Foods Contributing to Macronutrient Intake of Women Living in Puerto Rico Reflect Both Traditional Puerto Rican and Western-Type Diets

Abstract

Lack of variability in dietary intake within a population makes identification of relationships between diet and disease difficult. Studies in populations with greater interindividual variation can provide important insights. The Puerto Rican diet is in transition from a traditional to a more Western-type diet, resulting in greater interindividual variability. We identified foods contributing to absolute intake and variability in the intake of macronutrients among Puerto Rican women. One hundred women, aged 30–79, residents of San Juan, Puerto Rico, completed three, interviewer-administered, 24-h dietary recalls from which foods contributing to absolute intake and intake variability in intake of energy, fat, protein, carbohydrate and dietary fiber were determined. The overall prevalence of intake of foods was also calculated. Traditional Puerto Rican foods such as legumes, rice, and plantains were important contributors to the intake of calories and macronutrients as were foods more typical of Western diets including white bread and sweetened carbonated beverages. Identification of food sources of nutrients for this population with a diet in transition can contribute to the development of instruments to measure dietary intake and to understand the contribution of diet to the etiology of chronic disease among Puerto Rican women.

Dietary Intake and Its Determinants Among Adults Living in the Metropolitan Area of Puerto Rico

“…Similar to our study, others have found consistent results for low intake of fruit and vegetables and high intake of fried foods, starches, rice, and sugar-sweetened beverages [12,13,15]. A recent study ranked the top foods contributing to total energy among women in PR as white bread/rolls/crackers, rice, plantain dishes, rice and vegetable dishes, and reduced-fat milk [15]. While the percent contribution and specific ranking varied from our study, likely due to differences in food groupings, the results were consistent in ranking refined carbohydrates, dairy, and starch as the main contributors to energy.…”

“…Similar to our study, others have found consistent results for low intake of fruit and vegetables and high intake of fried foods, starches, rice, and sugar-sweetened beverages [12,13,15]. A recent study ranked the top foods contributing to total energy among women in PR as white bread/rolls/crackers, rice, plantain dishes, rice and vegetable dishes, and reduced-fat milk [15].…”

“…Only 32% of adults in PR have been reported to have sufficient vitamin D levels [14]. Reports on food sources are more limited, but a recent small study among adult women residing in San Juan, PR showed that both traditional Puerto Rican foods such as legumes, rice, and plantains, as well as typical Western diet foods such as white bread and sweetened carbonated beverages, contributed to energy intake [15]. As of 2013, there were 59 fast-food establishments per 100,000 residents in PR, and these were visited 7.3 (men) and 6.4 (women) times/month [16].…”

Strategies for Healthy Eating Promotion and Behavioral Change Perceived as Effective by Nutrition Professionals: A Mixed-Methods Study

“…The foods that were mentioned as difficult to eliminate from the diet have all been reported as frequently consumed in PR, especially sugary beverages, sweets and desserts, fats and fried foods, and white rice ( 6 , 7 , 9 , 10 ). Other populations have also expressed a high preference for white rice, a staple food in the Latino culture, over potential substitutes such as brown rice, despite a willingness to reduce its intake ( 27 , 28 ).…”

“…Despite these efforts, following a healthy diet continues to be challenging, as evidenced by the low diet quality reported for most residents of the United States, with well-documented disparities for low socioeconomic and racial/ethnic minority groups (2)(3)(4). Specifically, the population of Puerto Rico (PR) has inequitable health-related behaviors, including low diet quality and poor nutritional intake (5)(6)(7)(8)(9)(10), as well as the high prevalence of multiple chronic diseases that may be prevented by following a healthy lifestyle (11). It is thus important to understand which strategies for healthy eating may be appropriate for a population, especially underserved individuals with inequitable health.…”