Assistant Professor University of Michigan School of Public Health Ann Arbor, Michigan, United States
Objectives: Acculturation is associated with decreased diet quality among non-United States (US)-born adults, but there is limited research among non-US-born adolescents. We investigated the associations between birthplace and length of time living in the US, two measures of acculturation, with diet quality among adolescents (12-19 years old).
Methods: Data are from the National Health and Nutrition Examination Survey (2007-2018), which included two 24-hour dietary recalls (n=6,113) to calculate Healthy Eating Index-2015 (HEI-2015) total scores and component scores. Multivariate linear regression and generalized linear models were performed to compare HEI-2015 total scores and component scores between US-born adolescents (n=5342) and foreign-born adolescents with < 5 years (n=244) and ≥ 5 years (n=491) of U.S. residency.
Results: Foreign-born adolescents with < 5 years (53.27±0.71) and ≥5 years of US residency (50.45+0.71) had higher HEI-2015 total scores than US-born adolescents (46.99±0.29, p< 0.0001) and higher total vegetables, greens and beans, total fruits, whole fruits, seafood and plant proteins, and added sugars scores (p < 0.0001). Foreign-born adolescents with < 5 years of US residency had higher total fruit and saturated fat scores than those with ≥5 years of US residency (p < 0.001).
Conclusions: Being born outside the US and, to a lesser extent, living in the US for less time (among foreign-born adolescents) is associated with higher diet quality. Culturally informed health promotion programs may help to reduce diet-related disparities related to acculturation among adolescents.