Dietary Acculturation Research Articles

Characteristics of Dietary Behaviors and Effects of Dietary Acculturation in East African Immigrants Living in the San Diego Area: Preliminary Insights from the HAWAASH2 Study

Characteristics of Dietary Behaviors and Effects of Dietary Acculturation in East African Immigrants Living in the San Diego Area: Preliminary Insights from the HAWAASH2 Study

Dietary Acculturation Among International Students in the United Kingdom

There is a significant rise in the proportion of international students pursuing tertiary education in the United Kingdom. This population coming from different countries faces a lot of challenges which contribute to negative health effects and needs further attention. One among these challenges is dietary acculturation. This systematic review aims to explore the factors influencing dietary acculturation and its public health impacts among international students in the UK. Five online databases namely ProQuest Central, Web of Science, Scopus, PsycINFO and Medline were searched, and nine qualitative articles were selected that met the eligibility criteria which were then assessed for quality using Critical Appraisal Skills Programme (CASP) checklist. Methodology involved data extraction and a thematic synthesis, which identified three themes and several sub-themes. The findings of this review indicate that dietary acculturation among international students was affected by tight academic schedules and global fast-food chains. This led to students consuming unhealthy food, contributing to weight gain. However, having social ties and interaction were found to be helpful in dietary acculturation. Higher education institutions can emphasis on nutrition education with focus on substitute foods, alternatives to unhealthy choices, and initiatives to make bicultural food accessible to the students to make the new environment conducive to learning. Public health policies as well as regulations can be made on informed decisions based on an understanding of differences and specific needs of the foreign student population.

Acculturating to multiculturalism: a new dimension of dietary acculturation among Asian American, Native Hawaiian, and Pacific Islander women in the San Francisco Bay Area, USA

BackgroundDietary acculturation is the process by which diet and dietary practises from the environment of origin are retained or changed and/or those prevalent in a new environment are adopted. Despite rapid population growth the U.S., knowledge gaps exist on characterising dietary acculturation among Asian American, Native Hawaiian, and Pacific Islander communities (AANHPI). This study characterise dietary patterns in a sample representative of AANHPI on key demographic characteristics.MethodsData were from a 2013–2014 population-based case-control study in the San Francisco Bay Area, U.S. Survey items were adapted from dietary acculturation scales developed for AANHPI populations. Validated measures assessed social capital, social standing, discrimination and immigration experiences. A principal components factor analysis was conducted to characterise dietary patterns of acculturation.ResultsThree dietary patterns were identified: “Asian,” “Western,” and a distinct “Multicultural” factor. Respondents reporting a high-Asian diet tended to also report smaller social networks, higher levels of stress, and, among those born outside of the U.S., an educational standing that was better before immigration. Respondents reporting a high-Western diet tended to also report the highest level of discrimination. Those reporting a high-Multicultural diet tended to report higher neighbourhood collective efficacy.ConclusionsThe finding of a distinct “Multicultural” factor beyond the typical “Asian” and “Western” factors may reflect the multidirectional relationships between culture, diet, and dietary behavior, in which origin and destination cultures interact in complex ways and where foods from multiple ethnicities intermix.

Dietary Acculturation Is Associated With Altered Gut Microbiome, Circulating Metabolites, and Cardiovascular Disease Risk in US Hispanics and Latinos: Results From HCHS/SOL.

Dietary acculturation, or adoption of dominant culture diet by migrant groups, influences human health. We aimed to examine dietary acculturation and its relationships with cardiovascular disease (CVD), gut microbiota, and blood metabolites among US Hispanic and Latino adults. In the HCHS/SOL (Hispanic Community Health Study/Study of Latinos), US exposure was defined by years in the United States (50 states and Washington, DC) and US nativity. A dietary acculturation pattern was derived from 14 172 participants with two 24-hour dietary recalls at baseline (2008-2011) using least absolute shrinkage and selection operator regression, with food groups as predictors of US exposure. We evaluated associations of dietary acculturation with incident CVD across ≈7 years of follow-up (n=211/14 172 cases/total) and gut microbiota (n=2349; visit 2, 2014 to 2017). Serum metabolites associated with both dietary acculturation-related gut microbiota (n=694) and incident CVD (n=108/5256 cases/total) were used as proxy measures to assess the association of diet-related gut microbiome with incident CVD. We identified an empirical US-oriented dietary acculturation score that increased with US exposure. Higher dietary acculturation score was associated with higher risk of incident CVD (hazard ratio per SD, 1.33 [95% CI, 1.13-1.57]), adjusted for sociodemographic, lifestyle, and clinical factors. Sixty-nine microbial species (17 enriched from diverse species, 52 depleted mainly from fiber-utilizing Clostridia and Prevotella species) were associated with dietary acculturation, driven by lower intakes of whole grains, beans, and fruits and higher intakes of refined grains. Twenty-five metabolites, involved predominantly in fatty acid and glycerophospholipid metabolism (eg, branched-chain 14:0 dicarboxylic acid** and glycerophosphoethanolamine), were associated with both diet acculturation-related gut microbiota and incident CVD. Proxy association analysis based on these metabolites suggested a positive relationship between diet acculturation-related microbiome and risk of CVD (r=0.70, P<0.001). Among US Hispanic and Latino adults, greater dietary acculturation was associated with elevated CVD risk, possibly through alterations in gut microbiota and related metabolites. Diet and microbiota-targeted interventions may offer opportunities to mitigate CVD burdens of dietary acculturation.

Assessment of diet composition of Pakistani ethnic groups in the UK – does dietary pattern change between 1st and 2nd generations?

Dietary acculturation in immigrant groups can impact health and may increase the risk of conditions like diabetes and cardiovascular disease among East Asian immigrants as they adopt host-country eating patterns(1). Pakistani immigration to the UK has resulted in a dynamic cultural exchange, including modifications in culinary preferences and practices among Pakistani ethnic groups. Prior research indicates that second-generation adults exhibit more signs of acculturation in their choice of diets than their first-generation counterparts (2). There is limited understanding of the food habits or the effects of acculturation on this group. The primary purpose of this study was to investigate intergenerational disparities in food preferences among Pakistani immigrants and the impact of dietary acculturation.This cross-sectional study examined the food habits and acculturation experiences of 51 first (1G) and 51 second-generation (2G) participants of the Pakistani community living in London. Data was collected using survey questionnaires modified from previous studies (3,4). We compared traditional foods like paratha and samosa with Western options like fish and chips through a set of questions, from which a dietary score was calculated (Global scale) (5). We measured food acculturation using a 5-point scale, with higher scores indicating greater Western influence and lower scores indicating less Western acculturation. Scores ranged from 6 to 30 and were categorised as low, moderate, high, or very high. Data was analysed using SPSS (version 28.0). Chi-square and t-tests were applied to identify differences between groups with significance levels set to p&lt;0.05.Most of the participants were male (67%) with 38.8% aged 36-45 years. Urdu ethnicity predominated in both generations (64.8%). Significant differences in dietary restrictions for health conditions (p =.008), language (p = .001), consumption frequency of traditional Pakistani cuisine (p = .001), desserts/sweets (p = .001), chai/lassi (p = .017), popular UK meals, fizzy drinks, and inclusion of rice/flatbread (p = .003) emerged between first and second generations. Health-related dietary behaviours differed in fruits/vegetables, dairy, and meat consumption (p =.001). ‘Traditional’ and ‘Western’ dietary scores were significantly different between generations (‘Traditional’: 1G: 17.15 ± 3.52 vs 2G: 13.68 ± 4.71, p = .001; ‘Western’: 1G: 16.29 ± 1.98 vs 2G: 18.21 ± 3.84, p = .001). The results demonstrated a preference for traditional eating patterns by 1G, whereas a nuanced move towards Western food preferences was observed among the 2G participants, falling into the high category of global scale. 1G Participants cited language acquisition, time constraints, and financial issues as factors affecting their dietary changes.This study found significant differences in dietary habits and preferences between first- and second- generation Pakistani immigrants in the United Kingdom. The second generation displayed a more significant shift towards Western food patterns, possibly because of socio-cultural variables, language fluency, and adaptability to the local environment.

Reassessing Established Assumptions of Dietary Habits in the USA in the Context of Migration and Acculturation: a Qualitative Study of Latino Immigrants.

The growing prevalence of obesity in the USA disproportionately affects Latinos compared to non-Latino Whites. Immigration and acculturation have been associated with unhealthy dietary shifts among Latino immigrants, a phenomenon known as dietary acculturation. Emerging evidence points to a more nuanced relationship between dietary habits, immigration, and acculturation, highlighting the need for a more current comprehension of dietary acculturation. We explored how Latino immigrants' experiences in migrating to the USA have affected their perceived dietary habits and their experiences of how supportive the USA is in establishing healthy practices compared to their native country. Employing a descriptive qualitative study design, we conducted semi-structured interviews with 19 Latinos who had participated in a lifestyle change program between 2016 and 2019. We used thematic analysis to analyze the data and report emerging themes. Participants expressed divergent perceptions of their dietary habits post-immigration. Some affirmed prevailing assumptions of dietary acculturation, citing deteriorating diet quality in the USA in the context of a faster pace of life, healthier options in the native country, and shifts in the food environment that prevented access to healthy foods. Conversely, others held opposing views, attributing their perceived improved diet to unhealthy dietary habits in Latin America, coupled with increased access to and affordability of healthy foods in the USA. Our study contributes to the evolving understanding of dietary acculturation among Latino immigrants and provides a more nuanced and updated understanding of this process that reflects their current experiences in acculturating to the USA.

UNFAVORABLE VISA STATUS AND INTERSECTING ACCULTURATION FACTORS LINKED TO DEPRESSION

Aims: This study proposes that visa status and acculturation are important constructs for understanding depression among immigrants. Method: The association between visa status and acculturation with depression status among immigrants residing in the United States was examined. Visa status was operationalized as favorable and unfavorable. Acculturation was measured as English language proficiency and diet change. Depression was assessed as the presence of depressive symptoms or symptoms suppressed by antidepressants. Results: Results showed that immigrants with unfavorable visa statuses have higher levels of depression compared to favorable visa status holders. Also, English language proficiency was associated with higher levels of depression among unfavorable visa holders compared to favorable visa status holders. Lower dietary acculturation was associated with a higher level of depression among unlimited family, refugee, diversity, and other visa holders. Conclusions: Different visa categories appeared to have unique patterns of association with depression depending on their acculturation level and type.

Abstract P486: Dietary Acculturation is Associated With Altered Gut Microbiome, Circulating Metabolites, and Cardiovascular Disease Risk in US Hispanics/ Latinos: Results From the Hispanic Community Health Study/Study of Latinos

Introduction: Dietary acculturation, defined as diet adaptation after migration, is related to human health. However, the influence of dietary acculturation on cardiovascular disease (CVD) is largely unknown, nor is the potential mechanism clear. Hypothesis: Dietary acculturation (diet reflecting U.S. exposure - years in the U.S. and nativity [U.S. 50 states/DC vs. foreign-born]) is associated with altered gut microbiota and related metabolites, which may contribute to CVD risk. Methods: A dietary acculturation score was derived from 14172 participants with two 24-hr dietary recalls at baseline (2008-11) using LASSO regression (29 food groups as predictors of U.S. exposure). We evaluated associations of dietary score with incident CVD over 7 years follow-up (including coronary heart disease, stroke and heart failure, n=14172/211 total/cases) and gut microbiota (shotgun sequencing, n=2349, 2014-17). Further, we identified serum metabolites associated with diet-related microbiome (n=694, 2014-17) and examined associations of baseline metabolites with incident CVD (n=5256/108 total/cases). Results: We identified a dietary acculturation pattern (Fig1A) which increased with years in the U.S. and was highest in U.S.-born adults (Fig1B). Higher dietary acculturation was associated with risk of incident CVD (HR per SD, 1.33 [95%CI: 1.13-1.57]), adjusting for sociodemographic, lifestyle, and clinical factors. We identified 69 diet-related species (17 enriched and 52 depleted, mainly from Clostridium , Prevotella and Eubacterium , Fig1C), and 25 metabolites associated with both diet-related microbiome score and incident CVD (Fig1D). Proxy association analysis based on these metabolites suggested a positive relationship between diet-related microbiome and incident CVD (r=0.70, p&lt;0.001) (Fig1E). Conclusions: Among U.S. Hispanics/Latinos, greater dietary acculturation was associated with increased risk of CVD, possibly via diet-related alterations in gut microbiota and related serum metabolites.

Development of dietary assessment instruments which can take cultural diversity and dietary acculturation into account: eating in Sweden (‘Mat i Sverige’)

Abstract Since lack of culture-specific foods in dietary assessment methods may bias reported dietary intake, we identified foods and dishes consumed by residents not born in Sweden and describe consequences for reported foods and nutrient intake using a culturally adapted dietary assessment method. Design consisted of cross-sectional data collection using (semi-)qualitative methods of dietary assessment (and national diet survey instrument RiksmatenFlex) with subsequent longitudinal data collection using quantitative methods for method comparison (December 2020–January 2023). Three community-based research groups were recruited that consisted of mothers born in Sweden, Syria/Iraq, and Somalia, with a median age of 34, 37, and 36 years, respectively. Women born in Syria/Iraq and Somalia who had lived in Sweden for approximately 10 years, reported 78 foods to be added to RiksmatenFlex. In a subsequent study phase, 69% of these foods were reported by around 90% of the ethnic minority groups and contributed to 17% of their reported energy intake. However, differences between the three study groups in median self-reported energy intake remained (Sweden 7.19 MJ, Syria/Iraq 5.54 MJ, and Somalia 5.69 MJ). The groups also showed differences in relative energy contribution from fats and carbohydrates, as well as differences in energy intake from food groups such as bread and sweet snacks. We conclude that a dietary assessment instrument containing culture-specific foods could not resolve group differences in reported energy intake, although these foods provided content validity and contributed 17% of energy intake. The dietary habits collected in this study serve to develop new dietary assessment instruments.

Perceived barriers and facilitators to healthy eating among Pakistani women participating in the PakCat program in Catalonia: A qualitative approach

Immigrant women of Pakistani origin are among the most at-risk groups for type 2 diabetes, obesity, and heart failure in Catalonia. As the incidence of these diseases is associated with lifestyle factors, we approached this community with participatory research and conducted six focus groups (N = 36) among Pakistani women participating in the PakCat Program. The research process of this paper adhered to the COREQ checklist. Through the thematic analysis, we identified six main themes: social beliefs and attitudes, family environment, personal factors, dietary acculturation, traditional dietary patterns, and economic factors. We discovered both facilitators and barriers associated with each theme, but the findings indicated that Pakistani women encounter more inhibitors than enablers to following a healthy diet. The determination of these factors can facilitate the reinforcement of the aspects that help Pakistani women to follow a healthy diet and provide adequate tools to overcome the barriers.

Hypertension Prevalence, Awareness, Treatment, Control and Risk Factors in Tribal Population of India: a Multi-Centric Cross-Sectional Study.

The prevalence of hypertension is increasing in the tribal population of India. Lifestyle modifications, including dietary changes and acculturation, are the main reasons for the high prevalence of hypertension among the Indian indigenous (tribal) population. This paper reports hypertension prevalence, awareness, treatment, control and risk factors among tribes in five districts of different geographical zones of India. A cross-sectional study was conducted among the adult tribal population of 7590 from these states. Data related to blood pressure, anthropometry, demographic and behavioural variables were collected with prior consent from the participants. The prevalence of hypertension is 34.0% and 28.3% among men and women, respectively. Of the total hypertensives, 27.5% were aware of their hypertension status; of them, 83.9% were receiving treatment, and blood pressure was in control among 33.5% of patients who were receiving treatment. Age, alcohol intake, sedentary lifestyle, Particularly Vulnerable Tribal Groups status and body mass index are found to be significantly associated with the prevalence of hypertension. The prevalence of hypertension is high among these tribal populations, which could be due to modernization and acculturation. Awareness and treatment-seeking behaviour are poor. Hence, early screening, awareness campaigns for seeking treatment, and health promotion are immediately required. Comprehensive health promotion programs need to promote lifestyle modification and re-orientation of the primary health care system to improve availability and accessibility to hypertension screening and treatment.

The intersection of social determinants of health, the microbiome, and health outcomes in immigrants: A scoping review.

In the present scoping review, we explore whether existing evidence supports the premise that social determinants of health (SDoH) affect immigrant health outcomes through their effects on the microbiome. We adapt the National Institute on Minority Health and Health Disparities' research framework to propose a conceptual model that considers the intersection of SDoH, the microbiome, and health outcomes in immigrants. We use this conceptual model as a lens through which to explore recent research about SDoH, biological factors associated with changes to immigrants' microbiomes, and long-term health outcomes. In the 17 articles reviewed, dietary acculturation, physical activity, ethnicity, birthplace, age at migration and length of time in the host country, socioeconomic status, and social/linguistic acculturation were important determinants of postmigration microbiome-related transformations. These factors are associated with progressive shifts in microbiome profile with time in host country, increasing the risks for cardiometabolic, mental, immune, and inflammatory disorders and antibiotic resistance. The evidence thus supports the premise that SDoH influence immigrants' health postmigration, at least in part, through their effects on the microbiome. Omission of important postmigration social-ecological variables (e.g., stress, racism, social/family relationships, and environment), limited research among minoritized subgroups of immigrants, complexity and inter- and intra-individual differences in the microbiome, and limited interdisciplinary and biosocial collaboration restrict our understanding of this area of study. To identify potential microbiome-based interventions and promote immigrants' well-being, more research is necessary to understand the intersections of immigrant health with factors from the biological, behavioral/psychosocial, physical/built environment, and sociocultural environment domains at all social-ecological levels.

Considering the role of integration experiences in shaping immigrants' post-migration food choices and eating practices.

This article draws on data collected from qualitative interviews with 38 recent immigrants in two Ontario cities to provide an overview of recent immigrants' general dietary acculturation experiences. With insights from both Cockerham's health lifestyle theory and Berry's acculturation model, this article explores how structural inequalities related to integration and settlement may shape recent immigrants' post-migration food choices and eating practices. The results of this study revealed that immigrants from non-Western countries experienced greater challenges in healthy eating. Findings are in line with Cockerham's health lifestyle theory: immigrants' post-migration food choices and dietary acculturation strategies were not only bounded by socioeconomic status and cultural differences but were also shaped by various structural inequalities, especially those related to systematic barriers during the integration and settlement process. Overall, this paper provides a more holistic understanding of the multifaceted nature of immigrants' dietary acculturation experiences.

Differences in Nutrient Intake and Diet Quality among Non-Hispanic Black Adults by Place of Birth and Length of Time in the United States.

Prior research suggests that migrating to the United States (US) can negatively affect the diets and health of immigrants. There is limited information on how relocating to the US affects the diets of Black-identifying immigrants. To address this gap, this study examined differences in nutrient intake and diet quality among non-Hispanic Black adults by place of birth and length of time in the US. Cross-sectional data from the National Health and Nutrition Examination Survey (2005-2016) were analyzed. Approximately 6508 non-Hispanic Black adults were categorized into three groups: foreign-born (FB) living in the US <10 years (n = 167), FB living in the US ≥ 10 years (n = 493), and US-born (n = 5848). Multivariable-adjusted logistic and linear regression models were evaluated to identify differences in nutrient intake and diet quality (as measured by the Healthy Eating Index (HEI) of 2015) across the three groups when controlling for socio-demographics. Compared to US-born adults, both FB groups had significantly higher HEI-2015 scores and higher odds of meeting dietary recommendations for several nutrients: saturated fat, sodium, and cholesterol. There were no differences in nutrient intake between the two FB groups; however, FB (<10 years) adults had better diet quality than FB (≥10 years) ones. Place of birth and length of time in the US were associated with dietary intake among non-Hispanic Black adults. More research is needed to improve understanding of dietary acculturation among Black-identifying immigrants in the US.

Perceptions of dietary intake amongst Black, Asian and other minority ethnic groups in high-income countries: a systematic review of qualitative literature

Background Minority ethnic groups are a fast-growing population in many high-income countries, partly due to the increasing population of immigrants and second-generation migrants. The dietary practices of some of these minority ethnic groups might make them to be disproportionately affected by obesity and increase their risks of developing non-communicable diseases. Population-specific interventions and strategies are vital to addressing poor nutritional practices among this population. Thus, this study systematically reviewed the perceptions of dietary intake amongst Black, Asian and other minority ethnic groups in high-income countries.MethodsThis systematic review was conducted in line with the guidelines of the Joanna Briggs Institute (JBI) methodology for systematic reviews, using a meta-aggregative design. This systematic review identified and synthesised qualitative literature on the perceptions of dietary intake amongst BlackAsian and other minority ethnic groups in high-income countries. An extensive and comprehensive database search was conducted between January 2000 – May 2022 and included twenty (20) studies that met the eligibility criteria from six countries. The included studies were assessed for quality using the JBI qualitative assessment and review instrument. The JBI data extraction tools were used to retrieve relevant data from included articles, and the data were thematically analysed.ResultsWe identified eight major themes across this database: (1) “Social and Cultural Factors,” (2) “Availability and Accessibility,” (3) “Family and Community Influences,” (4) “Food Preferences”, (5) “Home Country Food Versus Host Country Food” (6) “Dietary Acculturation” (7) “Health and Healthy Eating” (8) “Perception of Nutritional Information.”ConclusionOverall, Black, Asian, and other minority ethnic groups individuals were found to be aware of the effects of unhealthy eating on their health, and some of them have nutritional knowledge, but social and cultural factors, including structural factors, were deterrents to their healthy eating behaviours. An important finding from this review is that some participants believed that nutritional information, based on bio-medical science, was intended for only White population groups and that it was antagonistic to their cultural and community well-being.

Beyond Dietary Acculturation: How Latina Immigrants Navigate Exclusionary Systems to Feed Their Families

Abstract Previous studies of dietary acculturation explain how immigrants’ diets change over time, but they don't tell us why. In response to calls for additional research on the complex social processes that shape health disparities, this study uses an intersectional approach to examine the role of food in the daily lives of 23 Latina immigrants living in North Carolina. Our findings, based on semi-structured interviews conducted over a five-year period, refute the idea of a unidirectional process in which immigrants abandon dietary customs from their home countries. Instead, we show how food decisions are complex, contradictory, and contextual. Latina immigrant mothers embraced and resisted parts of dominant food cultures. They strategically took risks and made tradeoffs to ensure that their families had enough food and the right kinds of food. However, political and economic structures limited their access to food and impeded their ability to autonomously make food decisions. We argue that an unequal and industrialized food system, restrictive and punitive immigration policies, and narrowly-defined food assistance programs infringe on immigrants’ ability to feed their families. By excluding and othering immigrant families, these structures reduce immigrants’ autonomy and perpetuate inequalities, contributing to what previous studies have described as dietary acculturation.

Similarities and Dissimilarities in Diet Quality Differences by Acculturation Level between Mexican Americans and Other Hispanic Americans: National Health and Nutrition Examination Survey 2015–2018

BackgroundEvidence suggests dietary acculturation can increase obesity and chronic disease risks. However, acculturation effects on diet quality among subgroups of Hispanic Americans is not well studied. ObjectivesEstimating percentages of Hispanic Americans with low, moderate, and high acculturation using 2 proxy measures with different language variables was the first objective. Identifying similarities and dissimilarities in diet quality differences by acculturation level between Mexican Americans and other Hispanic Americans was the second objective. MethodsThe study sample included 1733 Mexican American and 1191 other Hispanic participants aged ≥16 y from National Health and Nutrition Examination Survey 2015–2018. Proxy measures included in the 2 acculturation scales were nativity/United States residence length, immigration age, language spoken at home (home), and language of dietary recall (recall). Replicate 24-h dietary recalls were conducted, and diet quality was assessed using the 2015 Healthy Eating Index. Analyses included statistical methods for complex survey designs. ResultsFor Mexican Americans, 8%, 35%, and 58% had low, moderate, and high acculturation on the home scale compared with 8%, 30%, and 62% on the recall scale. For other Hispanics, 17%, 39%, and 43% had low, moderate, and high acculturation on the home scale compared with 18%, 34%, and 48% on the recall scale. Similarities between ethnicities included higher acculturation associated with lower intakes of fruits, vegetables, total protein foods, seafood and plant proteins, and saturated fats and greater intake of sodium. Dissimilarities included higher acculturation associated with more whole grains and added sugars intakes and less refined grains intake (Mexican Americans), and less total dairy and fatty acids intakes (other Hispanic Americans). ConclusionsHigher acculturation is associated with worsening diet quality for fruits, vegetables, and protein foods in all Hispanic Americans. However, associations of higher acculturation with worsening diet quality for grains, added sugars, dairy, and fatty acids were present only in specific subgroups of Hispanic Americans.

Dietary Acculturation and Food Habit Changes among Chinese Immigrants in Portugal.

Chinese individuals who immigrate to a Western country tend to change their eating patterns and behaviors depending on how long they live in the host country. This is dietary acculturation, and it can have a positive or negative impact on eating habits. Thus, we aimed to characterize the dietary acculturation of the Chinese immigrant community in Portugal and check the trend of the direction of this acculturation. The study involved 213 immigrants and assessed food consumption, meal patterns, and dietary acculturation. A mean Western acculturation score of 70.1 ± 8.9. was identified and 71.4% had a high Western acculturation score. No one had low or very high Western acculturation. Participants who have a higher level of acculturation tend to have higher energy and fat intake. The likelihood of mixing meals, including, and combining, Chinese and Portuguese meals and foods is associated with time spent in Portugal. Efforts should be made to encourage Chinese immigrants to make a positive dietary transition during their acculturation process.

Looking Across and Within: Immigration as a Unifying Structural Factor Impacting Cardiometabolic Health and Diet.

Immigration has been identified as an important social determinant of health (SDH), embodying structures and policies that reinforce positions of poverty, stress, and limited social and economic mobility. In the public health literature with regard to diet, immigration is often characterized as an individual-level process (dietary acculturation) and is largely examined in one racial/ethnic subgroup at a time. For this narrative review, we aim to broaden the research discussion by describing SDH common to the immigrant experience and that may serve as barriers to healthy diets. A narrative review of peer-reviewed quantitative, qualitative, and mixed methods studies on cardiometabolic health disparities, diet, and immigration was conducted. Cardiometabolic disease disparities were frequently described by racial/ethnic subgroups instead of country of origin. While cardiovascular disease and obesity risk differed by country of origin, diabetes prevalence was typically higher for immigrant groups vs United States (US)-born individuals. Common barriers to achieving a healthy diet were food insecurity; lack of familiarity with US food procurement practices, food preparation methods, and dietary guidelines; lack of familiarity and distrust of US food processing and storage methods; alternative priorities for food purchasing (eg, freshness, cultural relevance); logistical obstacles (eg, transportation); stress; and ethnic identity maintenance. To improve the health of immigrant populations, understanding similarities in cardiometabolic health disparities, diet, and barriers to health across immigrant communities-traversing racial/ethnic subgroups-may serve as a useful framework. This framework can guide research, policy, and public health practices to be more cohesive, generalizable, and meaningfully inclusive.

Government-Assisted Syrian Refugees' Perceptions of Dietary Acculturation in Canada

Diet acculturation is a complicated process where refugees must discover new ways of consuming traditional foods, adopt new foods, or eliminate other foods from their diets in a host country. The purpose of this phenomenological case study was to explore the ways in which Syrian refugees describe diet acculturation since their arrival to a city in Southern Ontario. Individuals eligible to participate were government-assisted Syrian refugees who were at least 18 years old. Purposive and snowball sampling methods were used to recruit participants. Researcher-constructed, semi-structured, face-to-face interviews were used to collect data in Arabic. Data were recorded and transcribed verbatim in Arabic and then translated to English. Inductive coding, second-cycle coding and thematic analysis were used to analyze the data. Using the dietary acculturation model as a lens, the study found participants sought to maintain a connection to their Syrian identity through food, yet food prices, access, and quality and perceptions of health, along with children’s peer influence resulting in bicultural eating patterns impacted the participants’ experiences with dietary acculturation. The results of the study will assist food and nutrition professionals in understanding dietary acculturation in the Syrian refugee population.