Abstract P068: Dietary Acculturation in Two Ethnic Populations Has a Differential Impact on Diet Quality
Introduction: The indigenous Arab minority population in Israel has higher rates of cardiovascular morbidity and mortality than the Jewish immigrant population. Differences in dietary intake may underlie some of these health disparities. We tested the hypothesis that dietary patterns differ by ethnicity.
Methods: A population-based, random sample (n=1,100) was selected, stratified by sex, ethnicity, and age (25–74 years). A food frequency questionnaire with 240 food items, including ethnic foods, was used to assess dietary intake and dietary change during adulthood. Food items were collapsed into 51 groups and entered into principle component analysis to identify dietary patterns. Multivariate regression models were fitted to assess the association between participant characteristics and the dietary patterns.
Results: Of 4 dietary patterns identified (Traditional Arabic, Healthy, Animal Protein, and Snack/Fast Food), the Traditional Arabic and Healthy patterns were the most dominant. The Traditional Arabic pattern included high intakes of “Mediterranean diet” components (e.g., olive oil, dairy products, whole grains, legumes, vegetables), as well as less healthy foods (e.g., refined-flour pita bread, meat dishes). Participants with a low score on this pattern had a high intake of starchy, high-fat, and sweet foods. The highest and lowest intake tertiles of this pattern were virtually mono-ethnic (98% Arab, and 98% Jewish, respectively), while the middle tertile was ethnically mixed. Arabs in the middle/lowest tertiles were younger (OR for 10y age increment: 0.71, 95% CI: 0.59–0.84), male (OR: 2.01, 95% CI: 1.38–2.95), and had made non-health related dietary change (OR: 2.40, 95% CI: 1.53–3.77). In contrast, Jews in the middle/highest tertiles had made health-related dietary change (OR: 2.06, 95% CI: 1.27–3.36). The Healthy pattern included a high intake of foods typically found in healthy Western dietary patterns (e.g., vegetables, fruit, low-fat dairy products, whole grains). Arabs had lower odds than Jews of being in the top tertile of the Healthy pattern among never-smokers (OR: 0.12, 95% CI: 0.07–0.21) and current smokers (OR: 0.16, 95% CI: 0.07–0.37); however the strength of this association diminished among past smokers (OR: 0.45, 95% CI: 0.20–1.04).
Conclusions: Jews are more likely than Arabs to have classic Western healthy eating patterns, and those who have undergone some dietary acculturation have done so for health-related reasons. The indigenous Mediterranean-style diet of Arabs has deteriorated, and adoption of foods of the immigrant population did not improve the health properties of their diet. These dietary characteristics may place Arabs at higher risk for cardiovascular morbidity and mortality.
- © 2012 by American Heart Association, Inc.