Ethnicities within Black populations have not been distinguished in most nutrition studies. We sought to examine dietary differences between African Americans (AA) and Haitian Americans (HA) with and without type 2 diabetes using the Healthy Eating Index, 2005 (HEI-05), and the Alternate Healthy Eating Index (AHEI). The design was cross-sectional N = 471 (225 AA, 246 HA) and recruitment was by community outreach. The eating indices were calculated from data collected with the Harvard food-frequency questionnaire. African Americans had lower HEI-05 scores β = −10.9 (−8.67, 13.1); SE = 1.12, P < .001 than HA. Haitian American females and AA males had higher AHEI than AA females and HA males, respectively, (P = .006) adjusting for age and education. Participants with diabetes had higher adherence to the HEI-05 β = 3.90 (1.78, 6.01), SE = 1.08, P < .001 and lower adherence to the AHEI β = −9.73 (16.3, −3.19), SE = 3.33, P = .004, than participants without diabetes. The findings underscore the importance of disaggregating ethnicities and disease state when assessing diet.

The study investigated differences in dietary patterns measured with the Healthy Eating Index (HEI) and the Alternate Healthy Eating Index (AHEI) in African Americans (AA) and Haitian Americans (HA) with and without type 2 diabetes (T2D). A cross‐sectional study conducted in AA (n=225) and HA (n=246). Participants were recruited from multiple sources from Miami‐Dade and Broward Counties, Florida. Demographic, anthropometric and lifestyle data were collected. Dietary variables were collected using a food frequency questionnaire and the HEI and the AHEI scores were calculated. T‐test, chi‐square and multinomial regressions were used for analysis. HA had a significantly higher AHEI scores (p=.001) compared to AA (p =.001). HEI scores were significantly higher for HA compared to AA (p=.001). AA were 3.6 times more likely than HA to have an intermediate diet adherence (p<.001) and 12 times more likely than HA to have a low diet adherence in the AHEI dietary pattern (p<.001). In the HEI dietary pattern, AA were 2.4 times more likely than HA to have an intermediate diet adherence (p<.001) and 5.2 times more likely than HA to have a low diet adherence (p<.001). Ethnicity is a commonly overlooked dimension of the heterogeneity in the black population living in the US. Adequate dietary evaluation may be conducive to focused nutrition interventions. Funding for this research was provided through an NIH/NIDDK sponsored grant.