title: Dietary patterns in Liberian refugees in Buduburam, Ghana.
abstract: Previous research suggests that acculturation (i.e., exposure and assimilation to local culture) is associated with changes in dietary patterns among immigrants. This study investigates this association in a refugee population using time in refugee settlement as a proxy for acculturation. A cross-sectional survey was conducted among a systematic sample to (a) identify dietary patterns in Liberian refugees and Ghanaians living in or near a refugee settlement, (b) compare adherence to these dietary patterns between groups, and (c) investigate the association between acculturation and dietary patterns in Liberian refugees. Participants were Liberian and Ghanaian women with young children living in the Buduburam refugee settlement or Awutu in Ghana (n = 480; 50% Liberian; mean age 28, SD 6.3, range 16-48 years). Time in settlement was assessed by self-report; food consumption was assessed by food frequency questionnaire. Principal component analysis was used to identify dietary patterns; a generalized linear model was used to test the association of interest. Three distinct dietary patterns emerged: Healthy, Sweets, and Fats. Ghanaians were more adherent to the Healthy pattern than Liberians (p < 0.05). Liberians were more adherent to the Sweets and Fats patterns than Ghanaians (p < 0.05). There were no significant differences in dietary pattern adherence among the Liberians based on time in settlement. Ghanaians living in Awutu were more adherent to the Healthy pattern than Ghanaians who lived in settlement (p < 0.05). Differences in dietary patterns were observed between Liberian refugees and Ghanaians. These differences were not associated with acculturation and may be related to the food environment in the settlement.
authors.affiliation: Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA.
authors.forename: Wilhelmenia L
authors.initials: WL
authors.lastname: Ross
authors.affiliation: Boston University School of Public Health, Boston, Massachusetts, USA.|Buduburam Nutrition Program, Ghana.
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Gallego-Pérez
authors.affiliation: Department of Nutrition and Food Science, University of Ghana, Legon, Ghana.
authors.forename: Anna
authors.initials: A
authors.lastname: Lartey
authors.affiliation: Buduburam Nutrition Program, Ghana.
authors.forename: Adam
authors.initials: A
authors.lastname: Sandow
authors.affiliation: Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, USA.
authors.forename: Rafael
authors.initials: R
authors.lastname: Pérez-Escamilla
authors.affiliation: Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, USA.
authors.forename: Amber
authors.initials: A
authors.lastname: Hromi-Fiedler
mesh_terms: D000069:Acculturation; D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D004032:Diet / Q000208:ethnology*; D000072001:Diet, Healthy; D005260:Female; D005869:Ghana; D006801:Humans; D007988:Liberia / Q000208:ethnology; D008875:Middle Aged; D015596:Nutrition Assessment; D010349:Patient Compliance; D025341:Principal Component Analysis; D012036:Refugees; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Ghana; Liberia; West Africa; acculturation; dietary patterns; refugees