Healthy Eating Index-2010 (HEI-2010), the present study aimed to examine diet quality and the impact of overall diet quality and its components on central obesity among Mexican-American men and women. DESIGN Cross-sectional data from NHANES 1999-2012 were used. The HEI-2010 data, including twelve components for a total score of 100, were collected with a 24 h recall interview. Central obesity was defined as a waist circumference of ≥88 cm for women and ≥102 cm for men. Weighted logistic regressions were performed to assess associations between HEI-2010 scores and central obesity. SETTING National Health and Nutrition Examination Survey (NHANES) 1999-2012. SUBJECTS A total of 6847 Mexican Americans aged ≥20 years with reliable dietary recall status and non-pregnancy status. RESULTS Higher HEI-2010 total score was associated with lower odds of central obesity in Mexican-American men (OR; 95 % CI=0·98; 0·98, 1·00). Among all Mexican Americans, one-unit higher score of total fruit and sodium (i.e. lower level of intake) was associated with 4 % (0·96; 0·93, 0·99) and 2 % (0·98; 0·96, 0·99) lower odds of central obesity, respectively. However, a higher total proteins score was associated with higher odds of central obesity (1·08; 1·00, 1·16). In gender-specific analyses, a higher whole fruit or sodium score was inversely associated with central obesity in men but not in women. CONCLUSIONS HEI-2010 scores of total fruit and sodium were inversely associated with central obesity among all Mexican Americans. However, total proteins score and central obesity was positively associated. In Mexican-American men, HEI-2010 total and whole fruit scores were inversely associated with central obesity.
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89
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Velasco-Mondragon E, Jimenez A, Palladino-Davis AG, Davis D, Escamilla-Cejudo JA. Hispanic health in the USA: a scoping review of the literature. Public Health Rev 2016; 37:31. [PMID: 29450072 PMCID: PMC5809877 DOI: 10.1186/s40985-016-0043-2] [Citation(s) in RCA: 279] [Impact Index Per Article: 34.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 11/16/2016] [Indexed: 12/14/2022] Open
Abstract
Hispanics are the largest minority group in the USA. They contribute to the economy, cultural diversity, and health of the nation. Assessing their health status and health needs is key to inform health policy formulation and program implementation. To this end, we conducted a scoping review of the literature and national statistics on Hispanic health in the USA using a modified social-ecological framework that includes social determinants of health, health disparities, risk factors, and health services, as they shape the leading causes of morbidity and mortality. These social, environmental, and biological forces have modified the epidemiologic profile of Hispanics in the USA, with cancer being the leading cause of mortality, followed by cardiovascular diseases and unintentional injuries. Implementation of the Affordable Care Act has resulted in improved access to health services for Hispanics, but challenges remain due to limited cultural sensitivity, health literacy, and a shortage of Hispanic health care providers. Acculturation barriers and underinsured or uninsured status remain as major obstacles to health care access. Advantageous health outcomes from the "Hispanic Mortality Paradox" and the "Latina Birth Outcomes Paradox" persist, but health gains may be offset in the future by increasing rates of obesity and diabetes. Recommendations focus on the adoption of the Health in All Policies framework, expanding access to health care, developing cultural sensitivity in the health care workforce, and generating and disseminating research findings on Hispanic health.
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Affiliation(s)
- Eduardo Velasco-Mondragon
- College of Osteopathic Medicine, Touro University California, 1310 Johnson Lane; H-82, Rm. 213, Vallejo, CA 94592 USA
| | - Angela Jimenez
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, USA
| | | | - Dawn Davis
- St. Louis University School of Medicine, St. Louis, USA
| | - Jose A. Escamilla-Cejudo
- Regional Advisor on Health Information and Analysis, Pan American Health Organization/World Health Organization, Foggy Bottom, USA
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90
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Yi SS, Beasley JM, Kwon SC, Huang KY, Trinh-Shevrin C, Wylie-Rosett J. Acculturation and activity behaviors in Chinese American immigrants in New York City. Prev Med Rep 2016; 4:404-409. [PMID: 27570733 PMCID: PMC4992039 DOI: 10.1016/j.pmedr.2016.08.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 08/05/2016] [Accepted: 08/07/2016] [Indexed: 11/30/2022] Open
Abstract
Asian Americans have lower levels of physical activity (PA) compared to other racial/ethnic groups; however, there is little understanding of the social and cultural determinants of PA in this population. Few analyses describe specific PA domains (occupation-, transportation-, recreation-related), focus on one Asian subgroup, or use validated scales. The study objective was to assess the association between acculturation and activity behaviors (meeting 2008 PA guidelines, activity minutes by PA domain, sitting time) in a cross-sectional sample of urban-dwelling, Chinese American immigrants. Data were from the Chinese American Cardiovascular Health Assessment (CHA CHA) 2010-11 among participants with valid reports of PA minutes, assessed by the WHO Global Physical Activity Questionnaire (n = 1772). Acculturation was assessed using the Stephenson Multigroup Acculturation Scale, a 32-item instrument which characterizes two acculturative dimensions: ethnic society (Chinese) immersion and dominant society (American) immersion (maximum possible scores = 4). Multivariable models regressing activity behaviors on acculturation were run, adjusting for age, sex, household income, education, and age at immigration. Ethnic society immersion was high (mean = 3.64) while dominant society immersion was moderate (mean = 2.23). Higher ethnic society immersion was associated with less recreation-related PA (- 40.7 min/week); higher dominant society immersion was associated with a higher odds of meeting PA guidelines (OR: 1.66 (1.25, 2.20), p < 0.001) and more recreation-related PA (+ 36.5 min/week). Given low PA levels in Chinese adults in China, results suggest that PA for leisure may increase and become a more normative behavior among Chinese American immigrants with acculturation. Understanding acculturation level may inform strategies to increase PA in Chinese Americans.
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Affiliation(s)
- Stella S. Yi
- NYU School of Medicine, Department of Population Health, United States
| | | | - Simona C. Kwon
- NYU School of Medicine, Department of Population Health, United States
| | - Keng-Yen Huang
- NYU School of Medicine, Department of Population Health, United States
| | | | - Judith Wylie-Rosett
- Albert Einstein College of Medicine, Department of Epidemiology and Population Health, United States
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91
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Fred Wen CK, Hsieh S, Huh J, Martinez LC, Davis JN, Weigensberg M, Spruijt-Metz D. The Role of Assimilating to the US Culture and the Relationship Between Neighborhood Ethnic Composition and Dietary Intake Among Hispanic Youth. J Racial Ethn Health Disparities 2016; 4:10.1007/s40615-016-0293-1. [PMID: 27753052 PMCID: PMC5529269 DOI: 10.1007/s40615-016-0293-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 09/26/2016] [Accepted: 09/28/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Dietary fiber and sugar intake have been shown to affect metabolic health in overweight Hispanic youth. Evidence on the influence of culture on fiber and sugar intake in Hispanic youth is limited. METHODS The associations among score for levels of assimilation, neighborhood ethnic characteristics, and daily total and added dietary sugar and dietary fiber intake were assessed using regression analyses. RESULTS One hundred twenty-four Hispanic youth (age = 13.6 ± 3.0, 106 female) were included. The proportion of Hispanic population in the neighborhood was positively associated with fiber intake (standardized β = 0.205, p < 0.01) and inversely associated with added (standardized β = -0.234, p < 0.01) and total sugar intake (standardized β = -0.229, p < 0.01). Youth's self-identified levels of assimilation inversely moderated (standardized β = -0.465, p = 0.036) the association between %HP and dietary fiber intake. CONCLUSIONS Hispanic youth residing in areas of that are predominantly populated with Hispanics may be protected from conforming to unhealthy dietary behaviors. This protective effect is weaker among Hispanic youth with higher level of assimilation.
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Affiliation(s)
- Cheng K Fred Wen
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Stephanie Hsieh
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jimi Huh
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lauren Cook Martinez
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jamie N Davis
- Department of Nutrition, University of Texas, Austin, Austin, TX, USA
| | - Marc Weigensberg
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Institute for Integrative Health, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Donna Spruijt-Metz
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Center for Social and Economic Research, University of Southern California, Los Angeles, CA, USA
- Department of Psychology, Dana and David Dornsife College of Letters, Arts, and Sciences, University of Southern California, Los Angeles, CA, USA
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92
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Perez LG, Chavez A, Marquez DX, Soto SC, Haughton J, Arredondo EM. Associations of Acculturation With Self-Report and Objective Physical Activity and Sedentary Behaviors Among Latinas. HEALTH EDUCATION & BEHAVIOR 2016; 44:431-438. [PMID: 27679665 DOI: 10.1177/1090198116669802] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Less than 50% of Latinas meet physical activity (PA) recommendations. Acculturation is a complex cultural phenomenon that may influence health behaviors, but associations between acculturation and Latinas' activity and sedentary levels are unclear. AIM To examine associations of acculturation with Latinas' domain-specific and total PA as well as sedentary time. METHOD We analyzed baseline data collected between 2011 and 2013 among 410 Latinas (18-65 years) from a PA promotion intervention in San Diego, CA ( Fe en Acción/ Faith in Action). Participants wore an accelerometer to assess moderate-to-vigorous PA (MVPA) and sedentary time and completed a survey assessing domain-specific PA, sociodemographics, and acculturation as measured by length of residence in the United States and the Bidimensional Acculturation Scale (BAS) for Hispanics. Higher acculturation was defined as longer residence in the United States or being either assimilated or bicultural as per scores on the Hispanic and Anglo domains of the BAS. RESULTS Based on weekly averages from the accelerometer, Latinas spent 103 minutes in MVPA and 76% of total activity in sedentary time. Only 32% met MVPA recommendations via self-reported leisure-time and transportation PA. Longer residence in the United States was inversely associated with reporting any transportation or occupational PA and meeting MVPA recommendations. Assimilated/bicultural Latinas had significantly less accelerometer-based total MVPA and higher sedentary time than their lower acculturated counterparts. CONCLUSIONS Overall, higher acculturation, based on either measure, was related to less activity. Our findings suggest interventions tailored to the acculturation levels of Latinas are needed to help reduce disparities in Latinas' PA and sedentary behaviors.
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Affiliation(s)
- Lilian G Perez
- 1 University of California, San Diego, CA, USA.,2 San Diego State University, San Diego, CA, USA.,3 Institute for Behavioral and Community Health, San Diego, CA, USA
| | - Adrian Chavez
- 3 Institute for Behavioral and Community Health, San Diego, CA, USA
| | | | - Sandra C Soto
- 1 University of California, San Diego, CA, USA.,2 San Diego State University, San Diego, CA, USA.,3 Institute for Behavioral and Community Health, San Diego, CA, USA
| | - Jessica Haughton
- 3 Institute for Behavioral and Community Health, San Diego, CA, USA
| | - Elva M Arredondo
- 2 San Diego State University, San Diego, CA, USA.,3 Institute for Behavioral and Community Health, San Diego, CA, USA
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Di Noia J, Monica D, Gray HL, Cullen KW. The Special Supplemental Nutrition Program for Women, Infants, and Children Fresh Start Randomized Controlled Trial: Baseline Participant Characteristics and Reliability of Measures. J Acad Nutr Diet 2016; 116:1899-1913. [PMID: 27663256 DOI: 10.1016/j.jand.2016.07.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 07/25/2016] [Indexed: 02/01/2023]
Abstract
BACKGROUND The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Fresh Start (WFS) is a randomized controlled trial of nutrition education to promote farmers' market fruit and vegetable (F/V) purchases and consumption among women enrolled in WIC. OBJECTIVES To describe the baseline characteristics (demographics and F/V intake [including F/V juice]) of WFS participants, compare the characteristics with those of WIC participants in New Jersey and nationwide, and examine the baseline reliability of study measures. DESIGN Cross-sectional. PARTICIPANTS/SETTING Seven hundred forty-four women served by a New Jersey-based WIC agency located in a densely populated, urban area. MAIN OUTCOME MEASURES Demographic characteristics; newly developed measures of farmers' market-related knowledge, attitudes, and skills; and validated measures of F/V intake. STATISTICAL ANALYSES Descriptive statistics to characterize the sample. One-sample t and one-sample sign tests to compare the characteristics with reference values. For dietary behaviors, comparisons were with state and national estimates of the frequency and quantity of F/V intake. RESULTS Participants had a mean age of 28.9±6.8 years and were predominantly Hispanic (59%), US-born (60%), never married (41%), unemployed (62%), receiving assistance other than WIC (70%), and food insecure (55%). Half reported a high school education or less. Higher proportions of WFS participants than WIC participants nationwide were represented among demographic groups at increased risk of inadequate F/V intake. WFS participants consumed more fruit (2.7 cups/day) but less vegetables (1.4 cups/day) than did women nationwide (1.1 and 1.4 cups/day, respectively; P<0.01). Although participants consumed recommended amounts of fruit, their vegetable intake was below recommended levels. All but two of the measures developed for the study had reliability coefficients at or above 0.60. CONCLUSIONS Intervention is warranted to improve participants' vegetable intake. Registered dietitian nutritionists should be aware of F/V intake differences that may require differential intervention strategies.
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94
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Brown SD, Ehrlich SF, Kubo A, Tsai AL, Hedderson MM, Quesenberry CP, Ferrara A. Lifestyle behaviors and ethnic identity among diverse women at high risk for type 2 diabetes. Soc Sci Med 2016; 160:87-93. [PMID: 27214712 PMCID: PMC4912226 DOI: 10.1016/j.socscimed.2016.05.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 05/09/2016] [Accepted: 05/13/2016] [Indexed: 01/03/2023]
Abstract
BACKGROUND Diet and physical activity lifestyle behaviors are modifiable risk factors for type 2 diabetes and are shaped by culture, potentially influencing diabetes health disparities. OBJECTIVES We examined whether ethnic identity-the strength of attachment to one's ethnic group, and a long-standing focus of psychological research-could help account for variations in lifestyle behaviors within a diverse population at high risk for chronic disease. METHODS Using data from the Gestational Diabetes' Effects on Moms trial, this US-based cross-sectional study included 1463 pregnant women (74% from minority ethnic/racial groups; 46% born outside the US) with gestational diabetes (GDM), a common pregnancy complication conferring high risk for type 2 diabetes after delivery. Mixed linear regression models examined whether ethnic identity is associated with lifestyle behaviors after adjusting for demographic, clinical, and acculturative characteristics (e.g., nativity and length of residence in the US). RESULTS In the overall sample, a one-unit increase in ethnic identity score was significantly associated with 3% greater fiber intake, 4% greater fruit/vegetable intake, 11% greater total activity, and 11% greater walking (p values < 0.01). Within ethnic/racial groups, a one-unit increase in ethnic identity score was significantly associated with 17% greater fiber intake among Filipina women; 5% lower total caloric intake among non-Hispanic White women; and 40% greater total activity, 35% greater walking, and 8% greater total caloric intake among Latina women (p values ≤ 0.03). CONCLUSION Results from this large study suggest that ethnic group attachment is associated with some lifestyle behaviors, independent of acculturation indicators, among young women with GDM who are at high risk for type 2 diabetes. Stronger ethnic identity may promote certain choices known to be associated with reduced risk of type 2 diabetes. Prospective research is needed to clarify the temporal nature of associations between ethnic identity and modifiable diabetes risk factors.
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Affiliation(s)
- Susan D Brown
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States.
| | - Samantha F Ehrlich
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Ai Kubo
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Ai-Lin Tsai
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Monique M Hedderson
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Charles P Quesenberry
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Assiamira Ferrara
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
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Khan SA, Jackson RT, Momen B. The Relationship between Diet Quality and Acculturation of Immigrated South Asian American Adults and Their Association with Metabolic Syndrome. PLoS One 2016; 11:e0156851. [PMID: 27299862 PMCID: PMC4907444 DOI: 10.1371/journal.pone.0156851] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 05/22/2016] [Indexed: 01/30/2023] Open
Abstract
Even though the total SA American population is increasing rapidly, there is a paucity of information on the relationship between diet quality, acculturation and health outcomes such as Metabolic Syndrome (MetS) in the low-income South Asian (SA) sub-population. Our goal was to examine diet quality, degree of acculturation and their potential influence on MetS in a diverse sample of SA Americans. A convenience sample of 401 adult SA men and women were studied using a cross-sectional study design. Volunteers from two low-income community health clinics in Maryland were interviewed by questionnaires. MetS, defined by the consensus harmonized definition by the presence of ≥ 3 of the 5 abnormal indicators, was studied. An interviewer obtained an automated self-administered 24-hour Recall (ASA24) and an acculturation index (using a previously validated (SL-ASIA). SA had a composite HEI2010 score of 68 suggesting an overall need for diet improvements. Males had a higher diet quality (mean HEI2010 score) than females. Males with MetS had lower diet quality (68) than males without MetS (73). The converse was true for females (68 vs. 65). Americanized (more acculturated) subjects had a higher diet quality compared to less acculturated SA. Small differences were found in diet quality scores among SA adults from different countries. Less acculturated females, had a higher percentage of MetS and lower diet quality compared to males. These results suggest that interventions are needed in males and females who were less acculturated because they may have greater MetS and lower diet quality compared to more Americanized SA.
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Affiliation(s)
- Saira A. Khan
- Department of Nutrition and Food Science, The University of Maryland, College Park, Maryland, United States of America
| | - Robert T. Jackson
- Department of Nutrition and Food Science, The University of Maryland, College Park, Maryland, United States of America
| | - Bahram Momen
- Department of Environmental Science, The University of Maryland, College Park, Maryland, United States of America
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Abstract
There are clear and persistent disparities in obesity prevalence within the USA. Some of these disparities fall along racial/ethnic lines; however, there are a number of other social and demographic constructs where obesity disparities are present. In addition to differing rates of obesity across groups, there is growing evidence that subgroups of patients both seek out and respond to obesity treatment differently. This review article explores the epidemiology of obesity disparities, as well as the existing evidence around how different groups may respond to behavioral, medical, and surgical therapies, and potential reasons for differential uptake and response, from culture, to access, to physiology. We find that the vast majority of evidence in this area has focused on the observation that African Americans tend to lose less weight in clinical trials compared to non-Hispanic whites and mainly pertains to behavioral interventions. Moving forward, there will be a need for studies that broaden the notion of health disparity beyond just comparing African Americans and non-Hispanic whites. Additionally, a more thorough examination of the potential for disparate outcomes after medical and surgical treatments of obesity is needed, coupled with the careful study of possible physiologic drivers of differential treatment response.
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Affiliation(s)
- Kristina H Lewis
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Weight Management Center, Wake Forest Baptist Medical Center, Winston-Salem, NC, 27157, USA
| | - Shenelle A Edwards-Hampton
- Department of General Surgery, Weight Management Center, Wake Forest Baptist Medical Center, Winston-Salem, NC, 27157, USA
| | - Jamy D Ard
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Weight Management Center, Wake Forest Baptist Medical Center, Winston-Salem, NC, 27157, USA.
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Eicher-Miller HA, Khanna N, Boushey CJ, Gelfand SB, Delp EJ. Temporal Dietary Patterns Derived among the Adult Participants of the National Health and Nutrition Examination Survey 1999-2004 Are Associated with Diet Quality. J Acad Nutr Diet 2016; 116:283-291. [PMID: 26138502 PMCID: PMC4696922 DOI: 10.1016/j.jand.2015.05.014] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 05/12/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND Temporal dietary patterns, the distribution of energy or nutrient intakes observed over a period of time, is an emerging area of dietary patterns research that incorporates time of dietary intake with frequency and amount of intake to determine population clusters that may have similar characteristics or outcomes related to diet quality. OBJECTIVE We examined whether differences in diet quality were present between clusters of individuals with similar daily temporal dietary patterns. DESIGN The first-day 24-hour dietary recall data from the cross-sectional National Health and Nutrition Examination Survey, 1999-2004, were used to determine proportional energy intake, time of intake, frequency of intake occasions, and mean diet quality. PARTICIPANTS/SETTING Data from 9,326 US adults aged 20 to 65 years were included. STATISTICAL ANALYSES PERFORMED The mean diet quality, classified by the Healthy Eating Index-2005, of participant clusters with similar temporal dietary patterns derived on the basis of individual proportional energy intake, time of intake, and frequency of intake, were inferentially compared using multiple linear regression that controlled for potential confounders and other covariates (P<0.05/6). RESULTS Diet quality differences were present between US population clusters exhibiting similar daily temporal dietary patterns (P<0.001 with one exception, which was P=0.08). Participant characteristics of race/ethnicity, age, household poverty-income ratio, and body mass index were associated with the temporal dietary patterns. The cluster representing the temporal dietary pattern with proportionally equivalent energy consumed during three evenly spaced eating occasions had a significantly greater mean total Healthy Eating Index-2005 score compared with the other temporal dietary pattern clusters. CONCLUSIONS Temporal dietary patterns are associated with differences in US adult daily diet quality, demonstrating that elements beyond food and nutrient intake, such as time, can be incorporated with dietary patterns to determine links to diet quality that enhance knowledge of the complicated interplay of time and dietary patterns.
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Affiliation(s)
- Heather A. Eicher-Miller
- Department of Nutrition Science, Purdue University, 700 W. State Street, West Lafayette, IN, 47907 USA
| | - Nitin Khanna
- Department of Electronics and Communication Engineering, Graphic Era University, Dehradun, Uttarakhand,India,
| | - Carol J. Boushey
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii, USA, (808)564-5915, and Department of Nutrition Science, Purdue University, 700 W. State Street, West Lafayette, IN, 47907 USA
| | - Saul B. Gelfand
- School of Electrical and Computer Engineering, Purdue University, 465 Northwestern Ave., West Lafayette, IN, 47907 USA, (765)494-3439,
| | - Edward J. Delp
- School of Electrical and Computer Engineering, Purdue University, 465 Northwestern Avenue, West Lafayette, IN 47907, (765)494-1740, (765)494-3358(FAX),
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98
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Viladrich A, Tagliaferro B. Picking fruit from our backyard's trees: The meaning of nostalgia in shaping Latinas' eating practices in the United States. Appetite 2016; 97:101-10. [DOI: 10.1016/j.appet.2015.11.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 11/11/2015] [Accepted: 11/12/2015] [Indexed: 12/20/2022]
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99
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Abraído-Lanza AF, Echeverría SE, Flórez KR. Latino Immigrants, Acculturation, and Health: Promising New Directions in Research. Annu Rev Public Health 2016; 37:219-36. [PMID: 26735431 DOI: 10.1146/annurev-publhealth-032315-021545] [Citation(s) in RCA: 179] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This article provides an analysis of novel topics emerging in recent years in research on Latino immigrants, acculturation, and health. In the past ten years, the number of studies assessing new ways to conceptualize and understand how acculturation-related processes may influence health has grown. These new frameworks draw from integrative approaches testing new ground to acknowledge the fundamental role of context and policy. We classify the emerging body of evidence according to themes that we identify as promising directions--intrapersonal, interpersonal, social environmental, community, political, and global contexts, cross-cutting themes in life course and developmental approaches, and segmented assimilation--and discuss the challenges and opportunities each theme presents. This body of work, which considers acculturation in context, points to the emergence of a new wave of research that holds great promise in driving forward the study of Latino immigrants, acculturation, and health. We provide suggestions to further advance the ideologic and methodologic rigor of this new wave.
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Affiliation(s)
- Ana F Abraído-Lanza
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY 10032;
| | - Sandra E Echeverría
- Department of Community Health Education, School of Urban Public Health, City University of New York-Hunter College, New York, NY 10035;
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100
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Black-White Latino Racial Disparities in HIV Survival, Florida, 2000-2011. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 13:ijerph13010009. [PMID: 26703656 PMCID: PMC4730400 DOI: 10.3390/ijerph13010009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 09/20/2015] [Accepted: 09/23/2015] [Indexed: 01/10/2023]
Abstract
This research aimed to estimate Black/White racial disparities in all-cause mortality risk among HIV-positive Latinos. Florida surveillance data for Latinos diagnosed with HIV (2000–2008) were merged with 2007–2011 American Community Survey data. Crude and adjusted hazard ratios (aHR) were calculated using multi-level Cox regression. Of 10,903 HIV-positive Latinos, 8.2% were Black and 91.9% White. Black Latinos were at increased mortality risk compared with White Latinos after controlling for individual and neighborhood factors (aHR 1.40, 95% confidence interval (CI) 1.21–1.62). In stratified analyses, risk factors for Black Latinos included: age ≥60 years compared with ages 13–19 (aHR 4.63, 95% CI 1.32–16.13); US birth compared with foreign birth (aHR 1.56, 95% CI 1.16–2.11); diagnosis of AIDS within three months of HIV diagnosis (aHR 3.53, 95% CI 2.64–4.74); residence in the 3rd (aHR 1.82, 95% CI 1.13–2.94) and 4th highest quartiles (aHR 1.79, 95% CI 1.12–2.86) of neighborhood poverty compared with the lowest quartile; and residence in neighborhood with 25%–49% (aHR 1.59, 95% CI 1.07–2.42) and ≥50% Latinos compared with <25% Latinos (aHR 1.58, 95% CI 1.03–2.42). Significant racial disparities in HIV survival exist among Latinos. Differential access to—and quality of—care and perceived/experienced racial discrimination may be possible explanations.
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