Dietary Practices Among US Immigrants: Energy Density as a Marker for Acculturation and Diet Quality

Abstract

Abstract Objectives The Dietary Guidelines Advisory Committee (DGAC) 2020 report indicates a need for examining the association between acculturation, dietary behaviors and disease risk. Dietary energy density (ED, kcal/g) is an established indicator of diet quality and a risk factor for chronic disease. Because ED is calculated using the whole diet, it is culturally relevant for use in a variety of populations. Past research on acculturation and diet indicates a need for more research using indicators that measure diet quality. The objective of the present study was to examine the relationship between acculturation, dietary intake, and dietary energy density. Methods Dietary data was collected using 24hour-recall in a nationally representative sample of 10 622 adults who participated in the 2013–2016 NHANES. Specific questions about acculturation were asked of participants. All data were analyzed using SAS 9.4 survey procedures to account for the complex survey design of the NHANES. Results A linear relationship between dietary ED and length of time in the US was observed (p-trend < 0.0001). Individuals who were in the US for < 5 years had the lowest dietary ED compared to those who had been in the US for the longest (1.39 vs. 1.84 kcal/g, P < 0.0004) representing ∼450 kcal/day difference after adjusting for relevant cofactors. Despite this difference, there was no difference in the amount of money spent on food compared with length of time in the US. Conclusions This study is consistent with other studies that examine changes in dietary patterns among those who have immigrated to the US. Findings from this study, specifically using ED as an indicator of diet quality, may provide recommendations to developing culturally inclusive efforts to encourage healthy diets. Funding Sources None.