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PubMed1998

Dietary Patterns of a Group of Children, Mothers and Grandmothers.

Information regarding the dietary patterns of life cycle cohorts may reveal the usefulness of nutrition education messages. We described the dietary patterns of a convenience sample of three life stages, children, mothers and grandmothers and determined differences between adjacent age cohorts, for per cent of energy as carbohydrate, fat and protein, number of servings from food groups and intake of key nutrients associated with food groups. Four days of dietary intake data were available for 76 children (8.8 - 12.9 years), 59 premenopausal females, 31 - 52 years (mothers) and 19 postmenopausal females, 58 - 83 years (grandmothers). The greatest difference was for per cent of energy as carbohydrate (mean SD), for which the value for mothers (48 7) was significantly lower than that for the children (53 5), while the grandmothers' intake (52 6) was similar to that of the children. Intake of Vegetables and Fruit also varied at 3.9 2 servings per day for children, 5.2 2 for mothers and 7.4 3 for grandmothers. The mothers' number of servings of Fats and Oils was significantly higher than that of the children and grandmothers, while children had the highest number of servings of Sweets and Desserts. Levels of nutrient intakes corresponded to the number of servings from major source food groups for each of the life-stage groups.

Journal Article↗
PubMed2006

A prospective study of dietary patterns, meat intake and the risk of gestational diabetes mellitus.

AIMS/HYPOTHESIS: The aim of this study was to prospectively examine whether dietary patterns are related to risk of gestational diabetes mellitus (GDM). METHODS: This prospective cohort study included 13,110 women who were free of cardiovascular disease, cancer, type 2 diabetes and history of GDM. Subjects completed a validated semi-quantitative food frequency questionnaire in 1991, and reported at least one singleton pregnancy between 1992 and 1998 in the Nurses' Health Study II. Two major dietary patterns (i.e. 'prudent' and 'Western') were identified through factor analysis. The prudent pattern was characterised by a high intake of fruit, green leafy vegetables, poultry and fish, whereas the Western pattern was characterised by high intake of red meat, processed meat, refined grain products, sweets, French fries and pizza. RESULTS: We documented 758 incident cases of GDM. After adjustment for age, parity, pre-pregnancy BMI and other covariates, the relative risk (RR) of GDM, comparing the highest with the lowest quintile of the Western pattern scores, was 1.63 (95% CI 1.20-2.21; p (trend)=0.001), whereas the RR comparing the lowest with the highest quintile of the prudent pattern scores was 1.39 (95% CI 1.08-1.80; p (trend)=0.018). The RR for each increment of one serving/day was 1.61 (95% CI 1.25-2.07) for red meat and 1.64 (95% CI 1.13-2.38) for processed meat. CONCLUSIONS/INTERPRETATION: These findings suggest that pre-pregnancy dietary patterns may affect women's risk of developing GDM. A diet high in red and processed meat was associated with a significantly elevated risk.

Adult↗
PubMed2005

A comparison of three dietary pattern indexes for predicting biomarkers of diet and disease.

OBJECTIVE: Examination of dietary indexes in association with objective biomarkers of dietary intake and chronic disease risk is an important step in their validation. We compared three dietary pattern indexes-Healthy Eating Index (HEI), Recommended Foods Score (RFS-24 hour recall), and Dietary Diversity Score for recommended foods (DDS-R)-for their ability to predict biomarkers of dietary intake, obesity, cardiovascular disease, and diabetes. METHODS: We used dietary and laboratory data from the third National Health and Nutrition Examination Survey to study these associations in 8719 disease-free adults aged > or =20 y. The HEI, developed by the USDA, was a sum of scores on consideration of ten individual components; the RFS was a sum of all recommended foods (lean meat, poultry and fish, whole grains, fruits and juices, low-fat dairy, and vegetables) mentioned in the recall; the DDS-R examined whether or not a recommended food was mentioned from each of the five major food groups. The independent association of the dietary pattern indexes with body mass index (BMI), blood pressure, and serum concentrations of several biomarkers were examined using regression methods to adjust for multiple covariates. RESULTS: All indexes were strong independent positive predictors of serum concentrations of vitamin C, E, folate, and all carotenoids (p < or = 0.00001), except lycopene, and were negative predictors of BMI, serum homocysteine, C-reactive protein, plasma glucose, and hemoglobin A1C (p < 0.05). The RFS and DDS-R were inversely associated with blood pressure and serum cholesterol (p < or = 0.03). CONCLUSIONS: The RFS and DDS-R performed as well or better than the HEI for predicting serum concentration of nutrients and biomarkers of disease risk.

Adult↗
PubMed2003

[Factors associated with dietary patterns in the urban Brazilian population].

This study evaluated factors associated with dietary patterns in the Brazilian population based on the Living Standards Survey conducted in the Northeast and Southeast regions of the country. Multi-stage probability sampling was employed to select the households, and for the present analysis 5,121 adults aged 20 to 50 years were included. Pregnant women and individuals reporting chronic health conditions were excluded. Through principal component analysis, two major family dietary patterns were identified: a mixed pattern, in which all groups and foods have approximately the same factor loading, and a second pattern based main1y on rice and beans, which was called a traditional diet. Weight and height were measured in the households, and food intake was based on a 21-item semi-quantitative family questionnaire. The Northeast (as compared to the Southeast) was negatively associated with the mixed pattern. Body mass index was positively associated with the mixed pattern, whereas leisure physical activity and Black skin color were negatively associated with the mixed pattern. Schooling and income levels explained most of the dietary variance, but after adjusting for education and income, region of residence remained significantly associated and was the third most important explanatory variable.

Adult↗
PubMed2005

Dietary pattern, inflammation, and incidence of type 2 diabetes in women.

BACKGROUND: Inflammation is considered a key mechanism leading to type 2 diabetes, but dietary exposures that lead to inflammation and diabetes are largely unknown. OBJECTIVE: Our objective was to investigate the relation between a dietary pattern associated with biomarkers of inflammation and the incidence of type 2 diabetes. DESIGN: We conducted a nested case-control study of 656 cases of type 2 diabetes and 694 controls among women in the Nurses' Health Study and 2 prospective cohort studies of 35,340 women in the Nurses' Health Study and 89,311 women in the Nurses' Health Study II who were followed for incident diabetes. RESULTS: Through the use of reduced rank regression, we identified a dietary pattern that was strongly related to inflammatory markers in the nested case-control study. This pattern, which was high in sugar-sweetened soft drinks, refined grains, diet soft drinks, and processed meat but low in wine, coffee, cruciferous vegetables, and yellow vegetables, was associated with an increased risk of diabetes (multivariate-adjusted odds ratio comparing extreme quintiles: 3.09; 95% CI: 1.99, 4.79). We identified 1517 incident cases of confirmed type 2 diabetes in the Nurses' Health Study (458,991 person-years) and 724 incident cases in the Nurses' Health Study II (701,155 person-years). After adjustment for body mass index and other potential lifestyle confounders, the relative risks comparing extreme quintiles of the pattern were 2.56 (95% CI: 2.10, 3.12; P for trend < 0.001) in the Nurses' Health Study and 2.93 (95% CI: 2.18, 3.92; P for trend < 0.001) in the Nurses' Health Study II. CONCLUSION: The dietary pattern identified may increase chronic inflammation and raise the risk of developing type 2 diabetes.

Adult↗
PubMed2000

The effect of dietary patterns on blood pressure control in hypertensive patients: results from the Dietary Approaches to Stop Hypertension (DASH) trial.

To determine the impact of dietary patterns on the control of hypertension we studied the subgroup of 133 participants with systolic blood pressure (BP) of 140 to 159 mm Hg and/or diastolic BP of 90 to 95 mm Hg enrolled in the Dietary Approaches to Stop Hypertension (DASH) study. Participants were fed a control diet for a 3-week period and were then randomized to receive for 8 weeks either the control diet; a diet rich in fruits and vegetables, but otherwise similar to control; or a combination diet rich in fruits, vegetables, and low-fat dairy products, including whole grains, fish, poultry, and nuts, and reduced in fats, red meats, sweets, and sugar-containing beverages. Sodium intake and body weight were held constant throughout the study. The combination diet significantly reduced systolic BP (-11.4 mm Hg, P < .001) and diastolic BP (-5.5 mm Hg, P < .001). The fruits-and-vegetables diet also significantly reduced systolic BP (-7.2 mm Hg, P < .001) and diastolic BP (-2.8 mm Hg, P = .013). The combination diet produced significantly greater BP effects (P < .05) than the fruits-and-vegetables diet. Blood pressure changes were evident within 2 weeks of starting the intervention feeding. After the 8-week intervention period, 70% of participants eating the combination diet had a normal BP (systolic BP < 140 and diastolic BP < 90 mm Hg) compared with 45% on the fruits-and-vegetables diet and 23% on the control diet. In patients with hypertension, the DASH combination diet effectively lowers BP and may be useful in achieving control of Stage 1 hypertension.

Adult↗
PubMed2003

An approach to construct simplified measures of dietary patterns from exploratory factor analysis.

Exploratory factor analysis might work well in elucidating the major dietary patterns prevailing in specific study populations. However, patterns extracted in one study population and their associations with disease risk cannot be reproduced with this data-specific method in other study populations. To construct less population-dependent pattern variables of similar content as original exploratory patterns, we proposed to derive so-called simplified pattern variables. They represent the sum of the unweighted standardised food variables which loaded high at the pattern of interest. Data from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam study suggest that these simplified pattern variables might adequately approximate factor analysis-based dietary patterns. A simplified pattern variable based on the six highest loading food variables showed a correlation >0.95 with the originally derived factor score, which consisted of forty-seven food variables. Moreover, simplified pattern variables might adequately approximate patterns across different study populations. A simplified pattern variable showed similar factor loadings, ranging from 0.34 to 0.52, as well as similar associations with nutrient intake as a 'western' pattern originally reported from an US study population. These simplified pattern variables can subsequently be used to study pattern associations with disease risk, especially in multi-centre studies. It is therefore an approach that might overcome one of the most frequently claimed limitations of factor analyses applied in epidemiology: their non-comparable risk estimates.

Diet↗
PubMed2000

Men who consume vegetable oils rich in monounsaturated fat: their dietary patterns and risk of prostate cancer (New Zealand).

OBJECTIVES: To investigate (i) dietary patterns associated with consumption of vegetable oils rich in monounsaturated fatty acids (MUFA), and (ii) the risk of prostate cancer associated with consumption of these oils. METHODS: A population-based case-control study was conducted in Auckland, New Zealand, involving 317 prostate cancer cases and 480 controls. A food-frequency questionnaire was used to collect data concerning consumption of MUFA-rich vegetable oils (including olive oil, canola or peanut oil) and other dietary variables. Biomarkers for fatty acids were measured in erythrocytes. RESULTS: The group of participants who reported regular consumption of greater than 5.5 ml of MUFA-rich vegetable oils per day had a diet relatively high in monounsaturated fat, vegetables, lycopene, vitamin E, selenium, and n-3 fish oils. Increasing levels of MUFA-rich vegetable oil intake were associated with a progressive reduction in prostate cancer risk (multivariate relative risk = 0.5; 95% confidence interval 0.3-0.9; > 5.5 ml per day vs. nonconsumption, p trend = 0.005), and similar trends were observed across all strata of socioeconomic status. Prostate cancer risk was not associated with intake of total MUFA or the major animal food sources of MUFA. CONCLUSION: This finding may be explained by the protective effect of an associated dietary pattern high in antioxidants and fish oils, an independent protective effect of MUFA-rich vegetable oils unrelated to the MUFA component, or a combination of these factors.

Adult↗
PubMed2001

Dietary patterns, nutrient intake and gastric cancer in a high-risk area of Italy.

OBJECTIVES: To better understand the role of overall dietary patterns and major energy-providing components in gastric cancer etiology. METHODS: In a population-based case-control study conducted in a high-risk area in central Italy, 382 gastric cancer cases and 561 controls were available for analysis. Multivariate models based on energy-adjusted residuals and completely partitioned logistic models were used; dietary patterns were evaluated by factor analysis and multiple correspondence analysis. RESULTS: Gastric cancer risk was inversely related to high energy-adjusted intakes of vegetable fat, sugar, beta-carotene, vitamin C, alpha-tocopherol, and nitrates. In contrast, significant positive associations emerged with high intake of protein, nitrite, and sodium. According to energy decomposition models, gastric cancer risk increased with increasing intake of protein and decreased with increasing intake of sugar and total fat. The pattern analysis identified four dietary profiles, overall explaining 75% of total dietary variability. Two patterns, named "traditional" and "vitamin-rich", were strongly associated with gastric cancer risk and overall accounted for 44% of estimated gastric cancer attributable risk. The other two patterns, "refined" and "fat-rich", were not consistently associated with gastric cancer. CONCLUSION: Innovative methodological approaches may contribute to better evaluation of the complex relationship between diet and cancer risk and to planning dietary interventions.

Adult↗
PubMedDate not supplied

[Sociodemographic differences in adherence to the Mediterranean dietary pattern in Spanish populations].

OBJECTIVES: Lower social classes tend to eat a less healthy diet. The aim of this study was to compare adherence to the Mediterranean dietary pattern among different demographic and social groups in the adult population. METHODS: A cross-sectional study was performed in southern and northern regions of Spain in healthy volunteers (15,634 men and 25,812 women), aged 29-69 years, who were members of the European Prospective Investigation on Cancer cohort in Spain. Nine groups of food were included in the definition of the Mediterranean diet: vegetables and garden products, fruits, pulses, cereals, red meat, fish, olive oil, milk and milk products, and wine. Two techniques were used in the analysis: comparison of the mean daily intake of each group and calculation of an overall score for all the foods according to educational level and original social class. RESULTS: Groups with the lowest educational levels consumed more cereals and pulses and lower quantities of vegetables, olive oil (women), milk and milk products (men). Wine consumption was positively associated with education in women and was negatively associated in men. Calculation of a score to measure overall adherence to the Mediterranean dietary pattern eliminated differences according to each food category. No variations were found according to educational level, but small differences were found in original social class. The adherence score was lowest in young adults and women and was slightly higher in the south than in the north of Spain. CONCLUSIONS: The results suggest that the Mediterranean dietary pattern is fairly uniform, at least in the adult population of the regions included in this study.

Adult↗
PubMed2005

Empirically derived dietary patterns and risk of postmenopausal breast cancer in a large prospective cohort study.

BACKGROUND: Inconsistent associations have been reported between diet and breast cancer. OBJECTIVE: We prospectively examined the association between dietary patterns and postmenopausal breast cancer risk in a US-wide cohort study. DESIGN: Data were analyzed from 40 559 women who completed a self-administered 61-item Block food-frequency questionnaire in the Breast Cancer Detection Demonstration Project, 1987-1998; 1868 of those women developed breast cancer. Dietary patterns were defined by using principal components factor analysis. Cox proportional hazard regression was used to assess breast cancer risk. RESULTS: Three major dietary patterns emerged: vegetable-fish/poultry-fruit, beef/pork-starch, and traditional southern. The vegetable-fish/poultry-fruit pattern was associated with higher education than were the other patterns, but was similar in nutrient intake to the traditional southern pattern. After adjustment for confounders, there was no significant association between the vegetable-fish/poultry-fruit and beef/pork-starch patterns and breast cancer. The traditional southern pattern, however, was associated with a nonsignificantly reduced breast cancer risk among all cases (in situ and invasive) that was significant for invasive breast cancer (relative hazard = 0.78; 95% CI = 0.65, 0.95; P for trend = 0.003). This diet was also associated with a reduced risk in women without a family history of breast cancer (P = 0.05), who were underweight or normal weight [body mass index (in kg/m(2)) < 25; P = 0.02], or who had tumors positive for estrogen receptor (P = 0.01) or progesterone receptor (P = 0.003). Foods in the traditional southern pattern associated with reduced breast cancer risk were legumes, low mayonnaise-salad dressing intake, and possibly cabbage. CONCLUSIONS: The traditional southern diet or its components are associated with a reduced risk of invasive breast cancer in postmenopausal women.

Adult↗
PubMedDate not supplied

Weight changes, exercise, and dietary patterns during freshman and sophomore years of college.

Weight gain and behavioral patterns during college may contribute to overweight and obesity in adulthood. The aims of this study were to assess weight, exercise, and dietary patterns of 764 college students (53% women, 47% men) during freshman and sophomore years. Students had their weight and height measured and completed questionnaires about their recent exercise and dietary patterns. At the beginning of freshman year, 29% of students reported not exercising, 70% ate fewer than 5 fruits and vegetables daily, and more than 50% ate fried or high-fat fast foods at least 3 times during the previous week. By the end of their sophomore year, 70% of the 290 students who were reassessed had gained weight (4.1+/-3.6 kg, p < .001), but there was no apparent association with exercise or dietary patterns. Future research is needed to assess the contributions of fat, muscle, and bone mass to observed weight gain and to determine the health implications of these findings.

Adult↗
PubMed2005

Consistent dietary patterns identified from childhood to adulthood: the cardiovascular risk in Young Finns Study.

Dietary patterns are useful in nutritional epidemiology, providing a comprehensive alternative to the traditional approach based on single nutrients. The Cardiovascular Risk in Young Finns Study is a prospective cohort study with a 21-year follow-up. At baseline, detailed quantitative information on subjects' food consumption was obtained using a 48 h dietary recall method (n 1768, aged 3-18 years). The interviews were repeated after 6 and 21 years (n 1200 and n 1037, respectively). We conducted a principal component analysis to identify major dietary patterns at each study point. A set of two similar patterns was recognised throughout the study. Pattern 1 was positively correlated with consumption of traditional Finnish foods, such as rye, potatoes, milk, butter, sausages and coffee, and negatively correlated with fruit, berries and dairy products other than milk. Pattern 1 type of diet was more common among male subjects, smokers and those living in rural areas. Pattern 2, predominant among female subjects, non-smokers and in urban areas, was characterised by more health-conscious food choices such as vegetables, legumes and nuts, tea, rye, cheese and other dairy products, and also by consumption of alcoholic beverages. Tracking of the pattern scores was observed, particularly among subjects who were adolescents at baseline. Of those originally belonging to the uppermost quintile of pattern 1 and 2 scores, 41 and 38 % respectively, persisted in the same quintile 21 years later. Our results suggest that food behaviour and concrete food choices are established already in childhood or adolescence and may significantly track into adulthood.

Adolescent↗
PubMed1992

Participation in school physical education and selected dietary patterns among high school students--United States, 1991.

Inadequate physical activity and unhealthy dietary patterns (particularly diets high in fat and low in fruits, vegetables, and grains) established during youth may extend into adulthood and may increase risk for chronic diseases, such as coronary heart disease and cancer (1-5). This report examines the prevalence of self-reported enrollment, attendance, and participation in school physical education (PE) and examines selected dietary patterns among students in grades 9-12 from two school-based components of CDC's Youth Risk Behavior Surveillance System (6): 1) the national Youth Risk Behavior Survey (conducted during April-May 1991) and 2) individual state and local Youth Risk Behavior Surveys (conducted by departments of education in 23 states and 10 cities during the same time).

Adolescent↗
PubMed2026

The Association of Diabetes-Related Dietary Patterns with Pancreatic Cancer Risk in the European Prospective Investigation into Cancer and Nutrition Study.

BACKGROUND: Pancreatic cancer is relatively rare but remains one of the most lethal tumors. Identifying modifiable risk factors is a crucial step to reduce disease burden. Evidence suggests a potential role of type 2 diabetes mellitus in its pathogenesis. OBJECTIVES: The objective of this study is to examine the association between dietary patterns related to diabetes and pancreatic cancer risk in a European population. METHODS: A total of 367,395 participants from the European Prospective Investigation into Cancer and Nutrition study were included. After a median follow-up of 14.9 y, 926 incident cases were identified. The Diabetes Risk Reduction Diet (DRRD), the Empirical Dietary Index for Hyperinsulinemia (EDIH), and the Empirical Dietary Index for Insulin Resistance (EDIR) were estimated from food frequency questionnaires at recruitment. Hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between dietary patterns and pancreatic cancer were calculated using multivariable Cox proportional hazards regression models, adjusted for relevant confounders. RESULTS: Adherence to DRRD showed no association with risk of pancreatic cancer (HRT3vsT1: 0.94; 95% CI: 0.79, 1.12). Higher adherence to EDIH was associated with a borderline 19% increased pancreatic cancer risk (HRT3vsT1: 1.19; 95% CI: 0.99, 1.44). No significant associations were observed in relation to EDIR. No heterogeneity was observed among the subgroups. CONCLUSIONS: Higher adherence to a hyperinsulinemic dietary pattern may contribute to risk of developing pancreatic cancer in our population. Further research is warranted to elucidate the potential role of dietary factors in cancer risk prevention.

Humans↗
PubMed2004

Dietary patterns and blood fatty acid composition in children with attention-deficit hyperactivity disorder in Taiwan.

Nutritional factors may be relative to attention-deficit hyperactive disorder (ADHD), although the pathogenic mechanism is still unknown. Based on the work of others, we hypothesized that children with ADHD have altered dietary patterns and fatty acid metabolism. Therefore, the aim of this study was to evaluate dietary patterns and the blood fatty acid composition in children with ADHD in the Taipei area of Taiwan. The present study found that 58 subjects with ADHD (average age 8.5 years) had significantly higher intakes of iron and vitamin C compared to those of 52 control subjects (average age 7.9 years) (P < 0.05). The blood total protein content in subjects with ADHD was significantly lower than that in control subjects (P < 0.05). On the other hand, children with ADHD had significantly higher blood iron levels compared to the control children (P < 0.05). Additionally, plasma gamma-linolenic acid (18:3 n-6) in children with ADHD was higher than that in control children (P < 0.05). Concerning the composition of other fatty acids in the phospholipid isolated from red blood cell (RBC) membranes, oleic acid (18:1n-9) was significantly higher, whereas nervonic acid (24:1n-9), linoleic acid (18:2n-6), arachidonic acid (20:4n-6), and docosahexaenoic acid (22:6n-3) were significantly lower in subjects with ADHD (P < 0.05). Our results suggest that there were no differences in dietary patterns of these children with ADHD except for the intake of iron and vitamin C; however, the fatty acid composition of phospholipid from RBC membranes in the ADHD children differed from that of the normal children.

Arachidonic Acid↗
PubMed2004

Major dietary patterns are related to plasma concentrations of markers of inflammation and endothelial dysfunction.

BACKGROUND: Endothelial dysfunction is one of the mechanisms linking diet and the risk of cardiovascular disease. OBJECTIVE: We evaluated the hypothesis that dietary patterns (summary measures of food consumption) are directly associated with markers of inflammation and endothelial dysfunction, particularly C-reactive protein (CRP), interleukin 6, E-selectin, soluble intercellular adhesion molecule 1 (sICAM-1), and soluble vascular cell adhesion molecule 1 (sVCAM-1). DESIGN: We conducted a cross-sectional study of 732 women from the Nurses' Health Study I cohort who were 43-69 y of age and free of cardiovascular disease, cancer, and diabetes mellitus at the time of blood drawing in 1990. Dietary intake was documented by using a validated food-frequency questionnaire in 1986 and 1990. Dietary patterns were generated by using factor analysis. RESULTS: A prudent pattern was characterized by higher intakes of fruit, vegetables, legumes, fish, poultry, and whole grains, and a Western pattern was characterized by higher intakes of red and processed meats, sweets, desserts, French fries, and refined grains. The prudent pattern was inversely associated with plasma concentrations of CRP (P = 0.02) and E-selectin (P = 0.001) after adjustment for age, body mass index (BMI), physical activity, smoking status, and alcohol consumption. The Western pattern showed a positive relation with CRP (P < 0.001), interleukin 6 (P = 0.006), E-selectin (P < 0.001), sICAM-1 (P < 0.001), and sVCAM-1 (P = 0.008) after adjustment for all confounders except BMI; with further adjustment for BMI, the coefficients remained significant for CRP (P = 0.02), E-selectin (P < 0.001), sICAM-1 (P = 0.002), and sVCAM-1 (P = 0.02). CONCLUSION: Because endothelial dysfunction is an early step in the development of atherosclerosis, this study suggests a mechanism for the role of dietary patterns in the pathogenesis of cardiovascular disease.

Adult↗
PubMed2004

Dietary pattern change and acculturation of Chinese Americans in Pennsylvania.

OBJECTIVE: To obtain information about dietary pattern change of Chinese Americans in Pennsylvania and its relationship with demographic characteristics and acculturation indicators. DESIGN: A cross-sectional self-administered survey. SUBJECTS: A convenience sample of 399 Chinese Americans. Statistical analyses performed t Tests, analysis of variance with Tukey post-hoc tests, Spearman rank correlation, and chi(2) test. RESULTS: After immigration, Chinese Americans increased consumption frequency of all seven food groups (grains, vegetables, fruits, meat/meat alternatives, dairy products, fats/sweets, and beverages) and Western foods while consumption frequency of traditional Chinese foods decreased. Dietary variety also increased after immigration. Higher education and higher income levels were associated with a larger increase in consumption frequency of grains, vegetables, and fruits. Persons who resided in the United States for a longer period of time shared a greater increase in their consumption frequencies of vegetables, fats/sweets, and beverages. Persons with better English proficiency had a greater increase in their consumption frequency of grains, fruits, meat/meat alternatives, and fats/sweets. CONCLUSIONS: This study can help nutrition educators design appropriate educational programs for first-generation Chinese Americans that can facilitate the adoption of more healthful dietary practices. Nutrition educators should consider the dietary changes of Chinese-American participants, such as skipping breakfast and increased consumption frequency of fats, sweets, and soft drinks, which were observed in this study. For example, acculturated first-generation Chinese Americans should be encouraged to decrease fats, sweets, and soft-drink consumption. Less-acculturated persons should be encouraged to maintain their healthful dietary pattern and increase consumption of vegetables and fruits.

Acculturation↗