Abstract
ObjectivesLittle is known about the multilevel determinants of dietary intake among Native American (NA) adults across multiple tribal communities. Thus, we aimed to identify the household and individual-level factors associated with daily consumption of fruits, vegetables (FV), and fiber among NA adults. MethodsA random sample of 601 adults from 6 NA communities was included in the baseline assessment of the OPREVENT2 trial. A semi-quantitative Block Food Frequency Questionnaire was used to estimate daily intakes of FV and fiber. An interviewer-administered questionnaire assessed individual (sex, age, education level, employment status, weight status, smoking status) and household (household size, federal nutrition program participation, and material standard of life score) factors. Outliers and respondents with missing data were not included (n = 61). Multiple logistic regression models assessed individual and household-level factors associated with adequate daily vegetable (2.5 cups for women, 3 cups for men) and fiber intake (women: 25 g, men: 38 g). Poisson regression was used to identify factors associated with daily consumption of at least 1 cup-equivalent of fruit. Analyses were controlled for daily caloric intake and seasonality. ResultsOn average, NA adults consumed 0.53 ± 0.42 servings of fruit and 2.48 ± 1.78 vegetables/day. Females were more likely than males to have adequate vegetable and fiber intake (OR 2.3; 95% CI 1.44–3.77 and OR 151.9; 95% CI 26.85–859.35). Adults ages >51 were twice as likely to have adequate vegetable intake (OR 2.1; 95% CI 1.22–3.62) and those ages 31–50 and > 51 had higher odds for adequate fiber intake (OR 3.4; 95% CI 1.15–10.29 and OR 12.9; 95% CI 3.88–43.26) than younger adults (ages 18–30). Employed adults were less likely to have adequate fiber consumption than unemployed (OR 0.5; 95% CI 0.25–0.98). Individual factors were not associated with fruit consumption. Household factors were not associated with FV or fiber consumption. ConclusionsIndividual factors were associated with vegetable and fiber intakes, underscoring the need for a targeted approach in improving diet quality among NA adults. Our results also suggest that future interventions should target improving FV and fiber intake among younger men who seem to be at higher risk of low diet quality. Funding SourcesNational Heart, Lung, and Blood Institute R01.
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