Relationships among Acculturation Using 2 Different Language Variables, Diet Quality, and Accuracy of Diet Quality Assessment in Non-Hispanic Asians Residing in the United States

Abstract

Background: Evidence suggests that acculturation can increase risks of poor diet, obesity, and chronic diseases. Yet questions remain regarding acculturation proxy measures and associations with diet quality in Asian Americans.

Objectives: Primary objectives included estimating percentages of Asian Americans with low, moderate, and high acculturation using 2 proxy measures of acculturation based on different language variables and determining if diet quality differences existed among acculturation levels using the 2 proxy acculturation measures.

Methods: Study sample included 1275 Asian participants aged ≥16 y from National Health and Nutrition Examination Survey 2015-2018. Nativity/length of United States residence, immigration age, language spoken at home (home), and language of dietary recall (recall) were used as proxy measures for 2 acculturation scales. Replicate 24-h dietary recalls were conducted and diet quality was assessed using 2015 Healthy Eating Index. Statistical methods for complex survey designs were used for analysis.

Results: Using home and recall language, 26% compared with 9% of participants were classified with low, 50% compared with 63% with moderate, and 24% compared with 28% with high acculturation. On the home language scale, participants with low and/or moderate acculturation had higher scores (0.5-5.5 points) for vegetables, fruits, whole grains, seafood and plant protein, saturated fats, added sugars, and total 2015 Healthy Eating Index than participants with high acculturation; participants with low acculturation had lower refined grain score (1.2 points) than participants with high acculturation. Results were similar for the recall language scale, except differences between participants with moderate and high acculturation were also observed for fatty acids.

Conclusions: Although percentages of Asian Americans classified with low, moderate, and high acculturation differed between the 2 proxy measures for acculturation, diet quality differences among acculturation groups were remarkably similar between the 2 proxy measures. Hence, use of either language variables may yield comparable results regarding the relationships between acculturation and diet in Asian Americans.

Keywords: Asian American; MyPlate; acculturation; accuracy of diet quality assessment; food security; measured diet quality; perceived diet quality.