Similarities and dissimilarities in diet quality differences by acculturation level between Mexican Americans and other Hispanic Americans: National Health and Nutrition Examination Survey 2015-2018

Authors: Thomson, Jessica; LANDRY, ALICIA - University Of Central Arkansas; Walls, Tameka

Submitted to: Journal of Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 6/12/2023
Publication Date: 7/1/2023
Citation: Thomson, J.L., Landry, A.S., Walls, T.I. 2023. Similarities and dissimilarities in diet quality differences by acculturation level between Mexican Americans and other Hispanic Americans: National Health and Nutrition Examination Survey 2015-2018. Journal of Nutrition. 153:2401-2412. https://doi.org/10.1016/j.tjnut.2023.06.012.
DOI: https://doi.org/10.1016/j.tjnut.2023.06.012

Interpretive Summary: The sizable and rapid growth of the Hispanic population in the United States (US) have shaped the nation’s demographic picture for several decades and Hispanics now account for 19% of all Americans. However, immigration may negatively affect health as higher acculturation can increase risks for poor diet, obesity, and other chronic diseases in Hispanic Americans. To lessen the negative effects of dietary acculturation for Hispanic Americans, questions regarding use of language variables as proxy measures of acculturation and links to dietary intake and accuracy of diet quality assessment need to be addressed. Using data from the National Health and Nutrition Examination Survey (NHANES) 2015-2018, two proxy measures of acculturation based on language spoken in the household and language of dietary recalls were created for Hispanic American participants. Diet quality was assessed by applying the Healthy Eating Index (HEI) to dietary recalls for which higher scores indicate more healthful dietary intake. Accuracy of diet quality assessment was determined by matching HEI score grades to perceived diet quality ratings. Statistical methods for complex survey designs were used for analysis. Similarities between ethnicities included higher acculturation associated with less consumption of fruits, vegetables, total protein foods, seafood and plant proteins, and saturated fats and more consumption of sodium – all negative dietary outcomes. Dissimilarities between ethnicities included associations of higher acculturation with more whole grains and less refined grains consumptions (Mexican Americans; favorable dietary outcomes), more added sugars consumption (Mexican American; negative dietary outcome), and less total dairy and fatty acids consumption (other Hispanic Americans; negative dietary outcomes). No link between acculturation and accuracy of diet quality assessment was found suggesting perception of diet quality is poor in Hispanic Americans regardless of acculturation level. In conclusion, similarities and dissimilarities between Mexican Americans’ and other Hispanic Americans’ diet quality differences by acculturation level exist regardless of language variable used to measure acculturation. The dissimilarity findings suggest that dietary disparities related to level of acculturation differ by country of origin in US Hispanics. Hence, researchers may want to consider identifying country of origin when studying relationships between acculturation and dietary outcomes in Hispanic Americans.

Technical Abstract: Background: Evidence suggests dietary acculturation can increase risks of obesity and chronic diseases. However, questions remain regarding acculturation proxy measures and their associations with diet quality in Hispanic Americans. Objective: Primary objectives included estimating percentages of Hispanic Americans with low, moderate, and high acculturation using two proxy measures based on different language variables; and identifying similarities and dissimilarities in diet quality differences by acculturation level between Mexican Americans and other Hispanic Americans. Methods: Study sample included 1,733 Mexican American and 1,191 other Hispanic participants =16 years of age from NHANES 2015-2018. Proxy measures included in the two acculturation scales were: nativity/length of United States (US) residence, immigration age, language spoken at home (home), and language of dietary recall (recall). Replicate 24-hour dietary recalls were conducted and diet quality was assessed using 2015 Healthy Eating Index. Statistical methods for complex survey designs were used for analysis. Results: For Mexican Americans, 8%, 35%, and 58% had low, moderate, and high acculturation on the home scale vs 8%, 30%, and 62% on the recall scale. For other Hispanics, 17%, 39%, and 43% had low, moderate, and high acculturation on the home scale vs 18%, 34%, and 48% on the recall scale. Similarities between ethnicities included higher acculturation associated with lower intakes of fruits, vegetables, total protein foods, seafood and plant proteins, and saturated fats and greater intake of sodium. Dissimilarities included higher acculturation associated with more whole grains and added sugars intakes and less refined grains intake (Mexican Americans), and less total dairy and fatty acids intakes (other Hispanic Americans). Conclusions: Similarities and dissimilarities between Mexican Americans’ and other Hispanic Americans’ diet quality differences by acculturation level exist regardless of language variable used to measure acculturation. Dissimilarity findings suggest that dietary disparities related to acculturation differ by country of origin in US Hispanics.