Improved dietary variety and adequacy but lower dietary moderation with acculturation in Chinese women in the United States

Abstract

Acculturation is associated with increased chronic disease risk among Asian Americans, but its association with different aspects of diet quality remains unclear. Associations of acculturation with diet quality were examined in a convenience sample of 243 Chinese participants in a study of diet and mammographic density in the Philadelphia region between January 2002 to May 2003. An acculturation index was created based on self-reported English proficiency and within- and cross-ethnicity social interactions. Diet Quality Index-International (DQI-I) scores were based on responses to an 88-item food frequency questionnaire. Odds ratios (ORs) for falling into a higher vs lower quartile for DQI-I and its components (ie, variety, adequacy, moderation, balance) were estimated with logistic regression analysis for polytomous outcomes. In the sample, mean age was 53.2 (standard deviation=10.5) years, body mass index (calculated as kg/m2) was 24.1 (standard deviation=3.5), and acculturation was significantly associated with improved dietary variety (OR: 2.4; 95% confidence interval [CI]: 1.5 to 3.8) and adequacy (OR: 1.6; 95% CI: 1.0 to 2.6) and lower dietary moderation (OR: 0.6; 95% CI 0.4 to 0.9), but these associations were evident only among women with less than a high school education. Acculturation and education were not associated with overall diet quality or balance. Although an association of less dietary moderation with acculturation suggests the likely importance of acculturation-related dietary change to chronic disease risk, these findings highlight the need for flexible dietary interventions among immigrant populations to discourage the adoption of some new dietary habits, while encouraging the retention of other, traditional ones.