Acculturation and Sociocultural Influences on Dietary Intake and Health Status among Puerto Rican Adults in Massachusetts

Abstract

Background Previous studies have shown negative consequences of acculturation on lifestyle factors, health status, and dietary intake of Hispanic immigrants in the US. Despite prevalent type 2 diabetes and low socioeconomic status (SES) among Puerto Rican adults living on the US mainland, little is known about acculturation in this group. Objective We investigated associations among acculturation, lifestyle characteristics, health status, and carbohydrate nutrition in Puerto Rican adults. A secondary objective was to investigate possible confounding and/or effect modification on these associations by SES. Design Cross-sectional data from the Boston Puerto Rican Health Study, which included 1219 Puerto Ricans in the Boston area, aged 45–75 years. Statistical analyses Characteristics were compared using ANCOVA, linear trend and Pearson’s chi-square tests across quartiles of acculturation. Tests for interaction by poverty status were conducted. Proportional contributions of foods to intake of total carbohydrate and fiber were assessed using SAS RANK. Results Levels of acculturation were low, despite young age at first arrival to the US mainland (25.4 ± 12.3 y) and long length of stay (34.2 ± 12.2 y). Greater English language use was associated with higher SES, alcohol consumption, physical activity, better perceived health, and less central obesity. Acculturation was associated with lower legume fiber and greater cereal fiber intake. Among those above the poverty threshold, acculturation was associated with lower dietary glycemic index and starch intake, and greater fruit and non-starchy vegetable intake. Conclusions In contrast to studies with Mexican Americans, the association of acculturation with dietary quality in these Puerto Rican adults was mixed, but tended toward better carbohydrate quality. Dietary recommendations should include maintenance of traditional, healthful dietary practices including consumption of legumes, but also reduction in refined grains, and greater inclusion of fruit, non-starchy vegetables, and whole grains. Interventions to improve access to better quality carbohydrate sources are necessary for this group disproportionately affected by diabetes.

Maternal employment, acculturation, and time spent in food-related behaviors among Hispanic mothers in the United States. Evidence from the American Time Use Survey

“…This discrepancy may speak to the greater similarities between the island of Puerto Rico and the mainland US than those seen between other countries of origin and the US. Previous research has shown different patterns of dietary acculturation and weight-status among Puerto Ricans and MexicanAmericans (Bates et al, 2008;Van Rompay et al, 2012). Our findings suggest that time in food preparation may be one of the mechanisms underlying these documented dietary differences.…”

“…It is theorized that the "obesogenic" environment encountered in the US (Giskes, van Lenthe, Avendano-Pabon, & Brug, 2011;Hill, Wyatt, Reed, & Peters, 2003) plays a role in the rising rates of obesity among im/migrant (Tovar et al, 2013). These relationships are not without nuance; dietary quality may improve with acculturation among Puerto Ricans (Van Rompay et al, 2012) for whom some evidence suggests that weight may trend downward over generations on the US mainland (Bates, Acevedo-Garcia, Alegría, & Krieger, 2008), although another study indicates a pattern of weight gain (Himmelgreen et al, 2004).…”

Food-group and nutrient-density intakes by Hispanic and Latino backgrounds in the Hispanic Community Health Study/Study of Latinos

“…Another Hispanic-Latino group in whom previous published dietary estimates exist is Puerto Ricans. HCHS/SOL Puerto Ricans, who were mainly from the Bronx, reported lower intakes of total energy, macronutrients, and fiber than did those who were living in the greater Boston area (27). However, differences may have been attributed to the type of methodology used to collect dietary data (ie, 24-h recalls compared with a food-frequency questionnaire).…”

A Healthy Lifestyle Score Is Associated with Cardiometabolic and Neuroendocrine Risk Factors among Puerto Rican Adults

“…Puerto Ricans reportedly follow inadequate dietary, physical activity, smoking, and sleep habits (37)(38)(39)(40), and they also present unique patterns of social integration, social and emotional support, and cultural adjustment (41)(42)(43)(44), which may increase their vulnerability for metabolic disorders. Using the AHA recommendations on diet, physical activity, and BMI, Bhupathiraju et al (45) developed a lifestyle score that was associated with lower CVD risk factors in Puerto Rican adults.…”