title: Acculturation and sociocultural influences on dietary intake and health status among Puerto Rican adults in Massachusetts.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  Cross-sectional data from the Boston Puerto Rican Health Study, which included 1219 Puerto Ricans in the Boston area, aged 45-75 years.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: 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.
authors.forename: Maria I
authors.initials: MI
authors.lastname: van Rompay
authors.forename: Nicola M
authors.initials: NM
authors.lastname: McKeown
authors.forename: Carmen
authors.initials: C
authors.lastname: Castaneda-Sceppa
authors.forename: Luis M
authors.initials: LM
authors.lastname: Falcón
authors.forename: José M
authors.initials: JM
authors.lastname: Ordovás
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Tucker
mesh_terms: D000069:Acculturation; D000368:Aged; D003430:Cross-Sectional Studies; D003466:Cultural Characteristics; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000208:ethnology; D004032:Diet / Q000208:ethnology* / Q000706:statistics & numerical data*; D004034:Diet Surveys; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004043:Dietary Fiber / Q000008:administration & dosage; D002149:Energy Intake / Q000502:physiology; D007887:Fabaceae; D005260:Female; D006304:Health Status; D006630:Hispanic or Latino / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D008019:Life Style; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D011203:Poverty; D011647:Puerto Rico / Q000208:ethnology; D012959:Socioeconomic Factors
chemical_list: D004040:Dietary Carbohydrates; D004043:Dietary Fiber