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Vyas MV, Redditt V, Mohamed S, Abraha M, Sheth J, Shah BR, Ko DT, Ke C. Determinants, Prevention, and Incidence of Cardiovascular Disease Among Immigrant and Refugee Populations. Can J Cardiol 2024; 40:1077-1087. [PMID: 38387721 DOI: 10.1016/j.cjca.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 02/15/2024] [Accepted: 02/18/2024] [Indexed: 02/24/2024] Open
Abstract
Immigration policies shape the composition, socioeconomic characteristics, and health of migrant populations. The health of migrants is also influenced by a confluence of social, economic, environmental, and political factors. Immigrants and refugees often face various barriers to accessing health care because of factors such as lack of familiarity with navigating the health care system, language barriers, systemic racism, and gaps in health insurance. Social determinants of health and access to primary care health services likely influence the burden of cardiovascular risk factors among immigrants. The relatively low burden of many cardiovascular risk factors in many immigrant populations likely contributes to the generally lower incidence rates of acute myocardial infarction, heart failure, and stroke in immigrants compared with nonimmigrants, although cardiovascular disease incidence rates vary substantially by country of origin. The "healthy immigrant effect" is the hypothesis that immigrants to high-income countries, such as Canada, are healthier than nonimmigrants in the host population. However, this effect may not apply universally across all immigrants, including recent refugees, immigrants without formal education, and unmarried immigrants. As unfolding sociopolitical events generate new waves of global migration, policymakers and health care providers need to focus on addressing social and structural determinants of health to better manage cardiovascular risk factors and prevent cardiovascular disease, especially among the most marginalized immigrants and refugees.
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Affiliation(s)
- Manav V Vyas
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; Division of Neurology, Li Ka Shing Knowledge Institute, St. Michael's Hospital-Unity Health, Toronto, Ontario, Canada
| | - Vanessa Redditt
- Crossroads Clinic, Women's College Hospital, Toronto, Ontario, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sebat Mohamed
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Mosana Abraha
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Javal Sheth
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Baiju R Shah
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; Department of Medicine, Sunnybrook Hospital, Toronto, Ontario, Canada
| | - Dennis T Ko
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; Department of Medicine, Schulich Heart Centre, Sunnybrook Hospital, Toronto, Ontario, Canada
| | - Calvin Ke
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; Department of Medicine, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada.
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LeBlanc KE, Baer-Sinnott S, Lancaster KJ, Campos H, Lau KHK, Tucker KL, Kushi LH, Willett WC. Perspective: Beyond the Mediterranean Diet-Exploring Latin American, Asian, and African Heritage Diets as Cultural Models of Healthy Eating. Adv Nutr 2024; 15:100221. [PMID: 38604411 PMCID: PMC11087705 DOI: 10.1016/j.advnut.2024.100221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 03/28/2024] [Accepted: 04/03/2024] [Indexed: 04/13/2024] Open
Abstract
The Mediterranean diet is a well-studied cultural model of healthy eating, yet research on healthy models from other cultures and cuisines has been limited. This perspective article summarizes the components of traditional Latin American, Asian, and African heritage diets, their association with diet quality and markers of health, and implications for nutrition programs and policy. Though these diets differ in specific foods and flavors, we present a common thread that emphasizes healthful plant foods and that is consistent with high dietary quality and low rates of major causes of disability and deaths. In this perspective, we propose that nutrition interventions that incorporate these cultural models of healthy eating show promise, though further research is needed to determine health outcomes and best practices for implementation.
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Affiliation(s)
| | | | - Kristie J Lancaster
- Department of Nutrition and Food Studies, New York University, New York, NY, United States
| | - Hannia Campos
- Department of Nutrition, Harvard University T.H. Chan School of Public Health, Boston, MA, United States
| | | | - Katherine L Tucker
- Department of Biomedical & Nutritional Sciences and Center for Population Health, University of Massachusetts Lowell, Lowell, MA, United States
| | - Lawrence H Kushi
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Walter C Willett
- Department of Nutrition, Harvard University T.H. Chan School of Public Health, Boston, MA, United States
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Moussaoui S, Combes S, Ibanez G, Gautier A, Relyea B, Vignier N. Are immigrants living in France more reluctant to receive vaccines than native-born French citizens? findings from the national health Barometer study. Vaccine 2022; 40:3869-3883. [DOI: 10.1016/j.vaccine.2022.05.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 04/12/2022] [Accepted: 05/14/2022] [Indexed: 01/04/2023]
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Jefferies K, Richards T, Blinn N, Sim M, Kirk SFL, Dhami G, Helwig M, Iduye D, Moody E, Macdonald M, Tomblin Murphy G, Martin-Misener R. Food security in African Canadian communities: a scoping review. JBI Evid Synth 2021; 20:37-59. [PMID: 34149022 DOI: 10.11124/jbies-20-00394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of this review is to chart the evidence relating to food security among African Canadian communities to inform future research and offer insight related to food security in African Canadian communities. INTRODUCTION Achieving food security is of global importance in the attainment of the United Nations Sustainable Development Goals. As a social determinant of health, food security, which refers to the unrestricted physical, economic, and timely access to safe and nutritious foods, impacts over four million Canadians. Yet, little is known about food security and the differential impacts of food insecurity among African Canadians. This scoping review sought to describe the current state of food security among African Canadians. INCLUSION CRITERIA Sources were considered for inclusion if they met the eligibility criteria outlined in the a priori protocol. Specifically, sources were considered if they: i) focused on Canada, ii) involved African Canadians, and iii) examined food security. No restrictions were placed on date of publication and language restrictions were limited to English and French. METHODS This scoping review was conducted in accordance with JBI methodology and comprised a search of published and unpublished sources. Data were extracted independently in Excel by two team members according to data items outlined in the extraction tool. In instances where articles were unavailable, authors of potential sources were contacted at the full-text review phase to request access to the full text of their article. Databases and relevant websites containing peer-reviewed, unpublished, and gray literature were searched. Ancestry searching and forward citation tracing were completed. RESULTS The search of databases yielded a total of 1183 records. Ancestry tracing yielded 287 records. After removing duplicates, 1075 titles and abstracts were screened for eligibility and 80 advanced to full-text screening. Seventy-five full-text articles were excluded based on inclusion criteria, leaving five articles that underwent data extraction. All included studies involved African Canadian participants in Canada (n = 5). All studies focused on adults (n = 5); one study included women and men participants (n = 1), while four focused exclusively on women (n = 4). Importantly, one study involving women participants included cis- and trans women as well as those identifying as queer (n = 1). Study designs reflected qualitative (n = 2), quantitative (n = 1), and mixed methods (n = 2) designs. CONCLUSIONS This review begins to fill a gap in understanding the current evidence available on food security as it impacts African Canadians. The findings of this review represent existing research, describing the type of evidence available and methodologies used, before suggesting implications for research and practice. The inclusion of only five studies reveals the limited evidence regarding the current state of food security among African Canadians. Further, included studies were exclusively conducted in urban settings; predominantly in one province. There is a need for further research in rural communities, in other provinces and territories, as well as with younger and older participants. Lastly, the urgent need to collect race-disaggregated data in Canada is evident.
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Affiliation(s)
- Keisha Jefferies
- School of Nursing, Dalhousie University, Halifax, NS, Canada Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): A JBI Centre of Excellence, Halifax, NS, Canada Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada Healthy Populations Institute, Dalhousie University, Halifax, NS, Canada School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada Nova Scotia Health, Halifax, NS, Canada Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS, Canada WK Kellogg Library, Dalhousie University, Halifax, NS, Canada
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Colorectal Cancer-Related Knowledge, Acculturation, and Healthy Lifestyle Behaviors Among Low-Income Vietnamese Americans in the Greater Philadelphia Metropolitan Area. J Community Health 2020; 45:1178-1186. [PMID: 33026553 DOI: 10.1007/s10900-020-00931-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2020] [Indexed: 10/23/2022]
Abstract
Colorectal cancer (CRC) is the second and fourth most common cancer in Vietnamese American women and men, respectively. Recent research has highlighted the importance of modifiable lifestyle behaviors such as smoking, alcohol use, dietary behaviors, and physical activities in CRC prevention for the general population. However, it is not well understood how well Vietnamese Americans knew about CRC prevention and risk factors, and whether there were any disparities in knowledge within this vulnerable population. This study examined whether comprehensive measures of acculturation and knowledge of CRC risk are associated with different health behaviors, specifically physical activity, protective dietary behaviors, and risky dietary behaviors in Vietnamese Americans. We recruited 374 Vietnamese Americans aged 50 or above from community-based organizations in the Vietnamese American communities in the greater Philadelphia metropolitan area. Through a cross-sectional survey, we collected data on their knowledge of CRC prevention and risk factors, acculturation-related factors, and sociodemographic characteristics. We found limited knowledge of CRC prevention and risk factors, and suboptimal physical activity and healthy dietary behaviors in the Vietnamese Americans. We also found that higher levels of knowledge about CRC and risk factors were associated with less unhealthy diets but not with more protective diets or physical activity. Acculturation was not significantly associated with overall dietary behaviors in our study. Our findings addressed gaps in current literature concerning the impact of knowledge about CRC risk factors and acculturation on different dimensions of dietary behaviors as well as physical activity. Research and practical implications were discussed.
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Hoyt AT, Ramadhani T, Le MT, Shumate CJ, Canfield MA, Scheuerle AE. Acculturation and selected birth defects among non-Hispanic Blacks in a population-based case-control study. Birth Defects Res 2020; 112:535-554. [PMID: 32134219 DOI: 10.1002/bdr2.1665] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 02/14/2020] [Accepted: 02/20/2020] [Indexed: 01/31/2023]
Abstract
BACKGROUND There are noted birth defects prevalence differences between race/ethnicity groups. For instance, non-Hispanic (NH) Black mothers are more likely to have an infant with encephalocele, although less likely to have an infant with anotia/microtia compared to NH Whites. When stratifying by nativity and years lived within the United States, additional variations become apparent. METHODS Data from the National Birth Defects Prevention Study were used to calculate descriptive statistics and estimate crude/adjusted odds ratios (aORs) and 95% confidence intervals (95%CIs) among NH Blacks with one of 30 major defects and non-malformed controls. Total case/controls were as follows: U.S.- (2,773/1101); Foreign- (343/151); African-born (161/64). Study participants were also examined by number of years lived in the U.S. (≤5 vs. 6+ years). RESULTS Compared to U.S.-born, foreign-born NH Black controls tended to be older, had more years of education, and were more likely to have a higher household income. They also had fewer previous livebirths and were less likely to be obese. In the adjusted analyses, two defect groups were significantly attenuated: limb deficiencies, aORs/95%CIs = (0.44 [0.20-0.97]) and septal defects (0.69 [0.48-0.99]). After stratifying by years lived in the United States, the risk for hydrocephaly (2.43 [1.03-5.74]) became apparent among those having lived 6+ years in the United States. When restricting to African-born mothers, none of the findings were statistically significant. CONCLUSIONS Foreign-born NH Blacks were at a reduced risk for a few selected defects. Results were consistent after restricting to African-born mothers and did not change considerably when stratifying by years lived in the United States.
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Affiliation(s)
- Adrienne T Hoyt
- Department of Health and Human Performance, University of Houston, Houston, Texas, USA.,Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas, USA
| | | | - Mimi T Le
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas, USA
| | - Charlie J Shumate
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas, USA
| | - Mark A Canfield
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas, USA
| | - Angela E Scheuerle
- Department of Pediatrics, Division of Genetics and Metabolism, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Dietary Micronutrient Intake of Participants in a "Partners Together in Health" Cardiac Rehabilitation Intervention. J Cardiopulm Rehabil Prev 2019; 38:388-393. [PMID: 30252779 DOI: 10.1097/hcr.0000000000000331] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE Current guidelines for cardiovascular health emphasize a "dietary pattern" approach that could be expected to increase intakes of micronutrients in addition to altering the macronutrient profile. However, the effect of interventions such as cardiac rehabilitation on the micronutrient quality of the diet has not been evaluated. Therefore, the goal of this study was to investigate changes in micronutrient intake of cardiac rehabilitation participants over time. METHODS This was a secondary analysis of data from a randomized clinical trial that assessed the effects of the Partners Together in Health intervention on physical activity and healthy eating behaviors. The intake of 9 micronutrients important in cardiovascular health was assessed using 3-d food records. A micronutrient adequacy score was evaluated at 3 time points (baseline, 3 and 6 mo). Changes over time in micronutrient intake were assessed using a general linear model. RESULTS Sixty-eight participants who were enrolled in the Partners Together in Health interventional trial completed the study. There was no significant difference in the mean micronutrient score at any time point. Intake of individual micronutrients did not improve over the 6-mo time frame with the exception of vitamin E, (8.7 mg vs 6.5 mg for at 6 vs 3 mo, P = .02). The proportion of participants with intakes meeting the Dietary Recommended Intake for each nutrient also remained the same over time. CONCLUSION Although cardiac rehabilitation programs may be effective in altering the macronutrient composition, improvements to overall diet quality may be tempered by a lack of improvement in intake of micronutrients.
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Antwi J, Huffman F, Sullivan S. Relationship of serum Vitamin D concentrations with Adipokines and Cardiometabolic risk among non-Hispanic black type 2 diabetic and non-diabetic subjects: a cross-sectional study. BMC Nutr 2018; 4:50. [PMID: 32153911 PMCID: PMC7050721 DOI: 10.1186/s40795-018-0259-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 12/05/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To report the association of serum 25-hydroxyvitamin D [25(OH)D] and its association with adipokines and cardiometabolic risk factors in Haitian Americans (HA) and African Americans (AA) by ethnicity and type 2 diabetes (T2D) status. METHODS A cross-sectional study in 197 HA (92 with T2D and 102 without T2D) and 200 AA (97 with T2D and 103 without T2D) recruited in South Florida. Serum 25(OH)D concentrations and adipokines were analyzed by ELISA and cardiometabolic risk factors were indexed by obesity, glycemic control, insulin sensitivity, lipid profile, and blood pressure. RESULTS Controlling for age, BMI, energy intake, smoking status and HOMA2-IR in multivariate linear regression analyses, serum 25(OH)D concentrations were significantly associated with WC (R2 = 0.760, B = - 0.092, P = 0.027), HbA1C (R2 = 0.142, B = - 0.012, P = 0.010), and TG (R2 = 0.159, B = - 1.192, P = 0.003) in only HA without T2D. While serum 25(OH)D concentrations were significantly associated with TC (R2 = 0.168, B = - 0.329, P = 0.040), log leptin (R2 = 0.544, B = - 0.007, P = 0.021), and adiponectin (R2 = 0.144, B = 0.111, P = 0.033), but slightly associated with LDL-c (R2 = 0.133, B = - 0.278, P = 0.064) in only AA without T2D. Among individuals with T2D, serum 25(OH)D concentrations were marginally associated with IL-6 (R2 = 0.109, B = 0.076, P = 0.085) in HA with T2D, and there was a trend toward significance with log leptin (R2 = 0.393, B = - 0.006, P = 0.075) in AA with T2D in regression analysis. CONCLUSIONS The findings that the associations of serum 25(OH)D concentrations with adipokines and cardiometabolic factors differ between HA and AA has clinical and public implications to guide design of T2D preventive strategies that are culturally specific even within the same ethnicity.
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Affiliation(s)
- Janet Antwi
- 0000 0001 2160 918Xgrid.264272.7Dietetics and Nutrition, Human Ecology Department, State University of New York at Oneonta, New York, USA
| | - Fatma Huffman
- 0000 0001 2110 1845grid.65456.34Department of Dietetics and Nutrition, Robert Stempel College of Public Health, Florida International University, Miami, USA
| | - Stacey Sullivan
- 0000 0001 2160 918Xgrid.264272.7Dietetics and Nutrition, Human Ecology Department, State University of New York at Oneonta, New York, USA
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Blanchet R, Nana CP, Sanou D, Batal M, Giroux I. Dietary acculturation among black immigrant families living in Ottawa—a qualitative study. Ecol Food Nutr 2018; 57:223-245. [DOI: 10.1080/03670244.2018.1455674] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Rosanne Blanchet
- School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Constance P. Nana
- School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Dia Sanou
- FAO Sub Regional Office for Eastern Africa, Addis Abeba, Ethiopia
| | - Malek Batal
- TRANSNUT, Department of Nutrition, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Isabelle Giroux
- School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
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Blanchet R, Sanou D, Batal M, Nana CP, Giroux I. Draw and Tell: Dietary Acculturation as Lived by Black Immigrant Children of African and Caribbean Descent Residing in Canada. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2017; 49:838-846.e1. [PMID: 28870609 DOI: 10.1016/j.jneb.2017.05.355] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 05/18/2017] [Accepted: 05/18/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Explore immigrant children's lived experience of dietary acculturation. DESIGN Draw and tell qualitative research. PARTICIPANTS A total of 167 school-aged children living in Ottawa, Canada, who had a mother born in sub-Saharan Africa or the Caribbean. METHODS Children made 2 drawings about foods, 1 related to Canada and the other to their home country, and explained their drawings and what they meant to them. These discussions were recorded and transcribed. ANALYSIS Foods were counted for each region (Canada/Africa/Caribbean). Thematic analysis was performed. RESULTS Most children drew different foods for Canada and their home country. Apples were the most frequently mentioned food for Canada. Pizza, juice and sugar-sweetened beverages, fries/poutine, and hamburgers were among the 10 most frequently mentioned foods for Canada, whereas none of the top 10 foods for African and Caribbean countries were highly processed. Rice, chicken, meat, and leafy vegetables were in the top 10 foods mentioned for the 3 regions. Emerging themes were food availability and variety, mothers' lack of time and fatigue, and the school eating environment. CONCLUSION AND IMPLICATIONS It seems that these black immigrant children experienced dietary acculturation and that changes in dietary habits have had mostly a negative impact on their diet.
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Affiliation(s)
- Rosanne Blanchet
- School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada.
| | - Dia Sanou
- Food and Agriculture Organization Subregional Office for Eastern Africa, Addis Ababa, Ethiopia
| | - Malek Batal
- TRANSNUT, Department of Nutrition, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Constance P Nana
- School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Isabelle Giroux
- School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
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Caspi CE, Tucker-Seeley RD, Adamkiewicz G, Roberto CA, Stoddard AM, Sorensen GC. Food Hardship and Obesity in a Sample of Low-Income Immigrants. J Immigr Minor Health 2017; 19:130-137. [PMID: 26872640 PMCID: PMC4982834 DOI: 10.1007/s10903-016-0344-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Very little work has examined the relationship between food hardship (having inconsistent financial resources to buy food) and obesity among immigrant groups. A cross-sectional study was conducted in a low-income, multi-racial/ethnic adult sample in greater Boston, MA (n = 828). Modified Poisson regression models estimated the association between food hardship obesity (BMI ≥ 30) among adults reporting food hardship; interactions were tested by place of birth. Body mass index (BMI) was based on anthropometric height and weight. In adjusted models, those experiencing food hardship were more likely to be obese (RR 1.17, CI 1.07, 1.29) than those not experiencing food hardship. Participants from Haiti reporting food hardship were more likely to be obese than those not reporting hardship (RR 1.58, CI 1.23, 2.04); this was not the case among other groups (US born, Puerto Rican, Latin American, Other). The relationship between food hardship and weight may vary among immigrant subgroups.
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Affiliation(s)
- Caitlin E Caspi
- Program in Health Disparities Research, Department of Family Medicine and Community Health, University of Minnesota, 717 Delaware St. SE, Minneapolis, MN, 55414, USA.
| | - Reginald D Tucker-Seeley
- Center for Community-Based Research, Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA, 02215, USA
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington St., Boston, MA, 02215, USA
| | - Gary Adamkiewicz
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, 677 Huntington St., Boston, MA, 02215, USA
| | - Christina A Roberto
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington St., Boston, MA, 02215, USA
- Department of Medical Ethics & Health Policy, Perelman School of Medicine, University of Pennsylvania, 423 Guardian Dr., Philadelphia, PA, 19104, USA
| | - Anne M Stoddard
- New England Research Institute, 9 Galen St., Watertown, MA, 02472, USA
| | - Glorian C Sorensen
- Center for Community-Based Research, Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA, 02215, USA
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington St., Boston, MA, 02215, USA
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Ross WL, Gallego-Pérez DF, Lartey A, Sandow A, Pérez-Escamilla R, Hromi-Fiedler A. Dietary patterns in Liberian refugees in Buduburam, Ghana. MATERNAL AND CHILD NUTRITION 2016; 13. [PMID: 27921367 DOI: 10.1111/mcn.12401] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 09/26/2016] [Accepted: 10/17/2016] [Indexed: 11/28/2022]
Abstract
Previous research suggests that acculturation (i.e., exposure and assimilation to local culture) is associated with changes in dietary patterns among immigrants. This study investigates this association in a refugee population using time in refugee settlement as a proxy for acculturation. A cross-sectional survey was conducted among a systematic sample to (a) identify dietary patterns in Liberian refugees and Ghanaians living in or near a refugee settlement, (b) compare adherence to these dietary patterns between groups, and (c) investigate the association between acculturation and dietary patterns in Liberian refugees. Participants were Liberian and Ghanaian women with young children living in the Buduburam refugee settlement or Awutu in Ghana (n = 480; 50% Liberian; mean age 28, SD 6.3, range 16-48 years). Time in settlement was assessed by self-report; food consumption was assessed by food frequency questionnaire. Principal component analysis was used to identify dietary patterns; a generalized linear model was used to test the association of interest. Three distinct dietary patterns emerged: Healthy, Sweets, and Fats. Ghanaians were more adherent to the Healthy pattern than Liberians (p < 0.05). Liberians were more adherent to the Sweets and Fats patterns than Ghanaians (p < 0.05). There were no significant differences in dietary pattern adherence among the Liberians based on time in settlement. Ghanaians living in Awutu were more adherent to the Healthy pattern than Ghanaians who lived in settlement (p < 0.05). Differences in dietary patterns were observed between Liberian refugees and Ghanaians. These differences were not associated with acculturation and may be related to the food environment in the settlement.
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Affiliation(s)
- Wilhelmenia L Ross
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Daniel F Gallego-Pérez
- Boston University School of Public Health, Boston, Massachusetts, USA.,Buduburam Nutrition Program, Ghana
| | - Anna Lartey
- Department of Nutrition and Food Science, University of Ghana, Legon, Ghana
| | | | - Rafael Pérez-Escamilla
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, USA
| | - Amber Hromi-Fiedler
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, USA
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Lo BK, Minaker LM, Mah CL, Cook B. Development and Testing of the Toronto Nutrition Environment Measures Survey-Store (ToNEMS-S). JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2016; 48:723-729.e1. [PMID: 27575848 DOI: 10.1016/j.jneb.2016.07.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 07/24/2016] [Accepted: 07/27/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To describe the adaptation and inter-rater reliability assessment of the Toronto Nutrition Environment Measures Survey-Store. METHODS A total of 55 food stores (2 bakeries, 2 dollar stores, 19 gas/convenience stores, 18 grocery stores, 4 pharmacies, 8 specialty stores, and 2 superstores) were assessed in 2014. Cohen's kappa and intra-class correlation coefficients (ICC) were assessed for inter-rater reliability for product availability, price, quality, ethno-cultural accessibility scores, and overall store scores. RESULTS Inter-rater reliability was high for availability (average kappa = 0.91), price (average ICC = 0.964), ethno-cultural accessibility score (ICC = 0.981), and overall store scores (ICC = 0.991). CONCLUSIONS AND IMPLICATIONS Measures in the Toronto Nutrition Environment Measures Survey-Store demonstrated excellent inter-rater agreement. Limited access to fruits and vegetables and ethno-cultural foods are related to diet-related chronic diseases, particularly among immigrants. Findings of the study may be useful in guiding public health programming.
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Affiliation(s)
- Brian K Lo
- Division of Nutritional Sciences, Cornell University, Ithaca, NY.
| | - Leia M Minaker
- Propel Centre for Population Health Impact, University of Waterloo, Waterloo, Ontario, Canada
| | - Catherine L Mah
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Brian Cook
- Toronto Food Strategy, Toronto Public Health, Toronto, Ontario, Canada
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Mabchour AE, Delisle H, Vilgrain C, Larco P, Sodjinou R. [Abdominal obesity and other cardiometabolic risk biomarkers: influence of socioeconomic status and lifestyle on two African-origin population groups, Cotonou (Benin) and Port-au-Prince (Haiti)]. Pan Afr Med J 2016; 24:306. [PMID: 28154661 PMCID: PMC5267786 DOI: 10.11604/pamj.2016.24.306.8530] [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: 12/01/2015] [Accepted: 07/04/2016] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Increased cardio metabolic risk (CMR) in low- and middle-income countries is largely due to rapid nutrition transition. We conducted a study of two African-origin populations groups living, however, in widely different settings. It aimed to assess the relationship between lifestyle and CMR biomarkers as well as between abdominal obesity (AO) and other biomarkers. METHODS The study included 200 Benineses from Cotonou and 252 Haitians from Port-with-Prince (PAP) aged between 25 to 60 years and apparently in good health. AO was specifically defined as waist circumference ≥ 88cm (men) and ≥ 95 cm (women). Other most common biomarkers were: high total cholesterol/HDL cholesterol ratio, high blood pressure and insulin resistance by HOMA (Homeostasis Model Assessement). Socioeconomic status, diet, alcohol and tobacco were documented by questionnaire. Two dietary patterns emerged from cluster analysis, one traditional and the other "transitional" with increasing frequency of western foods. RESULTS Socioeconomic status, consumption of alcohol and nicotinism were associated with CMR, but not the food diagram. AO was associated with other CMR markers, with no marked effect of socioeconomic status and lifestyle variables. CONCLUSION Specific TT threshold values are confirmed as socioeconomic status and lifestyle have an impact on CMR, but not the relationship between AO and other CMR biomarkers.
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Affiliation(s)
- Asma El Mabchour
- TRANSNUT, Centre Collaborateur de l'OMS sur la Transition Nutritionnelle, Département de nutrition, Faculté de médecine, Université de Montréal, Québec, Canada
| | - Hélène Delisle
- TRANSNUT, Centre Collaborateur de l'OMS sur la Transition Nutritionnelle, Département de nutrition, Faculté de médecine, Université de Montréal, Québec, Canada
| | - Colette Vilgrain
- Fondation Haïtienne de Diabète et des Maladies Cardiovasculaires (FHADIMAC), Port-au-Prince, Haïti
| | - Phillipe Larco
- Fondation Haïtienne de Diabète et des Maladies Cardiovasculaires (FHADIMAC), Port-au-Prince, Haïti
| | - Roger Sodjinou
- Organisation Ouest Africaine de la Santé (OOAS), Bobo-Dioulasso, Burkina Faso
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Major dietary patterns in relation to demographic and socio-economic status and food insecurity in two Iranian ethnic groups living in Urmia, Iran. Public Health Nutr 2016; 19:3337-3348. [DOI: 10.1017/s1368980016001634] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectiveTo identify major dietary patterns and their association with socio-economic status (SES) and food insecurity in two major ethnic groups living in Urmia, north-west Iran.DesignA cross-sectional study.SettingAll four geographical zones of Urmia city.SubjectsParticipants (n 723; 427 women and 296 men), aged 20–64 years, from two ethnic groups (445 Azeri Turks and 278 Kurds).ResultsThree major dietary patterns were extracted: ‘Traditional High SES’ (THS), ‘Traditional Low SES’ (TLS) and ‘Transitional’. After adjusting for confounders, the THS pattern was positively associated with education level and negatively associated with moderate or severe food insecurity in Azeri Turks; whereas, among Kurds, it was more common in women and positively associated with age. The TLS pattern was more common among men and negatively associated with educational level and all levels of food insecurity in Azeris; while, among Kurds, it was more common among men, positively associated with being married and negatively associated with household income/capita. The ‘Transitional’ pattern was positively associated with being employed and negatively associated with age and all levels of food insecurity in Azeris; while, among Kurds, it was more common among men and negatively associated with age, being married and physical activity level.ConclusionsFindings suggest that household SES and food insecurity are associated with detrimental dietary patterns and that this effect may be stronger than cultural and ethnic background. These patterns differ by age and gender. Therefore, such characteristics should be considered in planning and formulating diet-related policies and programmes.
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Sanou D, O'Reilly E, Ngnie-Teta I, Batal M, Mondain N, Andrew C, Newbold BK, Bourgeault IL. Acculturation and nutritional health of immigrants in Canada: a scoping review. J Immigr Minor Health 2015; 16:24-34. [PMID: 23595263 PMCID: PMC3895180 DOI: 10.1007/s10903-013-9823-7] [Citation(s) in RCA: 115] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Although recent immigrants to Canada are healthier than Canadian born (i.e., the Healthy Immigrant Effect), they experience a deterioration in their health status which is partly due to transitions in dietary habits. Since pathways to these transitions are under-documented, this scoping review aims to identify knowledge gaps and research priorities related to immigrant nutritional health. A total of 49 articles were retrieved and reviewed using electronic databases and a stakeholder consultation was undertaken to consolidate findings. Overall, research tends to confirm the Healthy Immigrant Effect and suggests that significant knowledge gaps in nutritional health persist, thereby creating a barrier to the advancement of health promotion and the achievement of maximum health equity. Five research priorities were identified including (1) risks and benefits associated with traditional/ethnic foods; (2) access and outreach to immigrants; (3) mechanisms and coping strategies for food security; (4) mechanisms of food choice in immigrant families; and (5) health promotion strategies that work for immigrant populations.
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Affiliation(s)
- Dia Sanou
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Thompson Hall-35 University Private (room 036), Ottawa, ON, K1N 6N5, Canada,
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Allen JD, Caspi C, Yang M, Leyva B, Stoddard AM, Tamers S, Tucker-Seeley RD, Sorensen GC. Pathways between acculturation and health behaviors among residents of low-income housing: the mediating role of social and contextual factors. Soc Sci Med 2014; 123:26-36. [PMID: 25462602 PMCID: PMC4425350 DOI: 10.1016/j.socscimed.2014.10.034] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Revised: 08/06/2014] [Accepted: 10/17/2014] [Indexed: 02/06/2023]
Abstract
Acculturation may influence health behaviors, yet mechanisms underlying its effect are not well understood. In this study, we describe relationships between acculturation and health behaviors among low-income housing residents, and examine whether these relationships are mediated by social and contextual factors. Residents of 20 low-income housing sites in the Boston metropolitan area completed surveys that assessed acculturative characteristics, social/contextual factors, and health behaviors. A composite acculturation scale was developed using latent class analysis, resulting in four distinct acculturative groups. Path analysis was used to examine interrelationships between acculturation, health behaviors, and social/contextual factors, specifically self-reported social ties, social support, stress, material hardship, and discrimination. Of the 828 respondents, 69% were born outside of the U.S. Less acculturated groups exhibited healthier dietary practices and were less likely to smoke than more acculturated groups. Acculturation had a direct effect on diet and smoking, but not physical activity. Acculturation also showed an indirect effect on diet through its relationship with material hardship. Our finding that material hardship mediated the relationship between acculturation and diet suggests the need to explicate the significant role of financial resources in interventions seeking to promote healthy diets among low-income immigrant groups. Future research should examine these social and contextual mediators using larger, population-based samples, preferably with longitudinal data.
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Affiliation(s)
| | - Caitlin Caspi
- University of Minnesota, Department of Family Medicine and Community Health, USA
| | - May Yang
- New England Research Institute, USA
| | - Bryan Leyva
- National Cancer Institute, National Institutes of Health, USA
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Turk MT, Fapohunda A, Zoucha R. Using photovoice to explore nigerian immigrants' eating and physical activity in the United States. J Nurs Scholarsh 2014; 47:16-24. [PMID: 25182119 DOI: 10.1111/jnu.12105] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2014] [Indexed: 01/07/2023]
Abstract
PURPOSE African immigrants are one of the fastest growing immigrant groups to the United States; there is a crucial need to learn about African immigrants' beliefs and lifestyle behaviors that may impact health. The purposes of this study were to (a) explore the perceptions and practices of Nigerian immigrants regarding healthy eating and physical activity in the United States; (b) assess the influence of cultural beliefs of Nigerian immigrants on eating and physical activity; (c) describe the role that healthcare providers can play in helping to promote healthy eating and physical activity; and (d) evaluate the feasibility and efficacy of using Photovoice to collect data on the perceptions and practices of Nigerian immigrants regarding healthy eating and physical activity. DESIGN Qualitative visual ethnography using Photovoice. METHODS Thirteen Nigerian immigrants were recruited. Data were collected using photography and focus group discussions at a church. Photovoice methodology and Leininger's four phases of qualitative analysis were used to analyze photographs, field notes, and focus group transcripts. FINDINGS Four overarching themes emerged from the data: moderation is healthy, Nigerian ways of living are healthy, acquiring American ways is unhealthy, and cultural context is important to promote healthy behaviors. CONCLUSIONS Photovoice was a feasible, effective methodology for collecting data on the perceptions and practices of Nigerian immigrants. Nigerian participants believed that adherence to traditional dietary and activity practices are healthy. Nurses and other healthcare providers must make concerted efforts to communicate with and educate Nigerian immigrants about healthful eating and activity behaviors within their cultural context. CLINICAL RELEVANCE The number of African immigrants to the United States has increased dramatically. Photovoice is a creative method to learn about the health beliefs and behaviors of the Nigerian immigrant population.
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Affiliation(s)
- Melanie T Turk
- Epsilon Phi, Assistant Professor, Duquesne University School of Nursing, Pittsburgh, PA, USA
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Ponce X, Rodríguez-Ramírez S, Mundo-Rosas V, Shamah T, Barquera S, de Cossio TG. Dietary quality indices vary with sociodemographic variables and anthropometric status among Mexican adults: a cross-sectional study. Results from the 2006 National Health and Nutrition Survey. Public Health Nutr 2014; 17:1717-28. [PMID: 24124890 PMCID: PMC10282364 DOI: 10.1017/s1368980013002462] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Revised: 06/28/2013] [Accepted: 07/25/2013] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To evaluate the dietary quality of Mexican adults' diet, we constructed three dietary quality indices: a cardioprotective index (CPI), a micronutrient adequacy index (MAI) and a dietary diversity index (DDI). DESIGN Data were derived from the 2006 National Health and Nutrition Survey, which is a national survey representative of the Mexican population with a stratified, multistage, probabilistic sample design. Dietary intake was assessed from an FFQ with 101 different foods and daily nutrient intakes were computed. The CPI evaluated compliance with seven WHO recommendations for the prevention of CVD, the MAI evaluated the intake of six micronutrients based on the estimated average requirements from the US Institute of Medicine and the DDI was constructed based on the consumption of thirty different food groups. SETTINGS Mexico. SUBJECTS Mexican adults aged 19-59 years old. RESULTS We evaluated the diet of 15 675 males and females. Adjusted means and adjusted proportions by age and sex were computed to predict adherence to dietary recommendations. Rural inhabitants, those living in the South and those from the lowest socio-economic status reported a significantly higher CPI (4·5 (se 0·08), 4·3 (se 0·08) and 4·2 (se 0·09), respectively; P < 0·05), but a significantly lower MAI and DDI, compared with urban inhabitants, those from the North and those of upper socio-economic status (P < 0·05). CONCLUSIONS The constructed diet quality indices identify nutrients and foods whose recommended intakes are not adequately consumed by the population. Given the epidemiological and nutritional transition that Mexico is experiencing, the CPI is the most relevant index and its components should be considered in Mexican dietary guidelines as well as in any food and nutrition programmes developed.
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Affiliation(s)
- Xochitl Ponce
- Research Center on Nutrition and Health, National Institute of Public Health, Av. Universidad 655, Col. Sta María Ahuacatitlán, Cuernavaca, Morelos, México CP 62508
| | - Sonia Rodríguez-Ramírez
- Research Center on Nutrition and Health, National Institute of Public Health, Av. Universidad 655, Col. Sta María Ahuacatitlán, Cuernavaca, Morelos, México CP 62508
| | - Verónica Mundo-Rosas
- Research Center on Nutrition and Health, National Institute of Public Health, Av. Universidad 655, Col. Sta María Ahuacatitlán, Cuernavaca, Morelos, México CP 62508
| | - Teresa Shamah
- Research Center on Nutrition and Health, National Institute of Public Health, Av. Universidad 655, Col. Sta María Ahuacatitlán, Cuernavaca, Morelos, México CP 62508
| | - Simón Barquera
- Research Center on Nutrition and Health, National Institute of Public Health, Av. Universidad 655, Col. Sta María Ahuacatitlán, Cuernavaca, Morelos, México CP 62508
| | - Teresa González de Cossio
- Research Center on Nutrition and Health, National Institute of Public Health, Av. Universidad 655, Col. Sta María Ahuacatitlán, Cuernavaca, Morelos, México CP 62508
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Migrant youth's emerging dietary patterns in Haiti: the role of peer social engagement. Public Health Nutr 2014; 18:1262-71. [PMID: 25068484 DOI: 10.1017/s1368980014001372] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The present study examines whether rural-to-urban migrant youth consume a greater diversity of high-sugar beverages and fried snacks (HSBFS) compared with their peers who remain in rural areas. It also tests whether the association between migration and HSBFS diversity is moderated by migrant youth's social engagement with their peers. DESIGN Participants were recruited in August and September 2011 following the completion of primary school (6th grade) and shortly before many rural youth migrate to urban areas. Participants were re-interviewed six months later. HSBFS diversity was assessed at follow-up; analyses control for baseline and follow-up characteristics. SETTING Baseline interviews occurred in rural Southeast Haiti. Follow-up interviews of migrants occurred at urban destinations in Haiti. SUBJECTS The sample includes 215 youth (mean age 15.9 years; 43.3 % female; 21.9 % rural-to-urban migrants) who were interviewed at baseline and follow-up. RESULTS Rural-to-urban migrant youth consumed a greater diversity of HSBFS products at follow-up than their rural counterparts (b=0.70, P≤0.05). Moreover, we found that this relationship varied by level of peer social engagement. Youth who migrated and had a high degree of peer social engagement consumed 2.2 additional types of HSBFS products daily than their counterparts who remained in rural areas and had low peer social engagement. CONCLUSIONS Higher HSBFS diversity among migrant youth is consistent with the patterns proposed by the nutrition transition. Interactions with peers may have an important influence as migrant youth adopt new dietary preferences. Emerging dietary patterns among youth migrants have important implications for health trajectories and the development of degenerative diseases.
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Kukaswadia A, Pickett W, Janssen I. Influence of country of birth and ethnicity on body mass index among Canadian youth: a national survey. CMAJ Open 2014; 2:E145-52. [PMID: 25295234 PMCID: PMC4183182 DOI: 10.9778/cmajo.20130088] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The body mass index (BMI) of youth often changes when they immigrate to a new country as a result of the adoption of new behaviours, a process called acculturation. We investigated whether BMI differs by country of birth (Canada v. other countries) and ethnicity, both individually and together. We also examined whether time since immigration and health-related behaviour explain any observed BMI differences. METHODS Data sources were the Canadian Health Behaviour in School-Aged Children study and the Canada Census of Population. Participants were youth in grades 6-10 (weighted sample n = 19 272). A questionnaire was used to assess participants' sociodemographic characteristics, height, weight and health-related behaviour. We calculated BMIs from participants' self-reported heights and weights and used World Health Organization growth references to determine BMI percentiles. RESULTS Based on self-reported heights and weights, BMI percentiles for foreign-born youth were lower than those of youth born in Canada (-4, 95% confidence interval [CI] -6 to -2). This difference did not decrease with time since immigration. Similarly, BMI percentiles were lower among East and Southeast Asian youth than their peers from the Canadian host culture (-4, 95% CI -6 to -2). Finally, BMI percentiles for foreign-born Arab and West Asian youth and East Indian and South Asian youth were lower than their Canadian-born peers of the same ethnicity (-14, 95% CI -22 to -7; -8, 95% CI -14 to -3). INTERPRETATION Immigrant generation and ethnicity were related to BMI among Canadian youth, both independently and together. Some ethnic groups showed differences by country of birth, i.e., East Indian and South Asian, while others showed no such difference, i.e., East and Southeast Asian. There was no association with time since immigration. Our findings reinforce the need to investigate country of birth and ethnicity when considering the determinants of childhood BMI.
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Affiliation(s)
- Atif Kukaswadia
- Department of Public Health Sciences, Queen’s University, Kingston, Ont
| | - William Pickett
- Department of Public Health Sciences, Queen’s University, Kingston, Ont
- Clinical Research Centre, Kingston General Hospital, Kingston, Ont
| | - Ian Janssen
- Department of Public Health Sciences, Queen’s University, Kingston, Ont
- School of Kinesiology and Health Studies, Queen’s University, Kingston, Ont
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de Hoog MLA, Kleinman KP, Gillman MW, Vrijkotte TGM, van Eijsden M, Taveras EM. Racial/ethnic and immigrant differences in early childhood diet quality. Public Health Nutr 2014; 17:1308-17. [PMID: 23651520 PMCID: PMC3883931 DOI: 10.1017/s1368980013001183] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Revised: 03/10/2013] [Accepted: 03/17/2013] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To assess racial/ethnic differences in the diet in young children and the explanatory role of maternal BMI, immigrant status and perception of child's weight. DESIGN Among white, black and Hispanic 3-year-olds, we used negative binomial and linear regression to examine associations of race/ethnicity with foods and nutrients assessed by a validated FFQ. SETTING Project Viva, Boston (MA), USA. SUBJECTS Children aged 3 years (n 898). RESULTS Mean age was 38·3 (sd 2·8) months; 464 (52 %) were boys and 127 mothers (14 %) were immigrants. After adjustment for sociodemographic factors, black and Hispanic children (v. white) had a higher intake of sugar-sweetened beverages (rate ratio (RR) = 2·59 (95 % CI 1·95, 3·48) and RR = 1·59 (95 % CI 1·07, 2·47), respectively) and lower intakes of skimmed/1 % milk (RR = 0·42 (95 % CI 0·33, 0·53) and RR = 0·43 (95 % CI 0·31, 0·61), respectively) and trans-fat (-0·10 (95 % CI -0·18, -0·03) % of energy and -0·15 (95 % CI -0·26, -0·04) % of energy, respectively). Among Hispanics only, a lower intake of snack food (RR = 0·83 (95 % CI 0·72, 0·98)) was found and among blacks only, a higher intake of fast food (RR = 1·28 (95 % CI 1·05, 1·55)) and lower intakes of saturated fat (-0·86 (95 % CI -1·48, -0·23) % of energy), dietary fibre (0·85 (95 % CI 0·08, 1·62) g/d) and Ca (-120 (95 % CI -175, -65) mg/d) were found. Being born outside the USA was associated with more healthful nutrient intakes and less fast food. CONCLUSIONS Three-year-old black and Hispanic (v. white) children ate more sugar-sweetened beverages and less low-fat dairy. Total energy intake was substantially higher in Hispanic children. Snack food (Hispanic children) and fat intakes (black children) tended to be lower. Children of immigrants ate less fast food and bad fats and more fibre.
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Affiliation(s)
- Marieke L A de Hoog
- 1 Department of Public Health, Academic Medical Centre, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, The Netherlands
| | - Ken P Kleinman
- 3 Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Matthew W Gillman
- 3 Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Tanja G M Vrijkotte
- 1 Department of Public Health, Academic Medical Centre, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, The Netherlands
| | - Manon van Eijsden
- 2 Department of Epidemiology, Documentation and Health Promotion, Public Health Service, Amsterdam, The Netherlands
| | - Elsie M Taveras
- 3 Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
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Terragni L, Garnweidner LM, Pettersen KS, Mosdøl A. Migration as a Turning Point in Food Habits: The Early Phase of Dietary Acculturation among Women from South Asian, African, and Middle Eastern Countries Living in Norway. Ecol Food Nutr 2014; 53:273-91. [DOI: 10.1080/03670244.2013.817402] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Shaban LH, Zarini GG, Exebio JC, Sukhram SD, Huffman FG. Serum vitamin D insufficiency and diabetes status in three ethnic minority groups. J Immigr Minor Health 2013; 14:926-32. [PMID: 22588624 DOI: 10.1007/s10903-012-9634-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The purpose of this study was to investigate the association between 25-hydroxyvitamin D [25(OH)D] levels and diabetes status in three ethnicities. This cross sectional study included Cuban Americans (n = 199), Haitian Americans (n = 253) and African Americans (n = 248) with and without type 2 diabetes (T2D) from Florida, U.S. Recruitment of participants was through mailing lists (Cuban Americans and African Americans) and community based sources (Haitian Americans). Adjusted logistic regression analysis indicated significant differences in the odds of having insufficient 25(OH)D levels by ethnicity [P < 0.001], diabetes status [P < 0.001], and their interaction [P < 0.001]. Holm's modified Bonferroni method showed that only Cuban Americans without T2D had significantly lower odds of having insufficient 25(OH)D compared to all other groups. Haitian American and African American participants and participants having T2D had the greatest risk of 25(OH)D insufficiency. Future studies should focus on the role of vitamin D supplementation and diabetes outcomes across ethnic groups.
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Affiliation(s)
- Lamya H Shaban
- Department of Dietetics and Nutrition, Florida International University, Miami, FL 33199, USA
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Murray AE, McMorrow AM, O'Connor E, Kiely C, Mac Ananey O, O'Shea D, Egaña M, Lithander FE. Dietary quality in a sample of adults with type 2 diabetes mellitus in Ireland; a cross-sectional case control study. Nutr J 2013; 12:110. [PMID: 23915093 PMCID: PMC3750542 DOI: 10.1186/1475-2891-12-110] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 07/26/2013] [Indexed: 01/04/2023] Open
Abstract
Background A number of dietary quality indices (DQIs) have been developed to assess the quality of dietary intake. Analysis of the intake of individual nutrients does not reflect the complexity of dietary behaviours and their association with health and disease. The aim of this study was to determine the dietary quality of individuals with type 2 diabetes mellitus (T2DM) using a variety of validated DQIs. Methods In this cross-sectional analysis of 111 Caucasian adults, 65 cases with T2DM were recruited from the Diabetes Day Care Services of St. Columcille’s and St. Vincent’s Hospitals, Dublin, Ireland. Forty-six controls did not have T2DM and were recruited from the general population. Data from 3-day estimated diet diaries were used to calculate 4 DQIs. Results Participants with T2DM had a significantly lower score for consumption of a Mediterranean dietary pattern compared to the control group, measured using the Mediterranean Diet Score (Range 0–9) and the Alternate Mediterranean Diet Score (Range 0–9) (mean ± SD) (3.4 ± 1.3 vs 4.8 ± 1.8, P < 0.001 and 3.3 ± 1.5 vs 4.2 ± 1.8, P = 0.02 respectively). Participants with T2DM also had lower dietary quality than the control population as assessed by the Healthy Diet Indicator (Range 0–9) (T2DM; 2.6 ± 2.3, control; 3.3 ± 1.1, P = 0.001). No differences between the two groups were found when dietary quality was assessed using the Alternate Healthy Eating Index. Micronutrient intake was assessed using the Micronutrient Adequacy Score (Range 0–8) and participants with T2DM had a significantly lower score than the control group (T2DM; 1.6 ± 1.4, control; 2.3 ± 1.4, P = 0.009). When individual nutrient intakes were assessed, no significant differences were observed in macronutrient intake. Conclusion Overall, these findings demonstrate that T2DM was associated with a lower score when dietary quality was assessed using a number of validated indices.
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Affiliation(s)
- Alison E Murray
- Department of Clinical Medicine, Trinity College Dublin, Trinity Centre for Health Sciences, St James's Hospital, Dublin 8, Ireland
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Abou El Hassan D, Hekmat S. Dietary acculturation of Arab immigrants in the Greater Toronto Area. CAN J DIET PRACT RES 2013; 73:143-6. [PMID: 22958634 DOI: 10.3148/73.3.2012.143] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
PURPOSE We explored the eating habits of Arab immigrants to determine whether they have maintained their traditional diet or have consumed a more Westernized diet since immigrating to Canada. METHODS Arab immigrants who had been in Canada for at least eight years and were currently living in the Greater Toronto Area were recruited. A sample of 24 Arab immigrants completed a mailed, self-administered questionnaire, and six participated in a focus group. The focus group discussion was transcribed verbatim and results were recorded. Latent content analysis was used to analyze, code, and categorize emerging themes. RESULTS Arab immigrants consumed a mixture of both Arabic and Western food and perceived their current diet to be healthier than it was before they immigrated to Canada. Factors that influenced their food choices included increased nutrition health awareness, differences in food preferences and preparation methods, and preservation of dietary practices in the new environment. CONCLUSIONS Our findings will help dietitians who work with Arab immigrants to become more aware of factors that motivate this group's food choices, and to create nutrition programs that are more culturally sensitive.
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Affiliation(s)
- Dahlia Abou El Hassan
- Division of Food and Nutritional Sciences, Brescia University College at the University of Western Ontario, London, ON, Canada
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Lindsay KL, Gibney ER, McAuliffe FM. Maternal nutrition among women from Sub-Saharan Africa, with a focus on Nigeria, and potential implications for pregnancy outcomes among immigrant populations in developed countries. J Hum Nutr Diet 2012; 25:534-46. [PMID: 22594552 DOI: 10.1111/j.1365-277x.2012.01253.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Pregnant women in countries of Sub-Saharan Africa (SSA) are at risk of poor nutritional status and adverse outcomes as a result of poverty, food insecurity, sub-optimal healthcare facilities, frequent infections and frequent pregnancies. Studies from Nigeria, for example, have revealed a high prevalence of both under- and over-nutrition, as well as nutrient deficiencies, including iron, folate, vitamin D and vitamin A. Subsequently, obstetric complications, including hypertension, anaemia, neural tube defects, night-blindness, low birth weight and maternal and perinatal mortality, are common. Migration patterns from SSA to the Western world are on the rise in recent years, with Nigerians now representing the most prevalent immigrant African population in many developed countries. However, the effect of immigration, if any, on the nutritional status and pregnancy outcomes of these women in their host countries has not yet been studied. Consequently, it is unknown to what extent the nutritional deficiencies and pregnancy complications occurring in Nigeria, and other countries of SSA, present in these women post-emigration. This may result in missed opportunities for appropriate antenatal care of a potential high-risk group in pregnancy. The present review discusses the literature regarding nutrition in pregnancy among SSA women, using Nigeria as an example, the common nutrition-related complications that arise and the subsequent obstetric outcomes. The concept of dietary acculturation among immigrant groups is also discussed and deficiencies in the literature regarding studies on the diets of pregnant immigrant women are highlighted.
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Affiliation(s)
- K L Lindsay
- UCD Obstetrics and Gynaecology, School of Medicine and Medical Science, National Maternity Hospital, Dublin 2, Ireland
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Ohlhorst SD, Slavin M, Bhide JM, Bugusu B. Use of Iodized Salt in Processed Foods in Select Countries Around the World and the Role of Food Processors. Compr Rev Food Sci Food Saf 2012. [DOI: 10.1111/j.1541-4337.2011.00182.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Abstract
A rising prevalence of CVD and diabetes has been observed in sub-Saharan Africa, particularly in cities. The aim of the present study conducted in Benin was to examine the mediating role of nutrition transition in the relationship of urbanisation level and socio-economic status (SES) to cardiometabolic risk markers. A total of 541 subjects in apparent good health were randomly selected from the main city of Cotonou, a small town and its surrounding rural areas. SES was assessed based on a proxy for income and on education. Dietary intake and physical activity were assessed with at least two non-consecutive 24 h recalls. Scores for micronutrient adequacy and preventive diet were used as indicators of diet quality. Cardiometabolic risk markers were BMI, waist circumference (WC), blood pressure, serum cholesterol and insulin resistance according to homeostasis model assessment. A more advanced stage of nutrition transition, which correlated with lower diet quality scores and less physical activity, was observed in the large city compared with less urbanised locations. More obesity and more adverse cholesterol profiles, but also lower blood pressure, were present in the large city. Urbanisation, income, sedentary lifestyle and alcohol consumption, but not diet quality, independently contributed to higher BMI and WC. Higher micronutrient adequacy was independently associated with a better cholesterol profile. The study confirmed the positive rural-urban gradient in nutrition transition and cardiometabolic risk, except for blood pressure. This risk could be mitigated by a more adequate diet, particularly micronutrient intake, and a more active lifestyle.
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Delisle H, Agueh V, Fayomi B. Partnership research on nutrition transition and chronic diseases in West Africa - trends, outcomes and impacts. BMC INTERNATIONAL HEALTH AND HUMAN RIGHTS 2011; 11 Suppl 2:S10. [PMID: 22166095 PMCID: PMC3247830 DOI: 10.1186/1472-698x-11-s2-s10] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Background Nutrition-related chronic diseases (NRCD) are rising quickly in developing countries, and the nutrition transition is a major contributor. Low-income countries have not been spared. Health issues related to nutritional deficiencies also persist, creating a double burden of malnutrition (DBM). There is still a major shortage of data on NRCD and DBM in Sub-Saharan Africa. A research program has been designed and conducted in partnership with West African institutions since 2003 to determine how the nutrition transition relates to NRCD and the DBM in order to support prevention efforts. Methods In Benin, cross-sectional studies among apparently healthy adults (n=540) from urban, semi-urban and rural areas have examined cardiometabolic risk (hypertension, obesity, dyslipidemia, insulin resistance) in relation to diet and lifestyle, also factoring in socio-economic status (SES). Those studies were followed by a longitudinal study on how risk evolves, opening the way for mutual aid groups to develop a prevention strategy within an action research framework. In Burkina Faso, a cross-sectional study on the nutritional status and dietary patterns of urban school-age children (n=650) represented the initial stages of an action research project to prevent DBM in schools. A cross-sectional study among adults (n=330) from the capital of Burkina Faso explored the coexistence, within these individuals, of cardiometabolic risk factors and nutritional deficiencies (anemia, vitamin A deficiency, chronic energy deficiency), as they relate to diet, lifestyle and SES. Results The studies have shown that the prevalence of NRCD is high among the poor, thereby exacerbating social inequalities. The hypothesis of a positive socio-economic (and rural–urban) gradient was confirmed only for obesity, whereas the prevalence of hypertension, insulin resistance and dyslipidemia did not prove to be higher among affluent city dwellers. Women were particularly affected by abdominal obesity, at 48% compared to 6% of men. Protective factors against the risk of NRCD were physical activity and adequate micronutrient intake. The research also showed that nutritional deficiencies were not restricted to schoolchildren in rural areas because in the capital of Ouagadougou, for example, 40% of schoolchildren were anaemic and 40% were vitamin A deficient. Partnership research has expanded to include advocacy and human resources training. Conclusion These initial studies on NRCD in West Africa indicate the relevance and urgency of prevention, even among low-income groups and countries. They show that the fight against NRCD as well as nutritional deficiencies should focus on women. Seeing how researchers from the African partner institutions have connections with decision-making authorities, the research findings could have an impact on prevention policies and programs in communities and schools alike. Greater support must nevertheless be provided to lobbying and advocacy work for an even greater impact. As well, the sustainability of the research program remains a challenge that requires resource mobilization and training for the purpose.
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Affiliation(s)
- Hélène Delisle
- TRANSNUT, WHO Collaborating Centre on Nutrition Changes and Development, Department of Nutrition, University of Montreal, P,O, Box 6128, Station Main, Montreal, QC H3C 3J7, Canada.
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Dekker LH, Snijder MB, Beukers MH, de Vries JHM, Brants HAM, de Boer EJ, van Dam RM, Stronks K, Nicolaou M. A prospective cohort study of dietary patterns of non-western migrants in the Netherlands in relation to risk factors for cardiovascular diseases: HELIUS-Dietary Patterns. BMC Public Health 2011; 11:441. [PMID: 21649889 PMCID: PMC3125375 DOI: 10.1186/1471-2458-11-441] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2011] [Accepted: 06/07/2011] [Indexed: 11/29/2022] Open
Abstract
Background In Western countries the prevalence of cardiovascular disease (CVD) is often higher in non-Western migrants as compared to the host population. Diet is an important modifiable determinant of CVD. Increasingly, dietary patterns rather than single nutrients are the focus of research in an attempt to account for the complexity of nutrient interactions in foods. Research on dietary patterns in non-Western migrants is limited and may be hampered by a lack of validated instruments that can be used to assess the habitual diet of non-western migrants in large scale epidemiological studies. The ultimate aims of this study are to (1) understand whether differences in dietary patterns explain differences in CVD risk between ethnic groups, by developing and validating ethnic-specific Food Frequency Questionnaires (FFQs), and (2) to investigate the determinants of these dietary patterns. This paper outlines the design and methods used in the HELIUS-Dietary Patterns study and describes a systematic approach to overcome difficulties in the assessment and analysis of dietary intake data in ethnically diverse populations. Methods/Design The HELIUS-Dietary Patterns study is embedded in the HELIUS study, a Dutch multi-ethnic cohort study. After developing ethnic-specific FFQs, we will gather data on the habitual intake of 5000 participants (18-70 years old) of ethnic Dutch, Surinamese of African and of South Asian origin, Turkish or Moroccan origin. Dietary patterns will be derived using factor analysis, but we will also evaluate diet quality using hypothesis-driven approaches. The relation between dietary patterns and CVD risk factors will be analysed using multiple linear regression analysis. Potential underlying determinants of dietary patterns like migration history, acculturation, socio-economic factors and lifestyle, will be considered. Discussion This study will allow us to investigate the contribution of the dietary patterns on CVD risk factors in a multi-ethnic population. Inclusion of five ethnic groups residing in one setting makes this study highly innovative as confounding by local environment characteristics is limited. Heterogeneity in the study population will provide variance in dietary patterns which is a great advantage when studying the link between diet and disease.
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Affiliation(s)
- Louise H Dekker
- Department of Public Health, Academic Medical Centre, University of Amsterdam, PO Box 22660, 1105 AZ, Amsterdam, the Netherlands.
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Delisle H. Findings on dietary patterns in different groups of African origin undergoing nutrition transition. Appl Physiol Nutr Metab 2010; 35:224-8. [PMID: 20383237 DOI: 10.1139/h10-008] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In population groups undergoing nutrition transition, it is important to identify healthy and culturally relevant dietary patterns that can be promoted as a means of preventing diet-related chronic diseases. Dietary pattern analyses using data-driven methods are useful for the purpose. The central question addressed in this overview paper is whether there are culture-specific healthy eating patterns, or whether healthy diets may be more universal. Our studies on dietary patterns in population groups of African origin living in Canada (Montreal), Europe (Madrid), and West Africa (urban and rural Benin) inform the discussion. Healthy or prudent, as opposed to Western, eating patterns are identified in several cultures, including groups of African origin. It appears that a limited number of foods predict diet quality and health outcomes in various population groups; in particular, fruit and vegetables, fish, whole-grain cereal, and legumes do so on the protective side, and sweets, processed meats, fried foods, fats and oils, and salty snacks do so on the negative side. Further research on dietary patterns and their healthfulness is required in diverse food cultures. In groups of African origin, traditional diets are healthier than the nontraditional dietary patterns that have evolved with globalization, urbanization, or acculturation, although micronutrient intakes need to improve. Additionally, healthy eating patterns are only feasible if access to food is adequate.
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Affiliation(s)
- Hélène Delisle
- Department of Nutrition, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada.
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Liu A, Berhane Z, Tseng M. Improved dietary variety and adequacy but lower dietary moderation with acculturation in Chinese women in the United States. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION 2010; 110:457-62. [PMID: 20184998 PMCID: PMC2829717 DOI: 10.1016/j.jada.2009.11.016] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2009] [Accepted: 08/03/2009] [Indexed: 11/19/2022]
Abstract
Acculturation is associated with increased chronic disease risk among Asian Americans, but its association with different aspects of diet quality remains unclear. Associations of acculturation with diet quality were examined in a convenience sample of 243 Chinese participants in a study of diet and mammographic density in the Philadelphia region between January 2002 to May 2003. An acculturation index was created based on self-reported English proficiency and within- and cross-ethnicity social interactions. Diet Quality Index-International (DQI-I) scores were based on responses to an 88-item food frequency questionnaire. Odds ratios (ORs) for falling into a higher vs lower quartile for DQI-I and its components (ie, variety, adequacy, moderation, balance) were estimated with logistic regression analysis for polytomous outcomes. In the sample, mean age was 53.2 (standard deviation=10.5) years, body mass index (calculated as kg/m2) was 24.1 (standard deviation=3.5), and acculturation was significantly associated with improved dietary variety (OR: 2.4; 95% confidence interval [CI]: 1.5 to 3.8) and adequacy (OR: 1.6; 95% CI: 1.0 to 2.6) and lower dietary moderation (OR: 0.6; 95% CI 0.4 to 0.9), but these associations were evident only among women with less than a high school education. Acculturation and education were not associated with overall diet quality or balance. Although an association of less dietary moderation with acculturation suggests the likely importance of acculturation-related dietary change to chronic disease risk, these findings highlight the need for flexible dietary interventions among immigrant populations to discourage the adoption of some new dietary habits, while encouraging the retention of other, traditional ones.
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Affiliation(s)
- Amy Liu
- Drexel University School of Public Health, 1505 Race Street, 11floor, Philadelphia, PA 19102
| | - Zekarias Berhane
- Assistant Professor, Drexel University School of Public Health, 1505 Race Street, 6floor, Philadelphia, PA 19102, tel 215-762-6121, fax 215-762-1174
| | - Marilyn Tseng
- Research Assistant Professor, California Polytechnic State University, San Luis Obispo, CA 93405
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Delisle HF, Vioque J, Gil A. Dietary patterns and quality in West-African immigrants in Madrid. Nutr J 2009; 8:3. [PMID: 19166606 PMCID: PMC2639619 DOI: 10.1186/1475-2891-8-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2008] [Accepted: 01/23/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Eating patterns of immigrants deserve to be better documented because they may reflect the extent of acculturation and associated health risks. The study assessed dietary patterns and quality in Bubi immigrants (from Equatorial Guinea) using cluster analysis and comparing different diet quality indexes. METHODS A random sample of 83 Bubi men and 130 women living in Madrid were studied. A 99-item food frequency questionnaire was administered, body weights and heights were self-reported and socio-demographic and health information was collected during interviews. Usual intakes were collapsed into 19 food groups. Cluster analysis of standardized food intakes per 1000 kcalories was performed. Dietary quality was appraised using the Alternative Mediterranean Diet Score, the Alternative Healthy Eating Index and scores of micronutrient adequacy and prevention based on WHO/FAO recommendations. RESULTS Two dietary patterns were identified. The 'Healthier' pattern, so confirmed by two dietary quality indexes, featured a higher consumption of fish, fruits, vegetables, legumes, dairy products and bread while the 'Western' pattern included more processed meat, animal fat, and sweetened foods and drinks. One third of the subjects were in the 'Healthier' food cluster, with the same proportion of men and women. Age >or= 30 and residence in Madrid >or= 11 years were independently associated with the healthier diet. Consumption of traditional foods was unrelated to dietary pattern, however. Overall, Bubi diets were somewhat protective because of high intakes of fruits and vegetables and monounsaturated fat (olive oil), but not with respect to sugar, cholesterol, omega-3 fatty acids and fibre. Less than two thirds of subjects had adequate intakes of iron, calcium and folate in both dietary phenotypes. Body mass index, physical exercise, and self-reported health and cardiovascular disease condition showed no significant association with the dietary pattern. CONCLUSION Cluster analysis combined with dietary quality assessment facilitates the interpretation of dietary patterns, but choosing the appropriate quality indexes is a problem. A small number of such indexes should be standardized and validated for international use. In the group studied, younger subjects and more recent immigrants were more likely to have a 'Western' pattern and should be a priority target for nutrition communication.
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Affiliation(s)
- Hélène F Delisle
- WHO Collaborating Centre on Nutrition Changes and Development, Department of Nutrition, Faculty of Medicine, Université de Montréal, PO Box 6128, Downtown Station, Montreal, Que, H3C 3J7, Canada.
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Sodjinou R, Agueh V, Fayomi B, Delisle H. Obesity and cardio-metabolic risk factors in urban adults of Benin: relationship with socio-economic status, urbanisation, and lifestyle patterns. BMC Public Health 2008; 8:84. [PMID: 18318907 PMCID: PMC2315643 DOI: 10.1186/1471-2458-8-84] [Citation(s) in RCA: 129] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2007] [Accepted: 03/04/2008] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND There is a dearth of information on diet-related chronic diseases in West Africa. This cross-sectional study assessed the rate of obesity and other cardiovascular disease (CVD) risk factors in a random sample of 200 urban adults in Benin and explored the associations between these factors and socio-economic status (SES), urbanisation as well as lifestyle patterns. METHODS Anthropometric parameters (height, weight and waist circumference), blood pressure, fasting plasma glucose, and serum lipids (HDL-cholesterol and triglycerides) were measured. WHO cut-offs were used to define CVD risk factors. Food intake and physical activity were assessed with three non-consecutive 24-hour recalls. Information on tobacco use and alcohol consumption was collected using a questionnaire. An overall lifestyle score (OLS) was created based on diet quality, alcohol consumption, smoking, and physical activity. A SES score was computed based on education, main occupation and household amenities (as proxy for income). RESULTS The most prevalent CVD risk factors were overall obesity (18%), abdominal obesity (32%), hypertension (23%), and low HDL-cholesterol (13%). Diabetes and hypertriglyceridemia were uncommon. The prevalence of overall obesity was roughly four times higher in women than in men (28 vs. 8%). After controlling for age and sex, the odds of obesity increased significantly with SES, while a longer exposure to the urban environment was associated with higher odds of hypertension. Of the single lifestyle factors examined, physical activity was the most strongly associated with several CVD risk factors. Logistic regression analyses revealed that the likelihood of obesity and hypertension decreased significantly as the OLS improved, while controlling for potential confounding factors. CONCLUSION Our data show that obesity and cardio-metabolic risk factors are highly prevalent among urban adults in Benin, which calls for urgent measures to avert the rise of diet-related chronic diseases. People with higher SES and those with a longer exposure to the urban environment are priority target groups for interventions focusing on environmental risk factors that are amenable to change in this population. Lifestyle interventions would appear appropriate, with particular emphasis on physical activity.
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Affiliation(s)
- Roger Sodjinou
- TRANSNUT, WHO Collaborating Centre on Nutrition Changes and Development, Department of Nutrition, Faculty of Medicine, Université de Montréal, C.P. 6128 Succursale centre-ville, Montréal Qc H3C 3J7, Canada
| | - Victoire Agueh
- Institut Régional de Santé Publique, Route des Esclaves, 01BP918, Ouidah, Bénin
| | - Benjamin Fayomi
- Institut des Sciences Biomédicales Appliquées, Université d'Abomey-Calavi, 01BP188 Cotonou, Bénin
| | - Hélène Delisle
- TRANSNUT, WHO Collaborating Centre on Nutrition Changes and Development, Department of Nutrition, Faculty of Medicine, Université de Montréal, C.P. 6128 Succursale centre-ville, Montréal Qc H3C 3J7, Canada
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What's in, what's coming, what's wanted. Public Health Nutr 2007. [DOI: 10.1017/s1368980007721985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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