Smith Danyel I, Sakarcan Eren, Adams-Campbell Lucile, Dash Chiranjeev
Office of Minority Health and Health Disparities Research, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, 1010 New Jersey Ave. SE, Washington, DC 20003, USA.
School of Medicine, University of South Carolina, 6311 Garners Ferry Rd., Columbia, SC 29209, USA.
Nutrients. 2025 Jan 8;17(2):215. doi: 10.3390/nu17020215.
BACKGROUND/OBJECTIVES: Nutrient-poor diet quality is a major driver of the global burden of metabolic syndrome (MetS). The US ranks among the lowest in diet quality and has the highest rate of immigration, which may present unique challenges for non-US-native populations who experience changes in access to health-promoting resources. This study examined associations among MetS, nativity status, diet quality, and interaction effects of race-ethnicity among Hispanic, Asian, Black, and White US-native and non-US-native adults.
We examined data from 5482 adult participants (≥20 years of age) in the National Health and Nutrition Examination Survey (2013-2018). MetS (per the ATP III panel guidelines) was assessed continuously (MetS z-score) and dichotomously. Dietary recalls were used to compute HEI-2015 scores. Nativity status and sociodemographic variables were assessed. Age-adjusted and multivariate-adjusted logistic regressions were conducted to examine the associations between nativity status and MetS and interaction effects by race-ethnicity.
Non-US-native participants displayed more guideline-adherent diet quality (55.23% vs. 49.38%, < 0.001) compared to their US-native counterparts-even when stratified by racial-ethnic groups. US-native participants had larger waist circumferences and elevated triglyceride levels. Non-US-native Black Americans had a 60% lower risk of having MetS even after adjusting for diet quality (OR: 0.39, 95% CI: 0.17, 0.88) compared to their US-native counterparts. For MetS components, non-US-native Asian participants reported a lower risk for dyslipidemia, while non-US-native multiracial participants had higher triglycerides.
Non-US-native groups display better diet quality compared to their US-native counterparts. However, the findings suggest that diet quality alone does not account for nativity-related cardiometabolic disparities, particularly in US-native Black Americans, thus necessitating interventions targeting the social determinants of health.
背景/目的：营养匮乏的饮食质量是全球代谢综合征（MetS）负担的主要驱动因素。美国在饮食质量方面排名靠后，且移民率最高，这可能给那些获得促进健康资源的机会发生变化的非美国本土人群带来独特挑战。本研究调查了美国本土和非美国本土的西班牙裔、亚裔、黑人及白人成年人中，代谢综合征、出生地状况、饮食质量以及种族 - 族裔间的交互作用之间的关联。
我们分析了国家健康与营养检查调查（2013 - 2018年）中5482名成年参与者（≥20岁）的数据。根据ATP III专家组指南对代谢综合征进行连续评估（代谢综合征z评分）和二分法评估。通过饮食回忆来计算HEI - 2015得分。评估出生地状况和社会人口统计学变量。进行年龄调整和多变量调整的逻辑回归分析，以研究出生地状况与代谢综合征之间的关联以及种族 - 族裔间的交互作用。
与美国本土参与者相比，非美国本土参与者的饮食质量更符合指南要求（55.23%对49.38%，<0.001），即使按种族 - 族裔群体分层也是如此。美国本土参与者的腰围更大，甘油三酯水平更高。与美国本土的黑人相比，非美国本土的美国黑人即使在调整饮食质量后，患代谢综合征的风险也低60%（OR：0.39，95%CI：0.17，0.88）。对于代谢综合征的各个组成部分，非美国本土的亚裔参与者血脂异常风险较低，而非美国本土的多族裔参与者甘油三酯水平较高。
与美国本土人群相比，非美国本土人群的饮食质量更好。然而，研究结果表明，仅饮食质量并不能解释与出生地相关的心血管代谢差异，特别是在美国本土的黑人中，因此需要针对健康的社会决定因素进行干预。
