Abstract
A healthy diet is associated with lower risk of chronic disease. African Americans generally have poor diet quality and experience a higher burden of many chronic diseases. We examined the associations of demographic and psychosocial factors and barriers to diet quality among African American adults. This cross-sectional study included 100 African American adults in a southeastern metropolitan area. Psychosocial factors (social support, self-efficacy), and barriers to healthy eating were assessed with validated measures. Diet quality was assessed using the Healthy Eating Index (HEI-2010). Nested linear regressions were used to examine the association between the variables of interest and HEI scores. Participants reported having social support (M (mean) = 2.0, SD (standard deviation) = 0.6, range 0–3), high levels of self-efficacy (M = 3.1, SD = 0.7, range 1–4), and low barriers (M = 1.4, SD = 0.6, range 0–4) to engage in healthy eating but total mean HEI scores needed improvement (M = 54.8, SD = 10.9, range 27.1–70.0). Participants consumed significantly higher empty calories and lower whole fruits, dairy, and total protein foods than the national average. Barriers to healthy eating (b = −12.13, p = 0.01) and the interaction between age and barriers (b = 0.25, p = 0.02) were most strongly associated with lower HEI scores. Younger African Americans with the highest barriers to healthy eating had the lowest HEI scores. Culturally appropriate interventions targeting empty calories, barriers to healthy eating, and knowledge of the Dietary Guidelines for Americans are needed for African Americans.
Highlights
Amidst reports of health improvements, African Americans living in the United States continue to be disproportionately impacted by chronic disease resulting in higher death rates compared to Nutrients 2019, 11, 519; doi:10.3390/nu11030519 www.mdpi.com/journal/nutrientsNutrients 2019, 11, 519 non-Hispanic whites [1,2]
This study is a secondary analysis of data from a parent study conducted in 2008–2009 that employed a cross sectional design to examine perceptions of healthy eating and physical activity among African American adults in Lexington, Kentucky
No participant had a diet rated in the “good” category (HEI > 80)
Summary
Amidst reports of health improvements, African Americans living in the United States continue to be disproportionately impacted by chronic disease resulting in higher death rates compared to Nutrients 2019, 11, 519; doi:10.3390/nu11030519 www.mdpi.com/journal/nutrientsNutrients 2019, 11, 519 non-Hispanic whites [1,2]. African Americans are 1.4 times as likely to be obese, 1.5 times more likely to have hypertension, and are more than twice as likely to have diabetes or a stroke than their non-Hispanic white counterparts [3,4,5,6,7]. This disparity leads to greater reduction in income (due to lost productivity), and higher cost for care in terms of responsibilities and medical expenses. Poor diet quality is a leading risk factor for chronic diseases and consumption of high quality diets have been associated with significantly lower risk in chronic disease and all-cause mortality [11,12,13,14,15]
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