Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA.
J Acad Nutr Diet. 2012 Jan;112(1):64-74. doi: 10.1016/j.jada.2011.08.049.
Previous studies have shown negative consequences of acculturation on lifestyle factors, health status, and dietary intake of Hispanic immigrants in the US. Despite prevalent type 2 diabetes and low socioeconomic status (SES) among Puerto Rican adults living on the US mainland, little is known about acculturation in this group.
We investigated associations among acculturation, lifestyle characteristics, health status, and carbohydrate nutrition in Puerto Rican adults. A secondary objective was to investigate possible confounding and/or effect modification on these associations by SES.
Cross-sectional data from the Boston Puerto Rican Health Study, which included 1219 Puerto Ricans in the Boston area, aged 45-75 years.
Characteristics were compared using ANCOVA, linear trend and Pearson's chi-square tests across quartiles of acculturation. Tests for interaction by poverty status were conducted. Proportional contributions of foods to intake of total carbohydrate and fiber were assessed using SAS RANK.
Levels of acculturation were low, despite young age at first arrival to the US mainland (25.4 ± 12.3 y) and long length of stay (34.2 ± 12.2 y). Greater English language use was associated with higher SES, alcohol consumption, physical activity, better perceived health, and less central obesity. Acculturation was associated with lower legume fiber and greater cereal fiber intake. Among those above the poverty threshold, acculturation was associated with lower dietary glycemic index and starch intake, and greater fruit and non-starchy vegetable intake.
In contrast to studies with Mexican Americans, the association of acculturation with dietary quality in these Puerto Rican adults was mixed, but tended toward better carbohydrate quality. Dietary recommendations should include maintenance of traditional, healthful dietary practices including consumption of legumes, but also reduction in refined grains, and greater inclusion of fruit, non-starchy vegetables, and whole grains. Interventions to improve access to better quality carbohydrate sources are necessary for this group disproportionately affected by diabetes.
先前的研究表明，文化适应对美国西班牙裔移民的生活方式因素、健康状况和饮食摄入有负面影响。尽管波多黎各成年人在美国大陆普遍患有 2 型糖尿病和低社会经济地位（SES），但对这一群体的文化适应知之甚少。
我们研究了波多黎各成年人的文化适应、生活方式特征、健康状况和碳水化合物营养之间的关系。次要目的是研究 SES 对这些关联的可能混杂和/或修饰作用。
横断面数据来自波士顿波多黎各健康研究，包括 1219 名年龄在 45-75 岁的波士顿地区波多黎各人。
使用方差分析（ANCOVA）、线性趋势和 Pearson 卡方检验比较特征，根据文化适应的四分位数进行分层分析。进行了按贫困状况的交互作用检验。使用 SAS RANK 评估食物对总碳水化合物和纤维摄入量的比例贡献。
尽管首次抵达美国大陆的年龄（25.4 ± 12.3 岁）和在美国的停留时间（34.2 ± 12.2 岁）都很短，但文化适应水平仍然很低。更多地使用英语与较高的 SES、饮酒、体力活动、更好的健康感知和较少的中心性肥胖有关。文化适应与豆类纤维和谷类纤维摄入量较高有关。在贫困线以上的人群中，文化适应与较低的饮食血糖指数和淀粉摄入量以及更多的水果和非淀粉类蔬菜摄入量有关。
与墨西哥裔美国人的研究相比，这些波多黎各成年人的文化适应与饮食质量的关联是混合的，但倾向于更好的碳水化合物质量。饮食建议应包括维持传统的健康饮食实践，包括食用豆类，但也应减少精制谷物，增加水果、非淀粉类蔬菜和全谷物的摄入。对于这个受糖尿病影响不成比例的群体，需要采取干预措施来改善获得高质量碳水化合物来源的机会。
