Nutrient intakes of whites, blacks, and Mexican Americans in southeast Texas

Correlation of dietary intake and colorectal cancer incidence among Mexican-American migrants: the multiethnic cohort study

Studies of migrants, along with geographic and temporal variations in incidence, indicate that colorectal cancer is especially sensitive to changes in environmental factors, including, most importantly, diet. The goal of this research was to examine the changes in dietary practices that may be consistent with the changing incidence of colorectal cancer in the Los Angeles Mexican-American population. Cancer incidence and dietary intake data were available for over 35,000 Latinos of Mexican national origin currently participating in the prospective Multiethnic Cohort Study, representing the largest sample of Mexican-origin Latinos of any such study in the United States. The dataset is unique in that changes in cancer rates and in dietary behaviors across three generations could be examined. Most of the change in colorectal cancer rates occurred between the first and second generations, and, correspondingly, nearly all the dietary change also occurred between the first and second generations. Although some food traditions were retained by Mexican Americans, the dietary changes due to acculturation were significant and support an association between colorectal cancer risk and certain dietary components, notably, alcohol as a risk factor and nonstarch polysaccharides and vegetables as protective factors.

Promotion of Healthy Eating: Among New Immigrant Women in Ontario

Little attention has been given to the dietary patterns of new immigrant women in Canada. Research suggests that before migration, many immigrants, especially those from non-Western countries, consume a healthy diet, but this changes on migration. This paper presents information from a recently completed literature review conducted for the Women's Health Council of the Ontario Ministry of Health and Long-Term Care. The paper includes a review of the major determinants of food choice and health promotion strategies appropriate to new immigrant women. Our findings suggest that nutrition intervention for new immigrant women must consider the social context of these women's lives, address cultural, linguistic, economic and informational barriers and consider how these change over time. Recommendations are also made on how to best promote healthy eating in this group.

Dietary fiber and lifestyle influence serum lipids in free living adult men

OBJECTIVE

The aim of this study was to determine the effect of dietary fiber consumption and lifestyle on serum lipids in adult men with non-restricted diet and physical activity.

METHODS

Two groups of 19 men were classified as high (48 g/day) and low fiber groups (27 g/day). Anthropometry, food frequency, daily weighed intakes and physical activity were done for a seven-day period. Fasting blood was collected and serum was analyzed for triglycerides, total cholesterol and lipoprotein cholesterol fractions.

RESULTS

Crude correlation coefficients showed that total cholesterol was negatively associated with physical activity, total dietary fiber and P/S ratio (r = 0.52; p < 0.001. r = -0.44; p < 0.01, r = 0.51, p < 0.001). LDL-C was also correlated negatively with total dietary fiber and P/S ratio (r = -0.34, p < 0.03; r = -0.53, p < 0.01). It was also positively associated with dietary cholesterol and body weight (r = 0.34, p < 0.03; r = 0.31, p < 0.05). Serum triglycerides had an inverse association with total dietary fiber and physical activity (r = -0.30: p < 0.05; r = -0.45, p < 0.004). After controlling for energy intake, total fat, saturated fat, dietary cholesterol, physical activity and body mass index, LDL-C/HDL-C, and TC/HDL-C, remained significantly associated with dietary fiber (r = 0.34; p < 0.05 and r = -0.38; p < 0.02, respectively).

CONCLUSIONS

This study provides evidence in free living men that there is an association between dietary fiber intake and favorable lipid status and that lifestyle defined by socioeconomic status, physical activity and the quality of the dietary fat intake can play an important role. Public health nutrition advice and policy should continue to emphasize the importance of these factors.

A 7-item versus 31-item food frequency questionnaire for measuring fruit, juice, and vegetable intake among a predominantly African-American population

OBJECTIVE

This study sought to determine which of 2 fruit and vegetable food frequency questionnaires (FFQs) most closely approximated intake measured by the average of four 24-hour dietary recalls.

DESIGN

Participants completed either a 31-item FFQ (n = 70) or 7-item FFQ (n = 76) on 2 occasions approximately 2 weeks apart. During the interval between FFQs1 participants provided four 24-hour dietary recalls via telephone interview.

SUBJECTS/SETTING

Participants were 146 persons with food preparation responsibilities in families of students in grades 3 through 5. Respondents were predominantly African-American women in Atlanta, Ga.

STATISTICAL ANALYSIS

Pearson correlation coefficients of log-transformed values estimated the reliability of each FFQ and compared FFQ estimates to reference values. The intraclass correlation coefficient evaluated consistency across 24-hour recalls.

RESULTS

The first FFQs overestimated intake approximately twofold. The 31-item FFQ estimates exceeded 7-item FFQ estimates by approximately 30% . Correlations with recall estimates were high for the 7-item FFQ and moderate to low for the 31-item FFQ. The second FFQ estimates were more highly correlated to reference values. From the first to the second administration, 7-item FFQ estimates dropped from 5.2 to 2.7 servings, and 31-item FFQ estimates dropped from 6.7 to 3.5 servings. Neither FFQ produced highly reliable estimates.

CONCLUSIONS

Mean total fruit and vegetable consumption was closer to reference estimates for the first 7-item FFQ and the second 31-item FFQ. The 7-item FFQ correlated more highly with reference estimates than did the 31-item FFQ. Therefore, we conclude that for African-American adults, a 1-time-administered FFQ using 7 broad food categories correlates more highly with reference values than a FFQ using 31 individual fruit and vegetable items.

Influences on diet, health behaviours and their outcome in select ethnocultural and religious groups

Diverse cultural components of behavior may have significant impacts on patterns of eating, drinking, and social interaction, irrespective of socioeconomic status. For example, the major world religions prescribe or proscribe specific dietary behaviors; some of these are rooted in historical or geographical origins as well as group folklore; and they have integral roles as expressions of religious piety and group cohesiveness. The literature is replete with ecological observations of between-country differences in disease trends, some of which have been associated with dietary practices. The study of distinct cultural and religious groups (especially migrants acculturating to new environments) and the extent to which they adhere to culturally-based dietary precepts, has advanced our knowledge of psychosocial influences on food habits, nutritional adequacy, and overall health. However, a relatively small proportion of culturally-based research studies conducted to date have explored cross-cultural, ethnic, or religious variables. This paper reviews some population-based differences in dietary habits and other behaviors by ethnocultural group or religious denomination; health consequences and suggestions for future research are discussed.

ICS-II USA research locations: environmental, dental care delivery system, and population sociodemographic characteristics

Secondary data sources are used to describe the ICS-II USA research locations in terms of external environment, dental care delivery system, and population sociodemographics. The Native American reservations located in Arizona, New Mexico, and South Dakota were rural, while the other research locations were primarily urban. Baltimore, Maryland, and the Native American communities had fluoridated water, but San Antonio did not. Dental services in Baltimore and San Antonio were predominantly financed by private sources, with a small public health component. Dental care services in Native American communities were largely Indian Health Services (IHS) financed by the US Government. Each geographical area exhibited diverse characteristics indicating unique challenges for the delivery of community and clinical dental services.

Macronutrient intakes among adult Hispanics: a comparison of Mexican Americans, Cuban Americans, and mainland Puerto Ricans

OBJECTIVES

The purpose of this study was to compare energy and macronutrient intakes between adult Mexican Americans, Cuban Americans, mainland Puerto Ricans, and non-Hispanics.

METHODS

Age-specific mean intakes were estimated based on 24-hour recalls from the Hispanic Health and Nutrition Examination Survey (HHANES) (1982 to 1984) and the Second National Health and Nutrition Examination Survey (NHANES II) (1976 to 1980) and were compared with the use of t tests.

RESULTS

Mexican Americans had higher total fat, saturated fat, and monounsaturated fat intakes than did Puerto Ricans and older Cuban Americans. Cuban Americans and Puerto Ricans had similar intakes, except for younger Cuban Americans, who had higher total and saturated fat and lower carbohydrate intakes. Cholesterol intakes among Mexican American men and 60- to 74-year-old women were higher than those among other Hispanic groups. Carbohydrate and protein intakes were higher among Hispanic groups compared with those among non-Hispanics while total fat intakes were generally lower.

CONCLUSIONS

Since macronutrient intakes differ between Hispanic groups, dietary research, recommendations, and interventions should be targeted to each group individually. Older Puerto Rican and Cuban American adults met population guidelines for reducing chronic disease risk for more macronutrients than any other group.

Dietary, alcohol, and tobacco intake among Mexican-American women of childbearing age: results from HANES data

PURPOSE

Dietary intake and substance abuse are important predictors of pregnancy outcome yet little is known about these behaviors in Mexican Americans. Dietary, tobacco, and alcohol intake of Mexican-American and non-Hispanic white women were compared across the reproductive cycle.

DESIGN

Four cross-sectional groups--interconceptional, pregnant, lactating, and postpartum non-lactating--were compared within and between ethnic groups.

SUBJECTS

A stratified sample of 682 women, 16 to 44 years old, of Mexican birth or origin from the Hispanic HANES was contrasted with a similarly stratified sample of 1,396 white non-Hispanic women from the NHANES:

MEASURES

Demographic, behavioral and health characteristics, food practices, and fluid intake were examined. Data on food servings were combined into five major food groups.

RESULTS

Compared with white non-Hispanics, Mexican-American women had lower socioeconomic status and worse perceived health. However, Mexican Americans reported lower consumption of tobacco, alcohol, diet soda, and caffeine, particularly during pregnancy and lactation. Although portion sizes for the foods consumed were not assessed, frequency of consumption of fruits and vegetables and milk was lower and meat higher among Mexican Americans.

CONCLUSIONS

Despite socioeconomic disadvantages, Mexican-American women have better health habits than white non-Hispanic women. From these data it is unclear how diet affects pregnancy outcomes in Mexican Americans.

Calcium intakes of Mexican Americans, Cubans, Puerto Ricans, non-Hispanic whites, and non-Hispanic blacks in the United States

OBJECTIVE

To compare dietary calcium intakes from food in Mexican Americans, Cubans, Puerto Ricans, non-Hispanic whites, and non-Hispanic blacks aged 11 through 74 years.

DESIGN

Population survey data from the Hispanic Health and Nutrition Examination Survey and the second National Health and Nutrition Examination Survey were used to calculate calcium intake from a single 24-hour recall. These data were compared by age and sex between the five population groups. Food sources of calcium in the three Hispanic groups were also examined using 24-hour recall data.

SUBJECTS

The sample consisted of 11,773 non-Hispanic whites, 1,728 non-Hispanic blacks, 4,739 Mexican Americans, 1,076 Cubans, and 1,835 Puerto Ricans.

MAIN OUTCOME MEASURES

Mean calcium intake, percentage intake of Recommended Dietary Allowance, and, for Hispanics, food sources of calcium.

STATISTICAL ANALYSES

Means were compared within age and sex groups between the five population groups using a t test.

RESULTS

Calcium intakes from food in the three Hispanic groups were similar to intakes of non-Hispanic whites and higher than intakes of non-Hispanic blacks. Although dairy foods were the main sources of calcium for Hispanics, corn tortillas were important calcium sources among Mexican Americans. Women consumed less calcium than the Recommended Dietary Allowance in all age and racial or ethnic groups.

APPLICATIONS

When assessing calcium intakes of the three Hispanic groups, ethnic differences in food sources of calcium need to be considered. Efforts to increase calcium intake in Hispanics also need to account for ethnic differences.

A comparison of diets of blacks and whites in three areas of the United States

Dietary factors may contribute to the increased cancer risk of blacks. As a first step to explore this hypothesis, we examined food frequency data obtained by interview with 1,976 adults (881 blacks and 1,095 whites) randomly selected from three areas of the United States. The a priori hypothesis was that blacks were more likely to consume diets low in fruits and vegetables and/or high in fat, particularly saturated fat. Contrary to expectation, blacks were more frequent consumers of fruits and vegetables considered to be protective against cancer (e.g., citrus fruits, cruciferous vegetables, and vegetables rich in vitamins A and C). Intake of both total and saturated fat was slightly lower among blacks than whites. This analysis does not rule out a role for these dietary factors in the etiology of cancer but indicates that ascribing the excess cancer risk among blacks to their frequency of fruit and vegetable consumption or intake of fat per se is inadequate. This suggests that alternative dietary explanations for the racial disparity in cancer risk should be pursued in future studies.

Colon cancer incidence: recent trends in the United States

Between 1976-78 and 1985-87, the age-adjusted incidence rates of invasive colon cancer in the United States rose by 15 percent, 3 percent, 21 percent, and 16 percent among White males, White females, Black males, and Black females, respectively. The increases in incidence occurred in all age groups over age 54 and affected each of the major subsites of the colon nearly equally. The larger rates of increase have resulted in higher incidence among Blacks than Whites by the mid-1980s and an increasingly greater excess of this cancer in males. Trends toward earlier diagnosis of invasive colon cancer were found, with increasing rates for localized and regional diseases coupled with stable or decreasing distant-stage disease-rates. The incidence of in situ colon cancer also rose substantially. The findings suggest that changes in diagnostic trends and risk-factor prevalence may be contributing to these patterns, and that the era when colon cancer predominated among White females is clearly over.

Racial differences in the risk of invasive squamous-cell cervical cancer

To investigate reasons for the higher rates of invasive squamous-cell cervical carcinoma among Blacks than Whites in the United States, we examined data from a case-control study of cervical cancer conducted in five geographic areas of the US, supplemented by incidence data from the Surveillance, Epidemiology, and End Results (SEER) Program, and hysterectomy prevalence data from the Cancer and Steroid Hormone Study. We observed only minor differences between Blacks and Whites in the magnitude of relative risks associated with a long interval since last Pap smear, multiple sexual partners, cigarette smoking, a higher number of births, and low levels of income and education. Thus, differences in the strength of associations contributed little to the higher incidence rare in Blacks, but the prevalence of these risk factors, except for cigarette smoking, was higher in Blacks than Whites. The SEER incidence rate ratio of 2.3 for Blacks compared to whites was increased to 2.7 when incidence rates utilized denominators corrected for prevalence of hysterectomy, while the rate difference increased from 14.9 to 25.8 cases per 100,000 person-years (PY). We estimated further that, after adjustment for prevalence of hysterectomy, the incidence rate for women at the lowest levels of exposure to the risk factors evaluated was 2.2 times higher in Blacks than Whites, but that the corresponding rate difference was only 2.2 cases per 100,000 PYs. Thus, our results suggest that racial differences in the prevalence of exposure to identified risk factors account for most of the difference in incidence rates. It remains to be determined what, as yet unidentified, aspects of lower socioeconomic status contribute to the higher incidence rate in Blacks.

Development of a food frequency instrument: ethnic differences in food sources

Dietary intake was assessed among 431 black, white, and Mexican American men and women in southeast Texas using 24-hour dietary recall interviews. These data were collected to provide information on ethnic-specific food sources of selected nutrients; this information was used to construct a food frequency questionnaire for a study of nutrient intake and cancer. Nutrient content of total fat, total vitamin A, and vitamin C was determined for all foods consumed and was aggregated across unique food codes. These aggregated food codes were then ranked according to the contribution of each food to the total population intake of each nutrient. Ethnic differences existed in food sources of nutrients that would not be identified if data from only the analysis of the combined data set were used. Generally, however, the food sources identified from analyses of the combined data set included those foods that were important nutrient sources for each of the ethnic groups as well.