Abstract

BackgroundEating patterns of immigrants deserve to be better documented because they may reflect the extent of acculturation and associated health risks. The study assessed dietary patterns and quality in Bubi immigrants (from Equatorial Guinea) using cluster analysis and comparing different diet quality indexes.MethodsA random sample of 83 Bubi men and 130 women living in Madrid were studied. A 99-item food frequency questionnaire was administered, body weights and heights were self-reported and socio-demographic and health information was collected during interviews. Usual intakes were collapsed into 19 food groups. Cluster analysis of standardized food intakes per 1000 kcalories was performed. Dietary quality was appraised using the Alternative Mediterranean Diet Score, the Alternative Healthy Eating Index and scores of micronutrient adequacy and prevention based on WHO/FAO recommendations.ResultsTwo dietary patterns were identified. The 'Healthier' pattern, so confirmed by two dietary quality indexes, featured a higher consumption of fish, fruits, vegetables, legumes, dairy products and bread while the 'Western' pattern included more processed meat, animal fat, and sweetened foods and drinks. One third of the subjects were in the 'Healthier' food cluster, with the same proportion of men and women. Age ≥ 30 and residence in Madrid ≥ 11 years were independently associated with the healthier diet. Consumption of traditional foods was unrelated to dietary pattern, however. Overall, Bubi diets were somewhat protective because of high intakes of fruits and vegetables and monounsaturated fat (olive oil), but not with respect to sugar, cholesterol, omega-3 fatty acids and fibre. Less than two thirds of subjects had adequate intakes of iron, calcium and folate in both dietary phenotypes. Body mass index, physical exercise, and self-reported health and cardiovascular disease condition showed no significant association with the dietary pattern.ConclusionCluster analysis combined with dietary quality assessment facilitates the interpretation of dietary patterns, but choosing the appropriate quality indexes is a problem. A small number of such indexes should be standardized and validated for international use. In the group studied, younger subjects and more recent immigrants were more likely to have a 'Western' pattern and should be a priority target for nutrition communication.

Highlights

  • Eating patterns of immigrants deserve to be better documented because they may reflect the extent of acculturation and associated health risks

  • We used the Alternative Healthy Eating Index (AHEI) [24], the Alternative Mediterranean Diet Score (AMDS) [25], and a prevention score and a micronutrient score based on Food and Agriculture Organization (FAO)/World Health Organization (WHO) recommendations [26,27] that we developed and used in different population groups [28,29,30]

  • Dietary patterns and quality in the Bubi population In the adult Bubi population of Madrid, we identified two dietary patterns using cluster analysis

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Summary

Introduction

Eating patterns of immigrants deserve to be better documented because they may reflect the extent of acculturation and associated health risks. The study assessed dietary patterns and quality in Bubi immigrants (from Equatorial Guinea) using cluster analysis and comparing different diet quality indexes. There are several good reasons to study dietary patterns and quality, including the fact that interactions and synergistic effects of foods and nutrients on health are better captured by studying the whole diet than individual components. The assessment of dietary patterns and quality is relevant among these groups as a means of appraising food acculturation and potential health consequences. Some studies suggest that recent immigrants are in better health than the host country residents – the "healthy immigrant effect" -, partly owing to health and wealth selection, but that with time, the prevalence of chronic disease factors among them reaches and even exceeds that of the native-born population [7,8,9,10,11]. Immigrants from poor areas of developing countries may be at further health risk because of suboptimal nutrition in their early life, according to the theory of developmental origins of chronic disease [16]

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