title: Assessing the association of nativity and acculturation to fast food restaurant use and its relationship to metabolic risk factors among US blacks with Afro-Caribbean ethnicity.
abstract: OBJECTIVE
  This investigation among Afro-Caribbean adults in the United States Virgin Islands (USVI) examined whether acculturation and preference for dining out accounted for variation by nativity in the frequency of fast food restaurant use, and assessed the relationship of fast food restaurant use to body weight and insulin resistance.
  
  
  METHODS
  A randomly selected sample of 679 Afro-Caribbean adults (aged ≥ 20 years), including 436 who were foreign-born and 243 who were native-born, were recruited on the island of St. Croix, USVI. Information on demographic characteristics, level of acculturation and dietary practices were obtained from participants by questionnaire. Fasting blood samples, which were measured for glucose and insulin, and anthropometric measurements were also collected from participants. Insulin resistance was estimated by the homeostasis model assessment (HOMA). Relationships between variables were assessed with analysis of variance and logistic regression analyses.
  
  
  RESULTS
  In bivariate analyses, birth in the USVI, younger age, being single, greater preference for dining out and higher levels of education and acculturation were significantly (P < .05) associated with fast food restaurant use. In multivariate logistic regression analyses, birth in the USVI, younger age and preference for dining out were independently associated with frequent (≥ 2 days/week) fast food restaurant use. The mean level of HOMA insulin resistance among participants increased significantly with more frequent use of fast food restaurants.
  
  
  CONCLUSIONS
  Among Afro-Caribbean adults in the USVI, fast food restaurant use is positively associated with insulin resistance and varies by nativity, but acculturation does not account for this variation.
authors.forename: Eugene S
authors.initials: ES
authors.lastname: Tull
authors.forename: Jerome
authors.initials: J
authors.lastname: Taylor
mesh_terms: D000069:Acculturation; D000328:Adult; D001741:Black or African American / Q000523:psychology*; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D054242:Emigrants and Immigrants / Q000523:psychology*; D057140:Fast Foods; D005260:Female; D005518:Food Preferences / Q000208:ethnology; D006801:Humans; D007333:Insulin Resistance / Q000208:ethnology*; D008297:Male; D008875:Middle Aged; D012147:Restaurants; D012307:Risk Factors; D012959:Socioeconomic Factors; D014767:United States Virgin Islands / Q000208:ethnology; D055815:Young Adult