The Effect of Race and Ethnicity on the Associations Between Metabolic Syndrome, Nativity, and Diet Quality in Adults: An Analysis of the National Health and Nutrition Examination 2013-2018

Abstract

BACKGROUND AND AIMS: The aim of this thesis is to investigate the potential effects race/ethnicity may have on the relationship between nativity, diet quality, and metabolic syndrome (MetS). Existing literature reports there is a clear inverse relationship between diet quality and metabolic syndrome , but lacks thorough exploration of race-based differences in this relationship. Existing research investigating the relationship between metabolic syndrome and other exposures like depression and acculturation is available, as are studies that explore the relationship between nativity and prevalence/severity of cardiometabolic factors within a single-race sample, but analyses of metabolic syndrome and nativity inclusive of multiple racial/ethnic groups seem to be missing from the body of current epidemiological literature.

METHODS: Diet quality was measured at the individual level by the Healthy Eating Index-2015 (HEI-2015) at the individual level, and prevalence of MetS as categorical and continuous variables was calculated. Significant differences in proportions and means were computed with chi square and one-way ANOVA tests, respectively. All analyses were performed using SAS Studio 3.8 Survey Procedures.

RESULTS: Significant differences in the distribution of participants by HEI-2015 Total Score quintiles were found for age group and nativity (P

DISCUSSION/CONCLUSION: The U.S. has more immigrants than any other country in the world who bring with them diverse values, beliefs, lifestyles, attitudes surrounding health and food, and distinct consumption patterns. Investigating race and nativity-based differences in cardiometabolic and nutritional health outcomes, alongside surveillance of the changes in food demand trends in the U.S. as a result of the ever-growing immigrant population, can act as valuable predictors of health outcomes and can aid in the development of culturally-relevant treatment approaches