Graduation Year

2011

Document Type

Dissertation

Degree

Ph.D.

Degree Granting Department

Epidemiology and Biostatistics

Major Professor

Elizabeth B. Pathak

Keywords

acculturation, diet, heart disease, immigrant, Jamaica

Abstract

Background: The South Florida region is home to over 85,000 Jamaican immigrants. Yet, little is known about the dietary intakes and predictors of risk of disease within this immigrant group. An assessment of dietary intakes and the development of dietary intake methodologies specific to the Jamaican population was important as it permitted accurate estimation of the nutrient intakes of this immigrant population whose dietary habits are not well documented. In addition, nothing is known about the prevalence of risk factors for heart disease or factors influencing risk factors among this immigrant group. The purpose of this study was to assess the nutrient intakes of Jamaican immigrants, develop a dietary assessment tool for use among Jamaican immigrants, determine factors associated with dietary intake pattern, and examine the association between acculturation, dietary intake pattern, and risk factors for heart disease.

Methods: A randomized 2-stage cluster sample design was used to identify Jamaican persons 25-64 years old within community organizations and churches in two Florida counties. Twenty-four hour recalls were conducted among 45 randomly selected persons to estimate nutrient intakes and determine foods for inclusion on a quantitative food frequency questionnaire (QFFQ). Ninety-one persons, including the 45 who participated in 24-hour dietary recalls, were administered a general health questionnaire that assessed acculturation, dietary intake pattern, and the prevalence of risk factors for heart disease. Predictors of dietary intake pattern, obesity, physical activity, hypertension, and diabetes were examined. Twenty-four hour recalls were analyzed using the Nutrient Data System for Research to obtain nutrient content information. Data from the health questionnaire was analyzed using linear, logistic, and mixed models in the SAS statistical software package.

Results: A total of 82 foods were included in the development of the QFFQ. As hypothesized, results for dietary intake pattern showed that less acculturated persons consumed traditional food more days per week compared to more acculturated persons (β=0.03 p<0.05). Other statistically significant predictors of dietary intake pattern included educational attainment (β=-0.56), socialization with other Jamaicans ((β=-0.44), age of migration to the US (β=0.02), and marital status (β=0.32). Findings for risk factor outcomes showed that women were less likely to be obese compared to men (β=-0.83 p<0.05) and older persons were more likely to be obese (β=0.05 p<0.05). Results for hypertension showed that less acculturated persons were more likely to have hypertension (β=0.05 p<0.05). Other statistically significant predictors of hypertension included educational attainment, obesity, and age. The small sample size precluded obtaining results for diabetes and physical activity.

Conclusion: Study results demonstrated that acculturation is an important predictor of both dietary intake pattern and hypertension. These results are important as they can help health professionals to understand predictors of risk in this immigrant population. These results provided a starting point for understanding the role of acculturation in dietary intake pattern and how these factors affected risk for illness in this population. Future studies must focus on methods of intervention that consider level of acculturation and dietary pattern in reducing risk for heart disease and other chronic illnesses.

Share

COinS