Abstract

ObjectivesAdults in Puerto Rico have a high prevalence of poor diet quality, behavior that, in other United States territories, has previously been associated with increased access to imported food products. These trends raise the question of whether consumption of local food, which accounts for only 15% of the Puerto Rican food environment, may contribute to healthy dietary intake. We aimed to investigate the association between purposefully purchasing local foods (PPLF) and diet quality in Puerto Rico. MethodsThe Puerto Rico Assessment of Diet, Lifestyle, and Diseases (PRADLAD) is a 2015 cross-sectional study of 380 adults (35–75y) sampled in San Juan. To assess PPLF, participants were asked, ‘How often do you purposely purchase foods from Puerto Rico (like fruits, vegetables, meat and other products that are produced here rather than being imported)? ’ Diet was assessed through a culturally-adapted food frequency questionnaire, and diet quality was defined using the Alternative Healthy Eating Index-2010 (AHEI). Statistical analysis was conducted among participants with valid dietary data (n = 248). Multivariable generalized linear models tested the association between PPLF and AHEI, adjusted for relevant sociodemographic and behavioral factors. ResultsNearly a third (33.9%) of participants reported never/sometimes, 33.5% reported often, and 30.6% reported always PPLF. As compared to never/sometimes PPLF, fully-adjusted mean AHEI scores were 3.56 (P = 0.0383) points higher among those often PPLF and 9.34 (P < 0.0001) points higher among those always PPLF. Compared to never/sometimes PPLF, those who always PPLF had higher fully-adjusted mean component scores for vegetables (P < 0.0001), fruits (P = 0.0002), whole grain (P = 0.0391), nuts and legumes (P = 0.034), trans fat (P = 0.0003), and long-chain (Ω-3) fats (P = 0.002). ConclusionsAdults in Puerto Rico who intentionally purchase local products had significantly higher diet quality, especially regarding plant-based foods and healthy fats intake. These findings point to possible dietary benefits associated with improving local food availability. Further research on the Puerto Rican food environment is needed, including potential poor diet quality associated with imported products. Funding SourcesPrivate anonymous donations, Dry Bean Health Research Program Incentive Award, and institutional funds. Supporting Tables, Images and/or Graphs▪▪▪

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