Abstract
Ethnicities within Black populations have not been distinguished in most nutrition studies. We sought to examine dietary differences between African Americans (AA) and Haitian Americans (HA) with and without type 2 diabetes using the Healthy Eating Index, 2005 (HEI-05), and the Alternate Healthy Eating Index (AHEI). The design was cross-sectional N = 471 (225 AA, 246 HA) and recruitment was by community outreach. The eating indices were calculated from data collected with the Harvard food-frequency questionnaire. African Americans had lower HEI-05 scores β = −10.9 (−8.67, 13.1); SE = 1.12, P < .001 than HA. Haitian American females and AA males had higher AHEI than AA females and HA males, respectively, (P = .006) adjusting for age and education. Participants with diabetes had higher adherence to the HEI-05 β = 3.90 (1.78, 6.01), SE = 1.08, P < .001 and lower adherence to the AHEI β = −9.73 (16.3, −3.19), SE = 3.33, P = .004, than participants without diabetes. The findings underscore the importance of disaggregating ethnicities and disease state when assessing diet.
Highlights
The risk for death among people with diabetes is approximately twice that of people without diabetes of similar age groups [1]
66% of AA had a high-school diploma and/or some college compared to 37.8% of HA
There were no differences in smoking by diabetes status; nearly 35% of AAs reported being current smokers as compared to less than 7% of HA
Summary
The risk for death among people with diabetes is approximately twice that of people without diabetes of similar age groups [1]. The prevalence of diabetes for Black nonHispanic adults (≥20 years) (14.7%) is nearly twice as compared to the general population (8.3%) [1]. Complications of diabetes may be prevented by adherence to a healthy diet [2]. A national survey reported that Americans consume foods that are high in added sugar and solid fats [3]. Blacks may have lower adherence to the national dietary guidelines than the general population. African Americans have not met the recommended number of servings from any food group despite their individual perception of their diet, which they considered “good or excellent” [6]. The nutritional patterns of Blacks may account for their higher prevalence of diabetes as compared to White non-Hispanics
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