Abstract
IntroductionUS Latinos are growing at the fastest rate of any racial/ethnic group in the United States and have the highest lifetime risk of diabetes. Acculturation may increase the risk of diabetes among all Latinos, but this hypothesis has not been studied in a nationally representative sample. The objective of this study was to test the hypothesis that acculturation was associated with an increased risk of diabetes in such a sample.MethodsWe conducted a cross-sectional analysis including 3,165 Latino participants in the 2007–2010 National Health and Nutrition Examination Survey. Participants with doctor-diagnosed diabetes and participants without diagnosed diabetes who had glycated hemoglobin (HbA1C) values of 6.5% or higher were classified as having diabetes. An acculturation score, ranging from 0 (lowest) to 3 (highest), was calculated by giving 1 point for each of 3 characteristics: being born in the United States, speaking predominantly English, and living in the United States for 20 years or more. Logistic regression was used to determine the association between acculturation and diabetes.ResultsThe prevalence of diabetes among Latinos in our sample was 12.4%. After adjusting for sociodemographic factors, the likelihood of diabetes (95% confidence interval [CI]) increased with level of acculturation— 1.71 (95% CI, 1.31–2.23), 1.63 (95% CI, 1.11–2.39), and 2.05 (95% CI, 1.27–3.29) for scores of 1, 2, and 3, respectively. This association persisted after further adjustment for body mass index (BMI), total dietary calories, and physical inactivity.ConclusionAcculturation was associated with a higher risk of diabetes among US Latinos, and this risk was only partly explained by BMI and weight-related behaviors. Future research should examine the bio-behavioral mechanisms that underlie the relationship between acculturation and diabetes in Latinos.
Highlights
Introduction USLatinos are growing at the fastest rate of any racial/ethnic group in the United States and have the highest lifetime risk of diabetes
After adjusting for sociodemographic factors, the likelihood of diabetes (95% confidence interval [CI]) increased with level of acculturation— 1.71, 1.63, and 2.05 for scores of 1, 2, and 3, respectively
This association persisted after further adjustment for body mass index (BMI), total dietary calories, and physical inactivity
Summary
Latinos are growing at the fastest rate of any racial/ethnic group in the United States and have the highest lifetime risk of diabetes. Acculturation may increase the risk of diabetes among all Latinos, but this hypothesis has not been studied in a nationally representative sample. Latinos in the United States have a higher lifetime risk of diabetes than those in other racial or ethnic groups [1]. Studies have consistently demonstrated that acculturation is associated with worsening diet quality [7] and increased weight [8]. Such evidence may suggest that acculturation is positively associated with diabetes risk among Latinos, considering the role of obesity in the pathogenesis of type 2 diabetes. The nature of the relationship between acculturation and diabetes in Latinos may have implications for the prevention, clinical care, and selfmanagement of diabetes in this high-risk population
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