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Ojo AS, Nnyanzi LA, Giles EL, Ells LJ, Awolaran O, Okeke SR, Afaya A, Bolarinwa OA. Perceptions of dietary intake amongst Black, Asian and other minority ethnic groups in high-income countries: a systematic review of qualitative literature. BMC Nutr 2023; 9:85. [PMID: 37443077 DOI: 10.1186/s40795-023-00743-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 07/04/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Minority ethnic groups are a fast-growing population in many high-income countries, partly due to the increasing population of immigrants and second-generation migrants. The dietary practices of some of these minority ethnic groups might make them to be disproportionately affected by obesity and increase their risks of developing non-communicable diseases. Population-specific interventions and strategies are vital to addressing poor nutritional practices among this population. Thus, this study systematically reviewed the perceptions of dietary intake amongst Black, Asian and other minority ethnic groups in high-income countries. METHODS This systematic review was conducted in line with the guidelines of the Joanna Briggs Institute (JBI) methodology for systematic reviews, using a meta-aggregative design. This systematic review identified and synthesised qualitative literature on the perceptions of dietary intake amongst BlackAsian and other minority ethnic groups in high-income countries. An extensive and comprehensive database search was conducted between January 2000 - May 2022 and included twenty (20) studies that met the eligibility criteria from six countries. The included studies were assessed for quality using the JBI qualitative assessment and review instrument. The JBI data extraction tools were used to retrieve relevant data from included articles, and the data were thematically analysed. RESULTS We identified eight major themes across this database: (1) "Social and Cultural Factors," (2) "Availability and Accessibility," (3) "Family and Community Influences," (4) "Food Preferences", (5) "Home Country Food Versus Host Country Food" (6) "Dietary Acculturation" (7) "Health and Healthy Eating" (8) "Perception of Nutritional Information." CONCLUSION Overall, Black, Asian, and other minority ethnic groups individuals were found to be aware of the effects of unhealthy eating on their health, and some of them have nutritional knowledge, but social and cultural factors, including structural factors, were deterrents to their healthy eating behaviours. An important finding from this review is that some participants believed that nutritional information, based on bio-medical science, was intended for only White population groups and that it was antagonistic to their cultural and community well-being.
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Affiliation(s)
- Abimbola S Ojo
- Centre for Public Health, School of Health & Life Sciences, University of Teesside, Teeside, UK
| | - Lawrence A Nnyanzi
- Centre for Public Health, School of Health & Life Sciences, University of Teesside, Teeside, UK
| | - Emma L Giles
- Centre for Public Health, School of Health & Life Sciences, University of Teesside, Teeside, UK
| | - Louisa J Ells
- Obesity Institute, School of Health, Leeds Beckett University, Leeds, UK
| | - Olusegun Awolaran
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Sylvester R Okeke
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | - Agani Afaya
- Mo-Im Kin Nursing Research Institute, College of Nursing, Yonsei University, 50‑1, Yonsei‑ro, Seodaemun‑gu, Seoul, Seoul, 03722, South Korea
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Obasanjo Afolabi Bolarinwa
- Department of Public Health, York St John University, London, UK.
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
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Poelman MP, Nicolaou M, Dijkstra SC, Mackenbach JD, Lu M, Karssenberg D, Snijder MB, Vaartjes I, Stronks K. Does the neighbourhood food environment contribute to ethnic differences in diet quality? Results from the HELIUS study in Amsterdam, the Netherlands. Public Health Nutr 2021; 24:5101-5112. [PMID: 33947481 PMCID: PMC11082797 DOI: 10.1017/s1368980021001919] [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: 08/09/2020] [Revised: 04/22/2021] [Accepted: 04/29/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The aim of the current study was to establish whether the neighbourhood food environment, characterised by the healthiness of food outlets, the diversity of food outlets and fast-food outlet density within a 500 m or 1000 m street network buffer around the home address, contributed to ethnic differences in diet quality. DESIGN Cross-sectional cohort study. SETTING Amsterdam, the Netherlands. PARTICIPANTS Data on adult participants of Dutch, South-Asian Surinamese, African Surinamese, Turkish and Moroccan descent (n total 4728) in the HELIUS study were analysed. RESULTS The neighbourhood food environment of ethnic minority groups living in Amsterdam is less supportive of a healthy diet and of less diversity than that of participants of Dutch origin. For example, participants of Turkish, Moroccan and South-Asian Surinamese descent reside in a neighbourhood with a significantly higher fast-food outlet density (≤1000 m) than participants of Dutch descent. However, we found no evidence that neighbourhood food environment characteristics directly contributed to ethnic differences in diet quality. CONCLUSION Although ethnic minority groups lived in less healthy food environments than participants of ethnic Dutch origin, this did not contribute to ethnic differences in diet quality. Future research should investigate other direct or indirect consequences of residing in less supportive food environments and gain a better understanding of how different ethnic groups make use of their neighbourhood food environment.
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Affiliation(s)
- Maartje P Poelman
- Chair Group Consumption and Healthy Lifestyles, Wageningen University & Research, PO Box 8130, Wageningen, The Netherlands
| | - Mary Nicolaou
- Department of Public Health, University of Amsterdam, Amsterdam Public Health Research Institute, Meibergdreef, Amsterdam, The Netherlands
| | - S Coosje Dijkstra
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan, Amsterdam, The Netherlands
| | - Joreintje D Mackenbach
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Upstream Team, Amsterdam UMC, The Netherlands
| | - Meng Lu
- Department of Physical Geography, Utrecht University, The Netherlands
| | - Derek Karssenberg
- Department of Physical Geography, Utrecht University, The Netherlands
| | - Marieke B Snijder
- Department of Public Health, University of Amsterdam, Amsterdam Public Health Research Institute, Meibergdreef, Amsterdam, The Netherlands
| | - Ilonca Vaartjes
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, The Netherlands
| | - Karien Stronks
- Department of Public Health, University of Amsterdam, Amsterdam Public Health Research Institute, Meibergdreef, Amsterdam, The Netherlands
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Assmus F, Galbete C, Knueppel S, Schulze MB, Beune E, Meeks K, Nicolaou M, Amoah S, Agyemang C, Klipstein-Grobusch K, Bahendeka S, Spranger J, Mockenhaupt FP, Smeeth L, Stronks K, Danquah I. Carbohydrate-dense snacks are a key feature of the nutrition transition among Ghanaian adults - findings from the RODAM study. Food Nutr Res 2021; 65:5435. [PMID: 34512231 PMCID: PMC8388941 DOI: 10.29219/fnr.v65.5435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 12/28/2020] [Accepted: 01/04/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND African populations in sub-Saharan Africa and African migrants in Europe are facing a rapid upsurge in obesity. This trend has been related to urbanization, migration and associated shifts in lifestyle, including dietary habits. Whether changes in eating patterns contribute to the rising burden of obesity among African populations is currently unknown. OBJECTIVE Our aims in conducting this study were to characterize eating patterns among Ghanaian adults living in their country of origin and in Europe and to explore associations of meal patterns with body mass index (BMI). DESIGN Within the cross-sectional RODAM (Research on Obesity and Diabetes among African Migrants) study, data of single 24-h dietary recalls from Ghanaian adults in rural Ghana (n = 20), urban Ghana (n = 42), and Europe (n = 172) were recorded. Eating frequencies, energy intake, and macronutrient composition of eating occasions (EOs, i.e. meals or snacks) were compared between study sites based on descriptive statistics and χ 2-/Kruskal-Wallis tests. RESULTS A rising gradient of EO frequencies from rural Ghana through urban Ghana to Europe was observed, mainly reflecting the differences in snacking frequencies (≥1 snack per day: 20 vs. 48 vs. 52%, P = 0.008). Meal frequencies were similar across study sites (≥3 meals per day: 30 vs. 33 vs. 38%, P = 0.80). Meals were rich in carbohydrates (median 54.5, interquartile range (IQR): 43.2-64.0 energy%) and total fats (median: 27.0, IQR: 19.9-34.4 energy %); their protein content was lowest in rural Ghana, followed by urban Ghana and Europe (P = 0.0005). Snacks mainly contained carbohydrates (median: 75.7, IQR: 61.0-89.2 energy%). In linear regression analyses, there was a non-significant trend for an inverse association between snacking frequencies and BMI. DISCUSSION AND CONCLUSIONS The observed integration of carbohydrate-dense snacks into the diet supports the growing evidence for a nutrition transition among African populations undergoing socioeconomic development. This analysis constitutes a starting point to further investigate the nutritional implications of increased snacking frequencies on obesity and metabolic health in these African populations.
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Affiliation(s)
- Frauke Assmus
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Cecilia Galbete
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Sven Knueppel
- Unit of Epidemiology, Statistics and Mathematical Modelling, Department of Exposition, German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Matthias B. Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Erik Beune
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Karlijn Meeks
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Mary Nicolaou
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Stephen Amoah
- Institute of Tropical Medicine and International Health, Charité - Universitaetsmedizin Berlin, Corporate Member of Freie Universitaet Berlin, Humboldt-Universitaet zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Charles Agyemang
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Kerstin Klipstein-Grobusch
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Division of Epidemiology & Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Silver Bahendeka
- St. Francis Hospital Nsambya, Uganda Martyrs University, Kampala, Uganda
| | - Joachim Spranger
- Department of Endocrinology and Metabolism, DZHK (German Center for Cardiovascular Research) partner site Berlin, Center for Cardiovascular Research (CCR), Charité – Universitaetsmedizin Berlin, Corporate Member of Freie Universitaet Berlin, Humboldt-Universitaet zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Frank P. Mockenhaupt
- Institute of Tropical Medicine and International Health, Charité - Universitaetsmedizin Berlin, Corporate Member of Freie Universitaet Berlin, Humboldt-Universitaet zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Liam Smeeth
- Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Karien Stronks
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Ina Danquah
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- Heidelberg Institute of Global Health, Universitaetsklinikum Heidelberg, Heidelberg, Germany
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Osei-Kwasi HA, Boateng D, Danquah I, Holdsworth M, Mejean C, Terragni L, Powell K, Schulze MB, Owusu-Dabo E, Meeks K, Beune E, Agyemang C, Klipstein-Grobusch K, Stronks K, Galbete C, Nicolaou M. Acculturation and Food Intake Among Ghanaian Migrants in Europe: Findings From the RODAM Study. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:114-125. [PMID: 31601528 DOI: 10.1016/j.jneb.2019.09.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 09/04/2019] [Accepted: 09/05/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE This study examined the role of migration and acculturation in the diet of Ghanaian migrants in Europe by (1) comparing food intake of Ghanaian migrants in Europe with that of Ghanaians living in Ghana and (2) assessing the association between acculturation and food intake. DESIGN Data from the cross-sectional multicenter study Research on Obesity and Diabetes among African Migrants were used. Food intake was assessed using a Ghana-specific food propensity questionnaire (134 items and 14 food groups); foods were grouped based on a model of dietary change proposed by Koctürk-Runefors. SETTING Ghana, London, Amsterdam, and Berlin. PARTICIPANTS A total of 4,534 Ghanaian adults living in Ghana and Europe, with complete dietary data. Of these, 1,773 Ghanaian migrants had complete acculturation data. MAIN OUTCOME MEASURE Food intake (the weighted intake frequency per week of food categories). ANALYSIS Linear regression. RESULTS Food intake differed between Ghanaians living in Ghana and Europe. Among Ghanaian migrants in Europe, there were inconsistent and small associations between acculturation and food intake, except for ethnic identity, which was consistently associated with intake only of traditional staples. CONCLUSIONS AND IMPLICATIONS Findings indicate that migration is associated with dietary changes that cannot be fully explained by ethnic, cultural, and social acculturation. The study provides limited support to the differential changes in diet suggested by the Koctürk-Runefors' model of dietary change.
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Affiliation(s)
- Hibbah Araba Osei-Kwasi
- Public Health Section, School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom; Department of Clinical Sciences and Nutrition, University of Chester, Parkgate Road, Tower Building, United Kingdom.
| | - Daniel Boateng
- Julius, Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, The Netherlands; School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Ina Danquah
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
| | - Michelle Holdsworth
- Public Health Section, School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom; Institute of Research for Development, UMR Nutripass IRD, UM, SupAgro, Montpellier, France
| | - Caroline Mejean
- MOISA, University of Montpellier, INRA, CIRAD, CIHEAM-IAMM, Montpellier SupAgro, Montpellier, France
| | - Laura Terragni
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet-Oslo Metropolitan University, Oslo, Norway
| | - Katie Powell
- Public Health Section, School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany; Institute of Nutritional Sciences, University of Potsdam, Nuthetal, Germany
| | - Ellis Owusu-Dabo
- Kumasi Centre for Collaborative Research in Tropical Medicine, College of Health Sciences, KNUST, Kumasi, Ghana
| | - Karlijn Meeks
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Erik Beune
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Charles Agyemang
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Kerstin Klipstein-Grobusch
- Julius, Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, The Netherlands; Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Karien Stronks
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Cecilia Galbete
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
| | - Mary Nicolaou
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Shareck M, Benmarhnia T, Berger N, Smith NR, Lewis D, Cummins S. Does the neighborhood food environment contribute to ethnic inequalities in fast-food intake? findings from the ORiEL study. Prev Med Rep 2019; 16:100998. [PMID: 31737470 PMCID: PMC6849409 DOI: 10.1016/j.pmedr.2019.100998] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 08/18/2019] [Accepted: 09/23/2019] [Indexed: 01/19/2023] Open
Abstract
The neighborhood food environment may contribute to ethnic inequalities in diet. Using data from 1389 participants in the Olympic Regeneration in East London (UK) study we assessed whether ethnic inequalities in neighborhood availability of fast-food restaurants mediated and/or modified ethnic inequalities in fast-food intake in 13–15 year-old adolescents. We compared the proportion of high fast-food consumers across “White UK”, “Black”, and “South Asian” ethnic categories. We used Poisson regression with robust standard errors to assess direct and indirect effects (mediation analysis) and risk ratios of high fast-food intake by ethnic category and fast-food restaurant availability level (effect measure modification analysis). There were ethnic inequalities in high fast-food intake, with risk ratios in adolescents of Black and South Asian background of 1.53 (95% CI: 1.25, 1.87) and 1.71 (95% CI: 1.41, 2.07) respectively compared to White UK participants. We found no evidence of a mediating effect by fast-food restaurant availability, but found some evidence of effect measure modification: ethnic inequalities in fast-food intake were largest in neighborhoods lacking fast-food restaurants, and narrowed as availability increased. Future research should explore why ethnic minorities are more likely to be high fast-food consumers than the majority ethnic group, especially when fast-food restaurant availability is lowest.
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Affiliation(s)
- Martine Shareck
- Division of Social and Behavioural Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Corresponding author at: Département des sciences de la santé communautaire, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, 3001 12 Ave N, Sherbrooke J1H 5H3, Canada.
| | - Tarik Benmarhnia
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, USA
| | - Nicolas Berger
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Daniel Lewis
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
| | - Steven Cummins
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
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Castaneda-Gameros D, Redwood S, Thompson JL. Nutrient Intake and Factors Influencing Eating Behaviors in Older Migrant Women Living in the United Kingdom. Ecol Food Nutr 2017; 57:50-68. [PMID: 29199859 DOI: 10.1080/03670244.2017.1406855] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study examines nutrient intake and factors influencing eating behaviors in a sample of 76 migrant older women (≥ 60 years) living in the UK. Nutrient intake was assessed using a 24-hr recall enhanced by an in-depth probing dietary interview. Median energy intake was significantly lower than the UK RNIs (5,125.4 v. 7,301.1 kJ/d, p < .001). Main nutrients of concern were retinol, vitamin D, magnesium, potassium, copper, selenium, and monounsaturated fatty acids. Semistructured interviews were conducted with a subsample (n = 46) and analyzed using thematic analysis. Although women were knowledgeable about what constitutes a healthy diet, factors such as the presence and awareness of obesity and noncommunicable diseases, changes to household roles, and dietary restrictions related to religious beliefs were identified key influences on participants' dietary intake. Strategies targeting this population need to promote not only a healthy energy balance, but also dietary adequacy to optimize nutrient intake.
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Affiliation(s)
- Diana Castaneda-Gameros
- a School of Sport, Exercise and Rehabilitation Sciences , University of Birmingham , Birmingham , UK
| | - Sabi Redwood
- b School of Social and Community Medicine , University of Bristol , Bristol , UK.,c NIHR CLAHRC West , Bristol , UK
| | - Janice L Thompson
- a School of Sport, Exercise and Rehabilitation Sciences , University of Birmingham , Birmingham , UK
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Abstract
AbstractOut-of-home foods (takeaway, take-out and fast foods) have become increasingly popular in recent decades and are thought to be a key driver in increasing levels of overweight and obesity due to their unfavourable nutritional content. Individual food choices and eating behaviours are influenced by many interrelated factors which affect the results of nutrition-related public health interventions. While the majority of research based on out-of-home foods comes from Australia, the UK and USA, the same issues (poor dietary habits and increased prevalence of non-communicable disease) are of equal concern for urban centres in developing economies undergoing ‘nutrition transition’ at a global scale. The present narrative review documents key facets, which may influence out-of-home food consumption, drawn from biological, societal, environmental, demographic and psychological spheres. Literature searches were performed and references from relevant papers were used to find supplementary studies. Findings suggest that the strongest determinants of out-of-home food availability are density of food outlets and deprivation within the built environment; however, the association between socio-economic status and out-of-home food consumption has been challenged. In addition, the biological and psychological drives combined with a culture where overweight and obesity are becoming the norm makes it ‘fashionable’ to consume out-of-home food. Other factors, including age group, ethnicity and gender demonstrate contrasting effects and a lack of consensus. It is concluded that further consideration of the determinants of out-of-home food consumption within specific populations is crucial to inform the development of targeted interventions to reduce the impact of out-of-home foods on public health.
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Exploring perceptions and beliefs about the cost of fruit and vegetables and whether they are barriers to higher consumption. Appetite 2017; 113:310-319. [PMID: 28263775 DOI: 10.1016/j.appet.2017.02.043] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Revised: 02/26/2017] [Accepted: 02/27/2017] [Indexed: 12/26/2022]
Abstract
BACKGROUND Fruit and vegetable (F&V) consumption is below recommendations, and cost may be a barrier to meeting recommendations. Limited evidence exists on individual perceptions about the cost, actual spending and consumption of F&V. This study investigated perceptions and beliefs about cost of F&V and whether this is a barrier to higher consumption. METHODS An online survey of Australian adults (n = 2474) measured F&V consumption; expenditure on F&V and food; and perceived barriers to consumption. Multivariable logistic regression examined associations between participants' responses about cost of F&V and demographic factors, and with actual consumption and expenditure on F&V. RESULTS Cost was identified as a barrier for 29% of people not meeting recommended fruit servings and for 14% of people not meeting recommendations for vegetables. Cost was a more common barrier for those on lower incomes (fruit aOR 1.89; 95% CI 1.20-2.98 and vegetables aOR 2.94; 95% CI 1.97-4.39) and less common for older participants (fruit aOR 0.33; 95% CI 0.17-0.62 and vegetables aOR 0.31; 95% CI 0.18-0.52). There was no association between the perceived barriers and actual F&V spending. Twenty percent of participants said F&V were not affordable; 39% said cost made it difficult to buy F&V, and for 23% the cost of F&V meant they bought less than desired. CONCLUSIONS A minority reported F&V were not affordable where they shopped and that cost was a barrier to higher consumption. However, it is apparent that young adults and those on low incomes eat less than they would like because of cost. Strategies that remove financial impediments to consumption are indicated for these population sub-groups.
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Osei-Kwasi HA, Nicolaou M, Powell K, Terragni L, Maes L, Stronks K, Lien N, Holdsworth M. Systematic mapping review of the factors influencing dietary behaviour in ethnic minority groups living in Europe: a DEDIPAC study. Int J Behav Nutr Phys Act 2016; 13:85. [PMID: 27465354 PMCID: PMC4964011 DOI: 10.1186/s12966-016-0412-8] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 07/20/2016] [Indexed: 12/25/2023] Open
Abstract
Background Europe has a growing population of ethnic minority groups whose dietary behaviours are potentially of public health concern. To promote healthier diets, the factors driving dietary behaviours need to be understood. This review mapped the broad range of factors influencing dietary behaviour among ethnic minority groups living in Europe, in order to identify research gaps in the literature to guide future research. Methods A systematic mapping review was conducted (protocol registered with PROSPERO 2014: CRD42014013549). Nine databases were searched for quantitative and qualitative primary research published between 1999 and 2014. Ethnic minority groups were defined as immigrants/populations of immigrant background from low and middle income countries, population groups from former Eastern Bloc countries and minority indigenous populations. In synthesizing the findings, all factors were sorted and structured into emerging clusters according to how they were seen to relate to each other. Results Thirty-seven of 2965 studies met the inclusion criteria (n = 18 quantitative; n = 19 qualitative). Most studies were conducted in Northern Europe and were limited to specific European countries, and focused on a selected number of ethnic minority groups, predominantly among populations of South Asian origin. The 63 factors influencing dietary behaviour that emerged were sorted into seven clusters: social and cultural environment (16 factors), food beliefs and perceptions (11 factors), psychosocial (9 factors), social and material resources (5 factors), accessibility of food (10 factors), migration context (7 factors), and the body (5 factors). Conclusion This review identified a broad range of factors and clusters influencing dietary behaviour among ethnic minority groups. Gaps in the literature identified a need for researchers to explore the underlying mechanisms that shape dietary behaviours, which can be gleaned from more holistic, systems-based studies exploring relationships between factors and clusters. The dominance of studies exploring ‘differences’ between ethnic minority groups and the majority population in terms of the socio-cultural environment and food beliefs suggests a need for research exploring ‘similarities’. The evidence from this review will feed into developing a framework for the study of factors influencing dietary behaviours in ethnic minority groups in Europe. Electronic supplementary material The online version of this article (doi:10.1186/s12966-016-0412-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hibbah Araba Osei-Kwasi
- Public Health Section, School of Health and Related Research-ScHARR, The University of Sheffield, Sheffield, UK
| | - Mary Nicolaou
- Department of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Katie Powell
- Public Health Section, School of Health and Related Research-ScHARR, The University of Sheffield, Sheffield, UK
| | - Laura Terragni
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - Lea Maes
- Department of Public Health, Ghent University, Ghent, Belgium
| | - Karien Stronks
- Department of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Nanna Lien
- Department of Nutrition, University of Oslo, Oslo, Norway
| | - Michelle Holdsworth
- Public Health Section, School of Health and Related Research-ScHARR, The University of Sheffield, Sheffield, UK.
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Jennings HM, Thompson JL, Merrell J, Bogin B, Heinrich M. Food, home and health: the meanings of food amongst Bengali Women in London. JOURNAL OF ETHNOBIOLOGY AND ETHNOMEDICINE 2014; 10:44. [PMID: 24886061 PMCID: PMC4035805 DOI: 10.1186/1746-4269-10-44] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 04/30/2014] [Indexed: 05/23/2023]
Abstract
BACKGROUND This paper explores the nature of food and plants and their meanings in a British Bengali urban context. It focuses on the nature of plants and food in terms of their role in home making, transnational connections, generational change and concepts of health. METHODS An ethnographic approach to the research was taken, specific methods included participant observation, focus group discussions and semi-structured interviews. Thirty women of Bengali origin were mostly composed of "mother" and "daughter" pairs. The mothers were over 45 years old and had migrated from Bangladesh as adults and their grown-up daughters grew up in the UK. RESULTS Food and plants play an important role in the construction of home "here" (London) while continuing to connect people to home "there" (Sylhet). This role, however, changes and is re-defined across generations. Looking at perceptions of "healthy" and "unhealthy" food, particularly in the context of Bengali food, multiple views of what constitutes "healthy" food exist. However, there appeared to be little two-way dialogue about this concept between the research participants and health professionals. This seems to be based on "cultural" and power differences that need to be addressed for a meaningful dialogue to occur. CONCLUSION In summary, this paper argues that while food is critical to the familial spaces of home (both locally and globally), it is defined by a complex interplay of actors and wider meanings as illustrated by concepts of health and what constitutes Bengali food. Therefore, we call for greater dialogue between health professionals and those they interact with, to allow for an enhanced appreciation of the dynamic nature of food and plants and the diverse perceptions of the role that they play in promoting health.
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Affiliation(s)
- Hannah Maria Jennings
- Centre for Pharmacognosy and Phytotherapy, UCL School of Pharmacy, University of London, 29-39 Brunswick Square, London WC1N 1AX, UK
| | - Janice L Thompson
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Joy Merrell
- College of Human and health Sciences, Swansea University, Singleton Park, Swansea, Wales SA2 8PP, UK
| | - Barry Bogin
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
| | - Michael Heinrich
- Centre for Pharmacognosy and Phytotherapy, UCL School of Pharmacy, University of London, 29-39 Brunswick Square, London WC1N 1AX, UK
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Maintenance of changes in food intake and motivation for healthy eating among Norwegian-Pakistani women participating in a culturally adapted intervention. Public Health Nutr 2012; 16:113-22. [PMID: 22781507 DOI: 10.1017/s1368980012002790] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To investigate maintenance of changes in food intake and motivation for healthy eating at follow-up 2 data collection after a lifestyle intervention among Pakistani immigrant women. DESIGN A culturally adapted lifestyle intervention, aiming at reducing the risk of type 2 diabetes mellitus. Data collection including FFQ and questions on intentions to change dietary behaviour was completed at baseline, right after the 7 ± 1 month intervention (follow-up 1) and 2-3 years after baseline (follow-up 2). SETTING Oslo, Norway. SUBJECTS Pakistani women (n =198), aged 25-60 years, randomized into control and intervention groups. RESULTS From follow-up 1 to follow-up 2 there was a shift from action to maintenance stages for intention to reduce fat intake (P < 0.001), change type of fat (P = 0.001), increase vegetable intake (P < 0.001) and reduce sugar intake (P = 0.003) in the intervention group. The reduction in intakes of soft drinks with sugar, fruit drinks with sugar and red meats, and the increase in intakes of vegetables and fish from baseline to follow-up 1 were maintained (significant change from baseline) at follow-up 2 in the intervention group. The intake of vegetables was higher (P = 0.019) and the intake of fruit drinks with sugar lower (P = 0.023) in the intervention group compared with the control group at follow-up 2. CONCLUSIONS The culturally adapted intervention had the potential of affecting intentions to change food behaviour among Pakistani immigrant women long after completion of the intervention and also of leading to long-term maintenance of beneficial changes in diet.
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Kumar R, Einstein G. Cardiovascular Disease in Somali Women in the Diaspora. CURRENT CARDIOVASCULAR RISK REPORTS 2012. [DOI: 10.1007/s12170-012-0233-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Barton M, Kearney J, Stewart-Knox BJ. Knowledge of food production methods informs attitudes toward food but not food choice in adults residing in socioeconomically deprived rural areas within the United Kingdom. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2011; 43:374-378. [PMID: 21419710 DOI: 10.1016/j.jneb.2009.12.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2009] [Revised: 12/22/2009] [Accepted: 12/29/2009] [Indexed: 05/30/2023]
Abstract
OBJECTIVE Understand food choice, from the perspective of people residing in socioeconomically deprived rural neighborhoods. METHODS Focus groups (n = 7) were undertaken within a community setting involving 42 adults (2 males and 40 females) recruited through voluntary action groups. Data were recorded, transcribed verbatim, and content analyzed. RESULTS Attitudes to food and health were influenced by knowledge of food production and processing. Healthful foods were considered those which were fresh and unprocessed, and taste was taken as an indicator of how the food had been produced. Despite negative views of food production, processed foods were consumed. Explanations for this tension between what people wanted to eat (unprocessed food) and what they actually chose to eat (processed food) were attributed to lifestyle compression. CONCLUSIONS AND IMPLICATIONS Dietary health promotion initiatives targeted at deprived rural dwellers should consider perceived issues regarding food production and processing that may influence views on food.
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Affiliation(s)
- Maria Barton
- Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, Northern Ireland, United Kingdom
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Shoneye C, Johnson F, Steptoe A, Wardle J. A qualitative analysis of black and white British women's attitudes to weight and weight control. J Hum Nutr Diet 2011; 24:536-42. [PMID: 21838745 DOI: 10.1111/j.1365-277x.2011.01198.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Rates of obesity among black African and black Caribbean women in the UK are consistently higher than among white women. Cultural, attitudinal and behavioural differences may contribute to ethnic variation in weight, and the present study aimed to explore attitudes towards weight and weight control among black and white British women using a qualitative approach. METHODS Ethnically homogeneous focus groups were carried out with 25 white women [mean (SD) body mass index (BMI, kg m(-2)) = 26 (7.2) kg m(-2) ] and 24 black women [mean (SD) BMI = 29 (6.6) kg m(-2) ]. Women were recruited from London boroughs (Lambeth, Southwark and Croydon) and Guildford, Surrey, and focus groups were conducted in London. Focus groups were recorded and transcribed verbatim, and were analysed using thematic analysis. RESULTS All participants had fairly good knowledge of the causes, consequences and treatment of being overweight. However, black women primarily emphasised the health consequences of being overweight, whereas white women were more likely to focus on the perceived social and emotional consequences. White women associated being overweight with negative character traits, whereas black women had a broadly positive attitude towards larger body sizes. CONCLUSIONS Black women were as well-informed about the causes and health risks of obesity as white women in this sample of mainly educated, working women, although they were more accepting of larger body sizes and experienced less social pressure to be slim.
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Affiliation(s)
- C Shoneye
- Epidemiology and Public Health, University College, London, UK
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Johnson M, Everson-Hock E, Jones R, Woods HB, Payne N, Goyder E. What are the barriers to primary prevention of type 2 diabetes in black and minority ethnic groups in the UK? A qualitative evidence synthesis. Diabetes Res Clin Pract 2011; 93:150-158. [PMID: 21752486 DOI: 10.1016/j.diabres.2011.06.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Revised: 06/01/2011] [Accepted: 06/06/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND This review aimed to synthesise available qualitative evidence on barriers and facilitators to the implementation of community based lifestyle behaviour interventions to reduce the risk of diabetes in black and minority ethnic (BME) groups in the UK. METHODS A search of medical and social science databases was carried out and augmented by hand-searching of reference lists and contents of key journals. Qualitative evidence was synthesised thematically. RESULTS A total of 13 papers varying in design and of mainly good quality were included in the review. A limited number of intervention evaluations highlighted a lack of resources and communication between sites. A lack of understanding by providers of cultural and religious requirements, and issues relating to access to interventions for users was reported. Behaviour change was impeded by cultural and social norms, and resistance to change. There were variations in the way dietary change and physical activity was approached by different groups and contrasting practices between generations. CONCLUSIONS Qualitative data provided insight into the ways that providers might improve or better design future interventions. Acknowledgement of the way that different groups approach lifestyle behaviours may assist acceptability of interventions.
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Affiliation(s)
- Maxine Johnson
- University of Sheffield, School of Health and Related Research, Sheffield, South Yorkshire S1 4DA, United Kingdom.
| | - Emma Everson-Hock
- University of Sheffield, School of Health and Related Research, Sheffield, South Yorkshire S1 4DA, United Kingdom
| | - Roy Jones
- University of Sheffield, School of Health and Related Research, Sheffield, South Yorkshire S1 4DA, United Kingdom
| | - Helen Buckley Woods
- University of Sheffield, School of Health and Related Research, Sheffield, South Yorkshire S1 4DA, United Kingdom
| | - Nick Payne
- University of Sheffield, School of Health and Related Research, Sheffield, South Yorkshire S1 4DA, United Kingdom
| | - Elizabeth Goyder
- University of Sheffield, School of Health and Related Research, Sheffield, South Yorkshire S1 4DA, United Kingdom
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Leung G, Stanner S. Diets of minority ethnic groups in the UK: influence on chronic disease risk and implications for prevention. NUTR BULL 2011. [DOI: 10.1111/j.1467-3010.2011.01889.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Social and cultural construction of obesity among Pakistani Muslim women in North West England. Public Health Nutr 2011; 14:1842-50. [DOI: 10.1017/s1368980010003472] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectiveThe present qualitative study explored health perceptions, diet and the social construction of obesity and how this relates to the initiation and maintenance of a healthier diet in UK Pakistani women.DesignPakistani women in Greater Manchester participated in focus group and one-to-one discussions. Semi-structured interviews employing fictional vignettes and body shape images were used to explore the participants’ beliefs and practices regarding diet, overweight/obesity and the risk of type 2 diabetes. Transcripts were analysed using phenomenological and sociological approaches.SettingInterviews took place either in local community and Pakistani resource centres or in private homes.SubjectsFirst- and second-generation women who were both active in the community and housebound. The women spoke English and/or Urdu.ResultsThe fifty-five participants lacked the motivation to address weight gain and were unsure how to do so. There was a limited awareness of the link between weight gain and type 2 diabetes. Other barriers included the influence of Islam, culture and familial expectations on home cooking, perceptions that weight gain is inevitable (owing to ageing, childbirth or divine predestination) and the prioritisation of family concerns over individual lifestyle changes. As the findings of the present research did not correspond to existing educational and behaviour change models, a new Health Action Transition conceptual model is proposed.ConclusionsHealth education programmes that aim to address obesity and its associated risks in the South Asian community must take into account the complex beliefs and practices and the multiple dimensions of religion, ethnic and social identity within this population. The present study provides further insight into these factors and proposes a novel model for use in designing and implementing education interventions for British Pakistani women.
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Changes in food habits and motivation for healthy eating among Pakistani women living in Norway: results from the InnvaDiab-DEPLAN study. Public Health Nutr 2009; 13:858-67. [PMID: 19941691 DOI: 10.1017/s1368980009992047] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Pakistani women in Oslo have high risk of overweight and type 2 diabetes. The objective is to present the effect of an intervention study on Pakistani women's intentions to change dietary behaviour and changes made in dietary intake. DESIGN The intervention group received culturally adapted lifestyle education, including diet and physical activity. The questionnaire, applied before and after the 7-month intervention, included FFQ and questions on intentions to change. SETTING Oslo, Norway. SUBJECTS A total of 198 Pakistani women, aged 25-63 years, randomised into control and intervention groups. RESULTS There was a shift in distribution of intentions to change the intake of selected foods in the intervention group after the intervention, resulting in significant differences between the groups. The daily intake of vegetables, fruits and fruit juice had increased (P = 0.043), and the intake of red meats (P = 0.001), full fat milk/yoghurt (P = 0.027) and sugar-rich drinks (P <or= 0.007) was reduced in the intervention group. The differences between intervention and control after the intervention were significant for sugar-rich drinks (P <or= 0.022). More women in the intervention group used olive and rapeseed oil and fewer used 'vegetable' oil after than before intervention (P < 0.011). Differences between intervention and control were significant (P = 0.001) for rapeseed oil. Comparing those who attended at least 60 % of the group sessions with the control group resulted in minor changes in these estimates. CONCLUSIONS Culturally adapted education has the potential to change Norwegian-Pakistani women;s intentions to make their diet healthier, and also to induce some beneficial, however modest, self-reported changes in diet.
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Perez-Cueto F, Verbeke W, Lachat C, Remaut-De Winter AM. Changes in dietary habits following temporal migration. The case of international students in Belgium. Appetite 2008; 52:83-8. [PMID: 18786581 DOI: 10.1016/j.appet.2008.08.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2008] [Revised: 08/13/2008] [Accepted: 08/14/2008] [Indexed: 11/26/2022]
Abstract
This paper reports findings from a cross-sectional survey carried out in April-May 2006 among international students enrolled at Ghent University in Belgium. The aim of the study was to assess their knowledge and attitudes related to nutrition, perceived changes in dietary habits, perceived barriers to healthy eating and the determinants of dietary changes since their arrival in Belgium. In total, 235 students from 60 countries participated. Following the reported dietary changes, which were factor-analyzed into "less energy-dense" foods, "more fruits and vegetables" and "less processed" foods, three clusters could be identified. Cluster 1 composed of students who increased their fruits, vegetables and fiber intake. Cluster 2, the largest, reported dietary changes overall and in particular towards less processed foods. Cluster 3 composed of students who changed in the main towards less energy-dense foods. Gender differences were observed in healthy dietary changes, particularly in males. Healthier choices were hindered by a perceived unavailability of healthy food products. Gender and availability of healthy foods should be taken into consideration when informing temporal migration populations, such as international students in this study, about the healthy food options available during their stay in a different cultural, food and dietary environment.
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Affiliation(s)
- Federico Perez-Cueto
- Department of Agricultural Economics, Ghent University, Coupure Links 653, 9000 Ghent, Belgium.
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Dubowitz T, Heron M, Bird CE, Lurie N, Finch BK, Basurto-Dávila R, Hale L, Escarce JJ. Neighborhood socioeconomic status and fruit and vegetable intake among whites, blacks, and Mexican Americans in the United States. Am J Clin Nutr 2008; 87:1883-91. [PMID: 18541581 PMCID: PMC3829689 DOI: 10.1093/ajcn/87.6.1883] [Citation(s) in RCA: 279] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Socioeconomic and racial-ethnic disparities in health status across the United States are large and persistent. Obesity rates are rising faster in black and Hispanic populations than in white populations, and they foreshadow even greater disparities in chronic illnesses such as diabetes and cardiovascular disease in years to come. Factors that influence dietary intake of fruit and vegetables in these populations are only partly understood. OBJECTIVES We examined associations between fruit and vegetable intake and neighborhood socioeconomic status (SES), analyzed whether neighborhood SES explains racial differences in intake, and explored the extent to which neighborhood SES has differential effects by race-ethnicity of US adults. DESIGN Using geocoded residential addresses from the Third National Health and Nutrition Examination Survey, we merged individual-level data with county and census tract-level US Census data. We estimated 3-level hierarchical models predicting fruit and vegetable intake with individual characteristics and an index of neighborhood SES as explanatory variables. RESULTS Neighborhood SES was positively associated with fruit and vegetable intake: a 1-SD increase in the neighborhood SES index was associated with consumption of nearly 2 additional servings of fruit and vegetables per week. Neighborhood SES explained some of the black-white disparity in fruit and vegetable intake and was differentially associated with fruit and vegetable intake among whites, blacks, and Mexican Americans. CONCLUSIONS The positive association of neighborhood SES with fruit and vegetable intake is one important pathway through which the social environment of neighborhoods affects population health and nutrition for whites, blacks, and Hispanics in the United States.
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