Acculturation and dietary change among Chinese immigrant women in the United States

Abstract

US Chinese immigrants undergo a transition to increased chronic disease risk commonly attributed to acculturative and dietary changes. Longitudinal data to confirm this are lacking. We examined acculturation and diet over time in 312 Chinese immigrant women in Philadelphia, recruited October 2005 to April 2008 and followed with interviews and dietary recalls until April 2010. Associations were modeled using generalized estimating equations to account for repeated measures over time. Increasing length of US residence was associated with a small (~1%/year) but significant increase in acculturation score (p < 0.0001), which in turn was significantly associated with increased energy density of the diet, percent of energy from fat, and sugar intake, and lower dietary moderation score. These findings provide longitudinal evidence that acculturation increases with length of US residence and is accompanied by dietary changes. However, the changes were small enough that their health impact is unclear. Factors besides acculturation that affect immigrant health and that affect the acculturation trajectory itself warrant investigation.

Figure 1

Predicted GEQA score by length of residence, in model including length of residence, level of education, and length of residence * education category interaction term.

Figure 2

Predicted (a) energy intake and (b) percent of energy from fat assuming GEQA=1 or 2 by level of education, for a reference study participant age 40–49 years old, married, and born in China. Model included age, level of education, marital status, birthplace, GEQA, and GEQA * education category interaction term.