Disentangling the roles of generational status and acculturation on dietary behaviors in disaggregated Asian American subgroups

Abstract

Introduction

Little is known on the independent effects of generational status and acculturation on the consumption of specific foods among disaggregated Asian American (AA) populations. This study explores the associations of generational status and acculturation with dietary behaviors of a nationwide non-probability sample of 3018 AAs (57.6% East Asian American (EAA), 18.9% South Asian American (SAA), 19.4% Southeast Asian American (SEAA)).

Methods

Recruited participants completed an online dietary survey designed and adapted for AAs to assess a range of diet and food purchasing behaviors. Generational status was assessed through participant and parental country of birth (1st-Gen, 2nd-Gen, 3rd-Gen); the Marin Short Acculturation Scale was adapted to measure acculturation. Linear regression models assessed the association of generational status and acculturation with consumption of 11 food/nutrient groups, adjusted for socio-economic variables.

Results

Compared to estimated US averages, participants reported lower fruit, dairy, and seafood intake yet lower red and processed meat, and higher whole grain, calcium, and fiber intake. Compared to EAA, SAA reported higher dairy (1.72 vs. 1.46 cups/day) and calcium (1029 vs. 954 mg/day) intakes, while SEAA reported lower vegetable intake (1.66 vs. 1.78 cups/day). In adjusted analyses, processed meat intake was higher among 2nd-Gen and 3rd-Gen vs.1st-Gen (+0.029 times/day; +0.061 times/day) participants. Higher acculturation was associated with lower vegetable, fiber, and seafood intake (−0.005 cups/day; −0.02 g/day; −0.002 times/day).

Conclusion

Greater attention to the role of generational status and acculturation in AA dietary behaviors is needed, and findings call for further research to understand the mechanisms behind the dietary influence of different socialization and acculturative processes.

Introduction

Understanding and addressing the complex health and social needs of Asian Americans (AAs), now the fastest growing racial and ethnic group in the United States (US) (Budiman & Ruiz, 2021), has become an area of increased research and policy focus. Non-communicable diseases (NCDs), such as diabetes and heart disease, represent major causes of death for AAs (Hastings et al., 2015), although disparities in health outcomes become apparent when disaggregating this subpopulation into country-of-origin subgroups. For example, Filpina/x/o, Asian Indian/South Asian, and Korean American adults have a high prevalence of diabetes (Wyatt et al., 2021), while heart disease represents a leading cause of death for Filipino, Japanese, and Asian Indian men (Hastings et al., 2015).

Disparities in NCDs may be, in part, linked to differences in diet practices (e.g., consumption of sweet and fried foods) (Beasley et al., 2019), but food group consumption data disaggregated by AA subgroup is limited or dated. However, preliminary data point to significant differences in AA dietary behaviors compared to other US populations and across different AA ethnic subgroups. The 2005 California Health Interview Survey, for example, indicates that the prevalence of consuming five or more fruit and vegetables (FVs) per day among both AA men (50%) and women (34%) was lower than Non-Hispanic White adults (59%; 41%), and ranged from 29% among Filipina women to 59% among Korean men (Maxwell et al., 2012). Previous work using national dietary recall data has also highlighted that key sources of salt and sugar in diets are different in AA adults compared to other ethnic subgroups (Firestone et al., 2017; Russo et al., 2020). Many AA subgroups report high seafood consumption (Sechena et al., 2003), and some AA subgroups (e.g., Japanese men and women in Hawaii) report higher red meat intake and lower fiber intake than Non-Hispanic adults (Steinbrecher et al., 2011). Importantly, lacking from the literature are studies assessing food and nutrient intake in national samples of AAs that provide information on AAs overall and on disaggregated AA subgroups.

While the degree of acculturation has been linked with unique dietary patterns among AA adults (Kirshner et al., 2020), what has been less explored is the role that generational status plays in the adoption of certain dietary practices. About 59% of AAs are foreign-born (i.e., first-generation / 1st-Gen Americans), and the remaining 41% of AAs are either second-generation / 2nd-Gen (US-born with at least one Asian-born parent) or third-generation / 3rd-Gen (US-born, with US-born parents and at least one Asian-born grandparent) (Pew Research Center, 2012). Prior research has shown that 2nd-Gen AAs are more than twice as likely to be obese than 1st-Gen AAs (Popkin & Udry, 1998), which suggests that obesity is linked to being born in the US. However, a recent review on youth in US immigrant families demonstrated that obesity was associated with lower levels of acculturation (Dondi et al., 2020). Such findings support the need for critical examination of generational status in parallel to acculturation in deconstructing differences in AA dietary practices.

In response to a growing call for more observational research related to NCD outcomes and lifestyle behaviors – including diet practices – observed in 2nd-Gen/3rd-Gen AA adults (Ali et al., 2020), we sought to explore dietary behaviors of a nationwide sample of AAs and their association with generational status and acculturation using a validated dietary screener adapted for AA adults, focusing on 11 key food and nutrient groups and disaggregating by Asian ethnic subgroup. To our knowledge, no research has collected data from a national sample of AA adults using a validated diet screener specifically designed or adapted to be culturally relevant across AA populations.