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Title: Diet quality among U.S.-born and foreign-born non-hispanic blacks: NHANES 2003-2012 data

Author
item BROWN, ALISON - Tufts University
item HOUSER, ROBERT - Friedman School Of Nutrition
item MATTEI, JOSIEMER - Harvard University
item REHM, COLIN - Albert Einstein College Of Medicine
item MOZAFFARIAN, DARIUSH - Friedman School Of Nutrition
item LICHTENSTEIN, ALICE - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item FOLTA, SARA - Friedman School Of Nutrition

Submitted to: The American Journal of Clinical Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 1/24/2018
Publication Date: 5/2/2018
Citation: Brown, A.G., Houser, R.F., Mattei, J., Rehm, C., Mozaffarian, D., Lichtenstein, A.H., Folta, S. 2018. Diet quality among U.S.-born and foreign-born non-hispanic blacks: NHANES 2003-2012 data. American Journal of Clinical Nutrition. 107(5):695-706. https://doi.org/10.1093/ajcn/nqy021.
DOI: https://doi.org/10.1093/ajcn/nqy021

Interpretive Summary: Non-Hispanic Blacks in the U.S. are less likely to meet national dietary recommendations than non-Hispanic Whites. However, most studies do not consider nativity of U.S. Blacks. Using the Alternative Healthy Eating Index-2010 (AHEI-2010) and Dietary Approach to Stop Hypertension (DASH) scores, this cross-sectional study compared diet quality between U.S.-born and foreign-born non-Hispanic Black adults aged 22-79 based on pooled nationally representative data (NHANES 2003-2012) as well as by length of U.S. residency. Foreign-born Blacks had significantly higher diet quality on the basis of both the AHEI-2010 and DASH scores compared to U.S-born Blacks and more favorable intakes for many of the individual score components. Among foreign-born Blacks, diet quality did not significantly differ by length of residency. Foreign-born Blacks were more likely to be in the high than low tertile for fruit (including and excluding fruit juice), vegetables (excluding starchy vegetables), proportion of whole grains, and omega-3 fatty acids. Foreign-born Blacks have better diet quality compared to their U.S.-born counterparts. Considering nativity among U.S. Blacks in nutrition research and public health efforts may improve accuracy of characterizing dietary intakes and facilitate development of targeted nutrition interventions to reduce diet-related diseases in the diverse Black population in the U.S.

Technical Abstract: BACKGROUND: Non-Hispanic Blacks in the U.S. are less likely to meet national dietary recommendations than non-Hispanic Whites. However, most studies do not consider nativity of U.S. Blacks. METHODS: Using the Alternative Healthy Eating Index-2010 (AHEI-2010) and Dietary Approach to Stop Hypertension (DASH) scores, this cross-sectional study compared diet quality between U.S.-born (n=3,911) and foreign-born (n=408) non-Hispanic Black adults aged 22-79y, based on pooled nationally representative data (NHANES 2003-2012); as well as by length of U.S. residency. Association between nativity and diet quality was done using multivariable-adjusted linear regression for the continuous total diet quality scores and their components, or multinomial (polytomous) logistic regression for categorical tertiles (low, medium, or high) of the total scores and their components. RESULTS: Foreign-born Blacks had significantly higher AHEI-2010 (beta 9.3,95% CI, 7.5,11.0) and DASH (beta 3.1, 95% CI, 2.5, 3.8) scores compared to U.S-born Blacks, and more favorable intakes for many of the score components. Among foreign-born Blacks, diet quality did not significantly differ by length of residency. Foreign-born Blacks were more likely to be in the high than low tertile for vegetables 17 (excluding starchy vegetables) (RRR 1.68, 95%CI 1.24, 2.29), fruit (excluding and including fruit juice; RRR 2.42, 95% CI 1.69, 3.47; RRR 2.95, 95% CI 1.90, 4.59), percent whole grains (RRR 2.39, 95%CI 1.64, 3.49), and omega-3 fatty acids (RRR 2.03, 95%CI 1.38, 2.97). CONCLUSIONS: Foreign-born Blacks have better diet quality compared to their U.S.-born counterparts. Considering nativity among U.S. Blacks in nutrition research and public health efforts may improve accuracy of characterizing dietary intakes and facilitate development of targeted nutrition interventions to reduce diet-related diseases in the diverse Black population in the U.S.