Dietary Patterns and Years Living in the United States by Hispanic/Latino Heritage in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Abstract

Background: Previous diet findings in Hispanics/Latinos rarely reflect differences in commonly consumed and culturally relevant foods across heritage groups and by years lived in the United States.

Objectives: We aimed to identify and compare a posteriori heritage-specific dietary patterns (DPs) and evaluate their associations with "healthfulness" [using the Alternative Healthy Eating Index-2010 (AHEI-2010)] and years living in the United States.

Methods: We used baseline data from a population-based cohort of 14,099 Hispanics/Latinos aged 18-74 y in the Hispanic Community Health Study/Study of Latinos. We performed principal factor analysis using two 24-h recalls to derive DPs, separately, in each heritage group (Cuban, Dominican, Mexican, Puerto Rican, Central American, and South American), and identified overarching DPs based on high-loading foods shared by ≥2 groups. We used multivariable linear regression to test associations of DPs with AHEI-2010 and years living in the United States.

Results: We identified 5 overarching DPs (Burgers, Fries, & Soft Drinks; White Rice, Beans, & Red Meats; Fish; Egg & Cheese; and Alcohol). All Burgers, Fries, & Soft Drinks DPs were inversely associated with AHEI-2010, whereas all Fish DPs (except Dominican) were positively associated with this index (all P-trend < 0.001). White Rice, Beans, & Red Meats DPs showed inverse associations in Cuban and Central American groups and positive associations in Mexican-origin individuals (all P-trend < 0.001). Fewer years living in the United States was associated with higher scores for White Rice, Beans, & Red Meats DPs in Cuban and Mexican heritage groups and lower scores on Burgers, Fries, & Soft Drinks DPs in Cuban, Mexican, and Puerto Rican groups (all P-trend < 0.01).

Conclusions: Our findings show substantial variation in DPs across Hispanics/Latinos and adherence to DPs by time in the United States, which could inform dietary interventions targeting this diverse US population. This trial was registered at clinicaltrials.gov as NCT02060344.

Keywords: HCHS/SOL; Hispanics/Latinos; a posteriori; diet; dietary acculturation; dietary patterns; heritage; nativity; principal factor analysis.

FIGURE 1

Flowchart of baseline study participants overall and by heritage in HCHS/SOL. Estimated energy intake was <1st or >99th sex-specific percentiles in HCHS/SOL or deemed unreliable by the interviewer. HCHS/SOL, Hispanic Community Health Study/Study of Latinos.

FIGURE 2

Mean AHEI-2010 scores by quintiles of heritage-specific a posteriori dietary patterns in HCHS/SOL (n = 14,099). Data are weighted mean AHEI-2010 scores (95% CIs) by quintiles of each heritage-specific dietary pattern from multivariable linear regression models showing significant mean AHEI-2010 score differences comparing higher with lowest quintiles (Q2–Q5 compared with Q1), adjusting for age (y), sex (men, women), highest education achieved (less than high school, high school or equivalent, beyond high school), and other heritage-specific dietary patterns (quintiles) (all Bonferroni-corrected for pairwise comparisons, P < 0.01; all P-trend < 0.001). Asterisks indicate significant pairwise comparisons for higher to lowest quintiles of each heritage-specific dietary pattern. Linear trends were tested by using the midpoint of each dietary pattern quintile as a continuous measure. CB, n = 2140; DM, n = 1189; MX, n = 5883; PR, n = 2343; SA, n = 991. AHEI-2010, Alternative Healthy Eating Index–2010; CA, Central American; CB, Cuban; DM, Dominican; HCHS/SOL, Hispanic Community Health Study/Study of Latinos; MX, Mexican; PR, Puerto Rican; Q, quintile; SA, South American.

FIGURE 3

Mean heritage-specific a posteriori dietary pattern scores by years living in the United States in HCH/SOL. Data presented are significant weighted heritage-specific dietary pattern mean score differences (95% CIs) comparing greater years living in the United States categories with US-born (referent, not shown) in HCHS/SOL, adjusting for age (y), sex (men, women), and highest education achieved (less than high school, high school or equivalent, beyond high school) (Bonferroni-corrected P < 0.01). Asterisks indicate significant individual pairwise comparisons for categories of years living in the United States compared with US-born (all Bonferroni-corrected for pairwise comparisons, P < 0.01). Linear trends were significant across all presented heritage-specific findings (P-trend < 0.01), except for the Western dietary pattern in Dominicans (P-trend = 0.036) and traditional dietary pattern in Mexicans (P-trend = 0.021). Linear trends were tested by using the midpoint of each category for years living in the United States in the overall sample as a continuous measure. CB, n = 2140; DM, n = 1189; MX, n = 5883; PR, n = 2343; SA, n = 991. CA, Central American; CB, Cuban; DM, Dominican; HCHS/SOL, Hispanic Community Health Study/Study of Latinos; MX, Mexican; PR, Puerto Rican; SA, South American.