It is quite clear that nutritional intake is associated with common health conditions such as obesity, hypertension (high blood pressure), cancer, diabetes (high blood sugar), and cardiovascular disease. People in the United States make daily decisions related to grocery purchases, meal choices, food preparation, and other factors influencing their consumption of food and nutrients, and, thus, likely affecting their health. However, much of the current knowledge and most published works are based on studies or other information that concern the general population. This information is important in influencing dietary patterns, but additional information is needed regarding specific regional and minority populations. Additionally, more detailed information is necessary to determine if there are any differences or similarities between these subpopulations. What follows is a general literature review related to minority groups in the United States.
African-American Influences
As might be surmised, the daily diet can be greatly influenced by cultural variables related to a specific ethnic group, as well as differences within an ethnic group. The socioeconomic status of a group is also relevant when considering decisions about dietary intake.
The prevalence of hypertension, cardiovascular disease, and diabetes is greater among African Americans than other groups. Dietary intake has been strongly associated with both of these conditions for many years. Therefore, it seems prudent to focus on diet in an attempt to reduce the number of premature disabilities and deaths as the result of these conditions.
However, the researchers Christian Lindquist, Barbara Gower, and Michael Goran found that African-American children and white children had similar dietary intake patterns. The small differences in consumption were found to be more favorable for African-American children. The researchers found, for example, that African-American children ate more fruits and vegetables than white children. Both groups, however, do not meet the national
standards for recommended daily intake. African-American children have a lower insulin sensitivity and higher acute insulin response than white children, suggesting a higher risk of diabetes.
Socioeconomic status (SES) has been connected to diabetes. African-American women are more likely to be diabetic if they have low SES. This association was not found to be evident in African-American men, however. While it is possible that a condition such as diabetes causes a reduction in or loss of income, and thus has a negative impact on SES, there is little evidence to support this theory.
Diets with a high fat content have been associated with various cancers. Brown and colleagues found that African Americans have higher frequency of being overweight and obese (20 percent or more above the recommended weight), while Caucasians use more vitamin C supplements. This may explain part of the higher incidence of multiple myeloma, a type of cancer, in African Americans. It is also congruent with literature that suggests vitamin C consumption may decrease the risk of some cancers.
African Americans generally have greater rates of hypertension and the associated complications, such as cerebrovascular accidents (strokes) and renal (kidney) disease. In 1996, Frederick Brancati and colleagues found that potassium supplements reduce blood pressure in African Americans who eat foods low in potassium. This phenomenon could be due to a distinct sensitivity to potassium, or because the diets are low in potassium, or a combination of both.
U.S. Regional Cooking
Regional cuisine in the United States has been influenced by the ingredients native to each region as well as by the culinary heritage of the groups that first settled there. Characteristic ingredients of New England cooking include seafood, cranberries, rhubarb, and apples. Heavily influenced by British settlers, cooking techniques in New England rely on roasting and boiling to produce such dishes as clam chowder, baked beans, and salt cod. The Southern states were influenced by French, English, and Spanish colonists and by African slaves, who often served as household cooks and who introduced okra, black-eyed peas, and eggplant to the menu. The region is fertile ground for rice, which is featured in the classic Southern rice pudding; other typical dishes include fried green tomatoes, squash casserole, fried chicken, cornbread, and grits. The Midwest is known for corn, beef, and dairy products, and the region's cooking techniques reflect the influence of German and Scandinavian settlers. Traditional dishes include beef pot roast, bratwurst, sauerkraut, and corn on the cob. In the Southwest, where Spanish and Mexican influences predominate, typical ingredients include chiles, cumin, cinnamon, tortillas, and tomatoes. Barbecuing is the best-known cooking technique, and common dishes include chili, burritos, flan, and other Tex-Mex interpretations of Mexican cooking. The Pacific Northwest is known for seafood, game, and berries. Dishes identified with the Pacific Northwest include salmon, venison, pumpkin soup, and gooseberry relish.
—Paula Kepos
From a sociological standpoint, Kaja Perina reported in 2001 that African-American television stations show more food (especially junk food) and beverage commercials during prime time than other stations. To compound the emphasis on weight management, Perina highlights that 27 percent of
actors on African American networks are overweight, compared to 2 percent of actors on other networks.
Another obstacle to satisfactory daily nutrition may be the inability to access ethnic foods in the inner city. Monique Brown suggests that quality comprehensive grocery stores are frequently missing from African American communities. Instead, smaller convenience marts provide limited foods and goods, severely limiting dietary choices, in addition to being more expensive than supermarkets.
The elderly population in the United States does not regularly follow dietary recommendations. Typically, not enough calories are consumed, as well as inadequate amounts of some vitamins and nutrients. Insufficient income, disability, inadequate knowledge, and lack of transportation contribute to poor dietary habits. The diets of elderly African Americans have been found to be deficient in energy, calcium, and vitamin B6, protein, thiamine, riboflavin, and iron. Black men tend to consume more energy, fat, and cholesterol than black women, but less vitamins C, B6, and thiamine.
Hispanic Influences
Mexican-American children who participated in a San Diego study related to children's activity and nutrition were more likely than non-Hispanic white children to be overweight, to eat more fat, and to exercise less. Those who watched more television were more likely to consume excess fat. However, children who ate less sodium were more knowledgeable about food and more likely to avoid fat consumption. Study participants who were identified as being in lower socioeconomic levels tended to consume more sodium. Accordingly, education has been a valuable tool in behavior modification programs for a variety of different target areas related to health.
Likewise, there is some evidence that Mexican-American children over fifteen years of age have smaller statures, but weigh more, than white children. This may have a negative effect on future health risks related to diabetes, cancer, and cardiovascular disease.
The economics of a family greatly influence choices related to food intake. If one family of four allocates $150 per week for groceries and another budgets $100, there is a wide disparity in the quantity of food eaten by these two families. Economically disadvantaged Hispanics in twelve counties in southern Colorado were found to focus on their children's nutritional habits and on avenues to preparing quick, healthy menus. Socioeconomic status and geographic isolation due to the mountains have a negative effect on the food availability of this cultural group, who frequently earn a living as migrant farm workers. Barriers to changing eating habits included lack of finances, limited education and cooking abilities, customs, and confusion related to communication from nutrition professionals.
Research by Judith A. Beto, Gopali Sheth, and Patricia Rewers suggests that a broad supply of basic foods are readily available to low-income families. For example, sugar, flour, eggs, pasta, and vegetables are commonly eaten by such families. However, the way in which the food is prepared varies, accounting for a wide difference in fat consumption. This data implies that education related to healthful food preparation can assist in reducing fat intake.
In addition to studies that investigate the Hispanic population in general, there are also some reports concentrating on nutrition that investigate individual sectors of this population. Indeed, researchers Carlos Crespo, Catherine Loria, and Vicki Burt note that Hispanics have lower or equal rates of hypertension, but higher prevalence rates of obesity and diabetes than non-Hispanic whites. Hispanic females appear to have increased awareness of treatment and control of hypertension than Hispanic males. In addition, Cuban-American women were more aware of their hypertensive state than Mexican-American and Puerto Rican females. The vast majority of Hispanic men with high blood pressure do not keep it under control. Moreover, Mexican-American and Puerto Rican women have higher rates of being overweight than other female and male Hispanics. In addition, people who are overweight are commonly diagnosed with hypertension.
Food purchasing practices also affect dietary intake. Geoffrey Paulin found that there are differences in the purchasing power of Hispanics compared to other groups, as well as within the subpopulations of the general group. Hispanics only have about two-thirds the income of non-Hispanics, and they are more likely to have participated in a food stamp program. Furthermore, Hispanics have fewer years of education and are less likely to live in rural areas. Hispanics usually purchase more meats, fruits, and vegetables than non-Hispanics, while purchasing fewer potatoes, sweets, and dairy products. This food purchasing pattern may reflect the origin of certain immigrant groups. For example, citrus fruits are commonly grown in Mexico, and bananas are grown in Central and South America. It is also noted that Hispanics spend less on snack foods, such as potato chips, candy, and cakes, and may view these foods as unnecessary or as a luxury.
There are also important differences within the specific Hispanic population. For example, Cubans spend twice as much money on coffee as Mexicans do. Such spending differences suggest that consumption habits are also different within Hispanic subpopulations.
There may also be changes in diets as the result of relocation. For example, Laura McArthur, Ruben Anguiano, and Diego Nocetti studied Hispanic immigrants in North Carolina who had resided in the United States for 10 years or less. They found that these immigrants did not generally maintain their dietary habits. Children were found to be greatly influenced by school meals. Foods high in fat and sugar were consumed in larger quantities than in the countries of origin of these immigrants. This type of change due to relocation is known as acculturation and is common in immigrant groups.
The need for continued research related to dietary intake patterns and influences is apparent. The majority of studies have historically investigated dietary behavior within the general population. However, it appears that cultural differences can affect the daily diet, and, thus, impact certain health conditions.
Beto, Judith A.; Sheth, Gopali; and Rewers, Patricia (1997). "Assessing Food Purchase Behavior among Low-Income Black and Hispanic Clients Using a Self-Reported Shelf Inventory." Journal of American Dietetic Association 97(1):69–70.
Brancati, Frederick L.; Appel, Lawrence J.; Seidler, Alexander J.; and Whelton, P. K. (1996). "Effect of Potassium Supplementation on Blood Pressure in African Americans on a Low-Potassium Diet." Archives of Internal Medicine 156(1):61–67.
Brown, Linda M.; Gridley, Gloria; Pottern, Linda; et al. (2001). "Diet and Nutrition as Risk Factors for Multiple Myeloma among Blacks and Whites in the United States." Cancer Causes and Control 12(2):117–125.
Brown, Monique R. (1999). "Supermarket Blackout: There Are Few Supermarkets in Cities, Meaning That Blacks Pay More for Food, Lose Out on Jobs and Go Elsewhere for Quality Goods." Black Enterprise 29(12): 81–94.
Cohen, Nancy L.; Ralston, Penny A.; Laus, Mary J.; et al. (1998). "Food Practices, Service Use, and Dietary Quality in Elderly Blacks." Journal of Nutrition for the Elderly 17(4):17–34.
Crespo, Carlos J.; Loria, Catherine M.; and Burt, Vicki L. (1996). "Hypertension and Other Cardiovascular Disease Risk Factors among Mexican Americans, Cuban Americans, and Puerto Ricans from the Hispanic Health and Nutrition Examination Survey." Public Health Reports, 3(2):7–10.
Lindquist, Christine H.: Gower, Barbara A.; and Goran, Michael I. (2000). "Role of Dietary Factors in Ethnic Differences in Early Risk of Cardiovascular Disease and Type 2 Diabetes." American Journal of Clinical Nursing 71(3):725–732.
McArthur, Laura H.; Anguiano, Ruben P; and Nocetti Diego (2001). "Maintenance and Change in the Diet of Hispanic Immigrants in Eastern North Carolina." Family and Consumer Sciences Journal 29(4):307–335.
Palmeri, Denise; Auld, Gary W.; Taylor, T.; et al. (1998). "Multiple Perspectives on Nutrition Education Needs of Low-Income Hispanics." Journal of Community Health 23(4):301-316.
Paulin, Geoffrey D. (2001). "Variation in Food Purchases: A Study of Inter-Ethnic and Intra-Ethnic Group Patterns Involving the Hispanic Community." Family and Consumer Sciences Research Journal 29(4):336–381.
Perina, Kaja (2001). "Obesity: Watch What You Watch." Psychology Today 34(5):32.
Robbins, Jessica; Vaccarino, Viola; Zhang, Heping; and Kasl, Stanislav V. (2001). "Socioeconomic Status and Type 2 Diabetes in African American and Non-Hispanic White Women and Men: Evidence from the Third National Health and Nutrition Examination Survey." American Journal of Public Health 91(1):76–83.
Ryan, Alan. S.; Roche, Alex F.; and Kuczmarski, Robert J. (1999). "Weight, Stature, and Body Mass Index Data for Mexican Americans from the Third National Health and Nutrition Examination Survey (NHANES III, 1988–1994)." American Journal of Human Biology 11:673–686.
Zive, Michelle M.; Frank-Spohrer, Gail C.; Sallis, James F.; et al. (1998). "Determinants of Dietary Intake in a Sample of White and Mexican-American Children." Journal of American Dietetic Association 98(11):1282–1289.
