(P29-057-23) Acculturation of Non-US Born Adults in NHANES 2011–2018 Is Associated With Higher Ultra-Processed Food (UPF) Consumption

Objectives: Increased ultra-process food (UPF) consumption has been linked to increased risks of negative health outcomes such as type 2 diabetes, obesity and all-cause mortality. Some studies have shown an increase of UPF consumption with acculturation and the influence of the Western diet on non-US born individuals is an area of increasing interest. The aim of this work was to investigate the association of acculturation using a newly developed acculturation index with UPF consumption in non-US born adults participating in the National Health and Nutrition Examination Survey (NHANES).

Methods: Dietary intake of non-US born adults in NHANES years 2011-2018 was assessed using the first day 24-h dietary recall and the relative daily energy intake comprised of ultra-processed food was used as the outcome of interest. An acculturation index (AI) was calculated based on the fraction of life spent in the US with a range of scores from 0 to 3 plus a language score ranging from 0 to 2 based on the predominance of English spoken at home. The effect of acculturation on UPF consumption was investigated after controlling for BMI, sex, age, and race. Complex survey sample regression analyses were used to evaluate the association between UPF and AI.

Results: A total of 3,782 non-US born adults (50% male) between 19-70 (45±13.9) years of age were assessed. Of the adults assessed, 42.2% had lower AI scores of 0 to 2 and 57.8% had AI scores of 3-5 (more accultured) and overall meal daily intake from UPF was 44%. When controlling for co-variates, acculturation was significantly associated with UPF consumption (β = 0.03, s.e. = 0.004, p < .001) meaning that for every unit increase in AI score, there was a three percent increase in mean UPF consumption.

Conclusions: We introduce a composite score to assess acculturation into the US. Based on this index, non-US born individuals who become more accultured consume diets higher in ultra-processed foods. Interventional strategies should be considered for non-US born individuals to promote culturally-based diets that encourage healthy eating behaviors from countries of origin.

Funding Sources: Funding for the research was provided by the National Institutes of Health (NIH) Intramural Research Program and the NIH Clinical Center.