Our study explored the process of acculturation among Mexican women living in southwest U.S., and the consequences regarding dietary risk factors associated to health. The cross-sectional study included face to face interviews with 150 migrant women and 150 non-migrant women. Interviews consisted of two non-consecutive 24-hour recalls, and data on anthropometry, acculturation, dietary change and lifestyle. Multiple regression analysis showed that consumption of calories from saturated fat and body mass index (BMI) were significantly higher in migrant women compared to non-migrant women, even after adjusting for other lifestyle and diet related variables. Overall, acculturation seems to be associated with more access to food rather than with a change in consumption of dietary risk components. Furthermore, acculturation was associated positively with socioeconomic status, indicating interplay of socioeconomic and cultural variables related to eating behavior in Mexican immigrant women. Positive association of BMI with acculturation and of acculturation with socioeconomic status suggests that health risk factors among Mexican immigrant women follow similar trends of those of women in their born country.
We are experiencing an era where the shift in focus from communicable to chronic diseases is challenging not only the current perspectives of health education, but also the priorities of health care. However, results from interventions to change health-related behaviors that considered lifestyle as short-term practices have been quite unsuccessful. Behaviors resulting from different lifestyles are understood not as isolated acts controlled by the individual, but as acts that are socially conditioned, culturally embedded, and economically constrained. (Green and Kreuter, 1991; CSDH, 2008) [
Concurring with the above perspective, being sensitive to how individuals define and understand health according to their cultural orientation will facilitate the health promoter’s work. The more a health promoter knows about the beliefs, attitudes, traditions and practices of a given cultural group and how they change within a new cultural setting, the more his/her activities will improve and become effective. Health facilitators that have an understanding and respect for the community’s ways could be more easily involved in a program intended to improve its health (González et al., 1991; Cyril et al., 2015) [
According to the document Healthy Border 2020: A Prevention & Health Promotion Initiative (2010) [
Not only Hispanics are one of the largest ethnic minority groups in the U.S. (Cortes-Bergoderi et al., 2013) [
Regional information on Mexican Americans’ health has been concentrated in those states with the largest numbers of Mexican Americans, such as California and Texas. There is, however, a growing interest in exploring other places in which the Mexican population is increasing. It is also imperative to understand the differences in the lifestyle and living conditions of Mexican Americans as a result of different historic development of their communities (Robinson, 1998; Roberts, 1995) [
Examining the data related to health status among Mexican Americans, it is notable that even though this group belongs to a minority group often classified as low income, it has a health prognosis that is related to variables somewhat different from other low income minority groups. Several studies and review papers, have explored the relationship between socioeconomic status (mainly through income, education and occupation) and health risk factors (i.e. obesity, smoking) (Sobal and Stunkard, 1989; Belcher, et al., 1993; Kumanyika and Golden 1991; Maurer et al., 1989; Samet et al., 1988; Hanis et al., 1983; Stern et al., 1981; Liao et al., 2007; Cortes-Bergoderi et al., 2013) [
Within the aforementioned, it is the aim of this study to further the understanding of the present social, cultural, and economic characteristics that shape the lifestyle, and as a consequence, the dietary pattern of a group of Mexican Americans in the border region of Arizona.
Conceptual FrameworkThe theoretical framework used to guide the present study is based on two ecosystem perspectives. It integrates the conceptual systems from the model of communication-acculturation developed by Kim (1991) [
The conceptual framework, incorporates an attempt to examine how differentiation (defined as the extent of the presence of dietary risk factors) in dietary behavior and food consumption among Mexican American families is related to the level of acculturation, socioeconomic, and demographic characteristics. Consequently, the dependent or outcome variables of the study were food consumption and dietary change, which are the main components of dietary behavior. Additional outcomes resulting from differentiated dietary behaviors and food consumption included an obesity indicator or Body Mass Index (BMI), and body fat distribution (from measures of waist-hip circumferences ratio). Some other variables that can affect the dependent variables were also explored such as smoking behavior, physical activity, alcohol consumption and stress.
Although the data analyzed for this study was collected during the summer of 1994 to spring of 1995, some arguments support its current validity. First, The Hispanic Paradox hypothesis documented from evidence that Hispanics living in the US have higher prevalence of several CV risk factors but lower mortality (Ayala et al., 2008; Cortes-Bergoderi et al., 2013) [
The type of research was cross-sectional and included a purposive site selection from which systematic random selection of units of study (women) were enrolled. Two populations were of interest for this study; migrant Mexican American families (FM) living in Yuma County, Arizona, and low-income non- migrant Mexican families (NM) from Hermosillo, Sonora, Mexico. This last group was considered as a reference group for nutritional variables as dietary intake, obesity and body composition indicators. Sample size was calculated using general formulas for group comparison and association analysis (Bowner et al., 1988) [
The first interview was conducted at the clinic and lasted 45 to 105 minutes; it consisted of a semi-structured 20-page questionnaire that included a 24-hour recall, a semiquantitative food frequency questionnaire (data not-shown, except for alcohol intake), validated scales for acculturation and emotional stress, dietary change and food preparation, behavioral health risk factors (smoking behavior, physical activity, weight concern, and health care), migration, employment, and educational background (Appendix A). We also collected anthropometric data. The second interview involved a 24-hour recall conducted at least one month from the first interview at the participant’s home, and lasted 20 to 30 mins (Conway et al., 2003) [
Food components were calculated by using a food dictionary containing foods and beverages consumed by women at two sites. The dictionary included foods from the USDA food data bank (Geghardt and Matthews, 1988) [
Concepts such as retention or addition of foods to common dietary practices among Mexican Americans were used to measure dietary change (Dewey et al., 1984; Romero et al., 1993) [
Weight and height were measured according to established protocols (Cameron, 1986) [
Acculturation was operationalized through a score obtained by using an acculturation scale developed from selected variables in Kim’s (1988) [
In the present study, only current smokers were considered; operationalization of alcohol consumption was described from the data in the food frequency questionnaire. From the daily activities reported in the pilot study done in the summer of 1993 in Arizona, an index of heavy, moderate, and light physical activity (PAL) was developed and registered depending on the activities reported by women. A modified scale developed by Krause and and Goldenhar (1992) [
In addition to the cross-sectional research described before, an ethnographic study was conducted in both studied communities (Patton, 1990) [
Questions belonging to dietary practices and socioeconomic and demographic variables were coded and input using the SAS and SPSS statistical software [
152 migrant women from Yuma County, and 157 non-migrant women from Hermosillo, Mexico were interviewed. Nineteen (12%) of the migrant women (Yuma) and 28 (18%) of the non-migrant women (Hermosillo) were pregnant at the time of the interview, and 9% and 13% (respectively) were lactating.
Migrants | Non-migrants | ||||
---|---|---|---|---|---|
X ± SD | Range | X ± SD | Range | ||
Family size* | 5.2 ± 2.0 | 2 - 15 | 4.9 ± 1.8 | 2 - 15 | |
Mother’s age* | 30.0 ± 5.7 | 19 - 48 | 27.5 ± 5.4 | 18 - 45 | |
Father’s age* | 32.4 ± 6.2 | 22 - 55 | 30.8 ± 6.5 | 18 - 48 | |
Level of schooling* | 8.9 ± 3.1 | 2 - >15 | 8.1 ± 2.9 | 0 - >15 | |
Type of Family | Total | % | Total | % | |
Male head of household | 100 | 67.5 | 135 | 90 | |
Female head of household | 49 | 32.5 | 15 | 10 |
*Significant differences at p < 0.05.
riod of the first interview. Migrant women were more likely to work in agriculture in Yuma County and as clerks before they migrated.
The acculturation scale included 11 items which represented the proficiency of language use and preference of language (7 items), social networks (3 items) and identity (1 item). A test of reliability resulted in a Cronbach’s alpha [
Scale range varied from 15 points (which indicated that women preferred and used Spanish language at all times, had friends and neighbors only of Mexican descent, attended social gatherings only with Mexican individuals, and identified themselves always as Mexican) to 77 points (which indicated that women used and preferred to speak English, attended social gatherings with American individuals only, and identified themselves always as American). Some of the items in the scale were not relevant for women that reported that they did not listen to the radio, read books, or magazines, or go to parties or social gatherings. Items that were not applicable were coded as 0. Percentages of women who had one, two or three not applicable items were as follows: 30 (20%) for 1 item, 12 (8%) for 2 items and 1 (0.6%) for 3 items.
Migrant and non-migrant women’s meal patterns were described using two criteria proposed by Sanjur (1995) [
There were no significant differences in mean consumption of total energy, energy from fat, saturated fat, and carbohydrates, as well as cholesterol, sodium, fiber, vitamin A, vitamin C, iron, and calcium intake between migrant and non-migrant women. Energy from total fat is over the recommendations in both studied groups, as well as saturated fat consumption in migrant women. On the other hand, fiber consumption seems to be high in both studied groups when compared to mean consumption in the total adult US population (≈17 g/day) (Storey and Anderson, 2014) [
Dietary change considered: a) perceived dietary change in the last year and in the last five years and the main reasons to change, and b) actual change in the consumption of 34 food items after migration for migrant women. Whether women’s food consumption increased, decreased, did not change or they never tried three different sets of food items (eleven basic foods, twelve traditional foods, and eleven processed foods) was assessed as the percentage of women in every category. In addition, a total score of change was computed for each category.
Among migrants 17% and 23.2% of women responded that they have made some change in their food consumption or cooking methods during the last year and last five years, respectively. Among non-migrants, the percentages were quite similar, with 19% and 18% of respondents stating that they have made some change in the foods they eat or the ways of cooking it. Migrant women’s main reasons for dietary change were driven by a change in legal status (i.e. marriage, 5%), more knowledge about cooking (3%), or the presence of an extended family member (i.e. mother-in-law, 2%). Only 8% of migrant women responded that they had made changes because of migration, 16% because of health reasons, and 2% because of food cost, which were originally expected to be the main reasons for dietary change.
Regarding change in traditional food consumption, the trend is distributed mainly among “decrease” and “stayed the same” categories. Traditional foods such as Mexican sweet bread, nopal (cactus), chicharrón (pork rinds) and tamales were foods that more than 40% of migrant women reported diminishing their intake. Except for Mexican sweet bread, nopal, chicharrón, and tamales are traditional foods that are not part of the daily consumption of foods among Mexicans, but are eaten during weekends or special events within the Mexican cultural heritage. Traditional foods that constitute part of the basic cultural eat-
Basic foods | ||||||||
---|---|---|---|---|---|---|---|---|
Increased | % | Decreased | % | Same | % | |||
Milk | 48.0 | Pork | 31 | Eggs | 62.0 | |||
Vegetables | 48.0 | Cheese | 22.7 | Rice | 62.0 | |||
Fruit | 44.7 | Eggs | 17.3 | Pasta | 59.3 | |||
Chicken | 44.0 | Pasta | 14.7 | Beef | 58.0 | |||
Beef | 32.0 | Fruit | 14.0 | Oil | 56.7 | |||
Oil | 28.7 | Vegetables | 12.0 | Cheese | 49.3 | |||
Cheese | 27.3 | Rice | 12.0 | Chicken | 48.7 | |||
Rice | 26.0 | Beef | 10.0 | Milk | 44.7 | |||
Pasta | 20.0 | Oil | 10.0 | Vegetables | 40.0 | |||
Eggs | 16.7 | Chicken | 7.3 | Fruit | 38.7 | |||
Pork | 15.3 | Milk | 6.7 | Pork | 23.3 | |||
Mean | 31.9 | 13.4 | 44.0 | |||||
Traditional foods | ||||||||
Increased | % | Decreased | % | Same | % | |||
Licuado | 27.3 | Sweet Mex. bread | 50.7 | Beans | 72 | |||
Lemonade | 20.0 | Nopal | 44.6 | Tortilla | 63.3 | |||
Chorizo | 16.7 | Tamales | 40.7 | Chile | 58.7 | |||
Stuffed peppers | 14.7 | Pork rinds | 40.0 | Lemonade | 46.0 | |||
Tamales | 14.0 | Lard | 38.7 | Chorizo | 42.0 | |||
Chile | 9.3 | Stuffed peppers | 32.7 | Tamales | 39.3 | |||
Sweet Mex. bread | 9.3 | Tortilla | 27.3 | Stuffed peppers | 36.7 | |||
Beans | 8.7 | Chile | 23.3 | Licuado | 32.0 | |||
Tortilla | 8.7 | Chorizo | 23.3 | Lard | 30.7 | |||
Nopal | 8.7 | Licuado | 20.0 | Sweet Mex. bread | 30.7 | |||
Lard | 3.3 | Beans | 19.3 | Nopal | 20.7 | |||
Pork rinds | 2.0 | Lemonade | 18.0 | Pork rinds | 16.7 | |||
Mean | 11.9 | 31.5 | 40.7 | |||||
Processed foods | ||||||||
Increased | % | Decreased | % | Same | % | |||
Cereal | 68.7 | Soda | 18.7 | Jello | 37.3 | |||
Ice cream | 50.7 | Chips | 17.3 | Soda | 34 | |||
Instant soup | 48.0 | Jello | 12.7 | Chips | 33.3 | |||
Canned fruit | 44.0 | Canned vegetables | 9.3 | Ice cream | 30.7 | |||
Canned vegetables | 42.0 | Canned fruit | 9.3 | Canned vegetables | 29.3 | |||
Turkey | 39.3 | Instant soup | 9.3 | Cereal | 22.7 | |||
Soda | 39.3 | Frozen vegetables | 8.7 | Instant soup | 16.0 | |||
Frozen Vegetables | 34.0 | Ice cream | 7.3 | Turkey | 16.0 | |||
Jello | 32.7 | Turkey | 6.7 | Canned fruit | 14.7 | |||
Chips | 31.3 | Spam | 5.3 | Spam | 6.7 | |||
Spam | 28.0 | Cereal | 4.7 | Frozen vegetables | 5.3 | |||
Mean | 41.6 | 9.9 | 22.3 | |||||
ing patterns of Mexicans, such as beans, tortillas, and chili, were reported by high percentages of migrant women (72%, 63%, and 59%, respectively) as “stayed the same.” This suggests that even after migration the majority of women (and, consequently, migrant families) continued to consume main traditional Mexican foods. Regarding processed foods intake, the trend was distributed mainly within the categories of “increased” and “stayed the same.” Percentages of women that increased processed foods consumption were, however, higher across all food items (cold dry cereals, ice cream, instant soup, and canned fruit).
According to different categories of BMI, 37% of migrant women and 36% of non-migrant women were in the overweight range. However, more migrant women (32%) were categorized as obese, as compared with 19% among non- migrant women. Migrant women exhibit an even higher degree in the category of extreme obesity (4%) as compared to non-migrant women (1%). Regarding waist/hip circumference ratios among migrant and non-migrant women, and using the cut-off point of 0.8%, 52% and 42% of migrant and non-migrant women were at some risk of cardiovascular disease according to their body fat distribution pattern.
Migrant women showed physical activity level (PAL) ranging from light to moderate levels, while non-migrant women had moderate and heavy PAL levels. Conversely, migrant women were more likely to be engaged in some kind of regular physical exercise (36%) than non-migrant women (13%). In general, however, high percentages of women in both migrant (64%) and non-migrant (87%) groups did not report engaging in any kind of regular physical exercise.
Smoking did not appear as a prevalent health risk among the study sample, since only a small percentage of women reported being current smokers in both migrant and non-migrant groups (10 and 12% respectively). Among migrant women 16% (1% daily, 3% weekly, 4% monthly, and 6% yearly) consumed some kind of alcoholic beverage (beer, any kind of liquor, or wine). Among non-mi- grant women, 22% consumed alcoholic beverages (6% weekly, 7% monthly, and 8% yearly).
Among migrant women, the reliability test revealed a moderately reliable stress scale (Cronbach’s alpha = 0.66) with a point range of 9 to 18. Mean score of stress for migrant women was 12.6 ± 2.2.
Comparisons of BMI, total energy, energy from total fat, saturated fat and carbohydrates were done between migrant and non-migrant women, after adjusting for some socioeconomic and demographic variables. Variables included for adjustments were age, education, type of family, physical activity level, energy consumption (for BMI), lactation, pregnancy, and smoking.
Predictor variables | Estimated regression coefficients | p value |
---|---|---|
Constant | 1.511 | 0.0000 |
Centered age | 0.0021 | 0.0262 |
Centered age2 | 0.0001 | 0.2876 |
Physical Activity level | −0.0151 | 0.0359 |
Smoking | 0.0036 | 0.8226 |
Education | −0.0038 | 0.0274 |
Type of family | 0.0073 | 0.5690 |
Lactation | 0.0045 | 0.7850 |
Energy | −0.00001 | 0.0348 |
Migration status | 0.0248 | 0.0245 |
R2 = 0.11 Sig. F = 0.0002 |
Predictor variables | Estimated regression coefficients (total energy) | p value | Estimated regression coefficients (total fat) | p value | Estimated regression coefficients (saturated fat) | p value | Estimated regression coefficients (carbohydrates) | p value | |||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Constant | 2054.4 | 0.0000 | 5.37 | 0.0000 | 2.90 | 0.0000 | 7.658 | 0.0000 | |||||
Centered age | −8.39 | 0.2493 | −0.0009 | 0.9538 | −0.0004 | 0.9666 | 0.0113 | 0.4883 | |||||
Centered age2 | 0.7148 | 0.4277 | −0.0031 | 0.1087 | −0.0016 | 0.1807 | −0.0057 | 0.0047 | |||||
Physical Activity level | −107.6 | 0.0526 | 0.1663 | 0.1601 | 0.0930 | 0.2093 | 0.2601 | 0.0362 | |||||
Smoking | −119.2 | 0.3288 | 0.4237 | 0.1130 | 0.2020 | 0.2271 | 0.1677 | 0.5480 | |||||
Education | 0.3120 | 0.3120 | 0.0168 | 0.5504 | 0.0129 | 0.4641 | −0.0253 | 0.3910 | |||||
Type of family | 0.3299 | 0.3299 | −0.4530 | 0.0316 | −0.2284 | 0.0831 | −0.0974 | 0.6573 | |||||
Pregnancy | 0.3173 | 0.3173 | 0.2195 | 0.3320 | 0.1942 | 0.1709 | −0.0772 | 0.7442 | |||||
Lactation | 415.9 | 0.001 | −0.2170 | 0.4276 | −0.0863 | 0.6140 | 0.1992 | 0.4864 | |||||
Migration status | −197.4 | 0.0171 | 0.0611 | 0.7283 | 0.322 | 0.0037 | −0.7091 | 0.0001 | |||||
R2 = 0.10 Sig. F = 0.0003 | R2 = 0.05 Sig. F = 0.1116 | R2 = 0.08 Sig. F = 0.0062 | R2 = 0.11 Sig. F = 0.0002 | ||||||||||
Variables | “Best fitting” models | ||
---|---|---|---|
Acculturation | β (BMI) | p | |
Age | Constant | 1.621 | 0.0000 |
Age2 | Age | 0.0057 | 0.0000 |
Education | PAL | −0.0229 | 0.0242 |
Family income | Age at migration | −0.0038 | 0.0002 |
Smoking | Energy | −0.00002 | 0.0291 |
Stress | |||
Type of family | R2 = 0.21 Signif. F = 0.0000 | ||
Score basic | |||
Score processed | |||
Score traditional | β (Waist/Hip) | p | |
Food stamps $ | Constant | 0.7412 | 0.0000 |
Lactation | Acculturation | 0.1062 | 0.0787 |
Work status | Age | 0.0039 | 0.0131 |
Family size | Education | −0.0044 | 0.0981 |
Age at migration | |||
Energy | R2 = 0.09 Signif. F = 0.011 | ||
Physical Activity level (PAL) |
significant. In addition to acculturation, education was significant in the same model, indicating that the variation in waist/hip ratio is also related to socioeconomic status.
One of the main dietary risk factors for chronic diseases is, as referred earlier, high levels of total energy and fat intake, and especially the proportion of total energy from fat. In this study, intake of fat and calories provided by fat and saturated fat are thought to be influenced by dietary change, and in particular by that change related to the process of migration and exposure to a new culture. In this context, the variation in consumption of total energy, energy from total and saturated fat, and carbohydrates was explored mainly as a function of acculturation, controlling for socioeconomic, demographic, and health related variables. The three sub-scales related to dietary change were also included in the model as was proposed initially in the conceptual model.
The full model presented in
Predictor variables Full model | Predictor variables “best fitting” models | Estimated regression coefficients | p value | Predictor variables “best fitting” models | Estimated regression coefficients | p value |
---|---|---|---|---|---|---|
Constant | Energy | Saturated fat | ||||
Log Acculturation | Constant | 1104.5 | 0.0139 | Constant | 3.03 | 0.0000 |
Centered age | Acculturation | 858.1 | 0.0274 | Physical activity level | 0.1523 | 0.0994 |
Centered age2 | Physical activity level | −215.3 | 0.0039 | |||
Physical activity level | ||||||
Age at migration | R2 = 0.08 Signif. F = 0.0048 | R2 = 0.02 Signif. F = 0.099 | ||||
Education | ||||||
Family Income | ||||||
Smoking | Carbohydrates | |||||
Lactation | Constant | 7.215 | 0.0000 | |||
Pregnancy | Centered age2 | −0.0045 | 0.0755 | |||
Score basic | ||||||
Score processed | R2 = 0.02 Signif. F = 0.07 | |||||
Score traditional | ||||||
Food stamps $ | ||||||
Stress | ||||||
Family size | ||||||
Work status | ||||||
Type of family |
smaller magnitude, some of the variance in energy consumption. Acculturation was positively and significantly related to energy consumption. Physical activity level as well was significantly, but negatively, related to energy consumption. Upon further exploring the association of the socioeconomic, demographic and health-related variables and calories provided by total fat and saturated fat consumption, the full model did not explain significantly the variation in consumption of these nutrients. However, there is a trend that shows that saturated fat intake increases as the level of physical activity level rises. The R2 for this model indicates, however, that the magnitude of variance explained is very small. In summary, it seems that the more acculturated migrant women are, the more energy they consume. Having a higher BMI seems to be associated with the exposure to the new culture, as well as to lower levels of physical activity.
Although the data shows that energy consumption is negatively associated to BMI, when one separates the group of migrant women into women with BMI ≥ 30 and women with BMI < 30, the association of mean energy consumption and BMI behaves differently. Women with BMI < 30 showed a BMI that is negatively and significantly associated with energy consumption (p = 0.001). On the other hand, for women with BMI ≥ 30 the association is positive and significant (p = 0.041). If we look at the association of BMI with energy consumption, and adjusting for physical activity, women with BMI < 30 continue to show a significant and negative association; meanwhile in women with a BMI ≥ 30 association is no longer significant (p = 0.07). These results could mean interplay of effects of physical activity on the association of energy consumption and BMI. In addition, it seems that none of the socioeconomic, demographic, or cultural variables were associated with fat or saturated fat consumption. Fat consumption, however, could be associated to some other health-related variables or lifestyle characteristics not explored in our models.
Based on present findings, it seems that the variance in acculturation is explained by a set of variables representing different domains: family context variables, socioeconomic, and demographic variables. The model seems to indicate that having a father born in the U.S. affects the process of acculturation negatively, while having a grandmother born in the U.S. influences acculturation positively. The more acculturated the women are, they depend less on food stamps.
Predictor variables Full model | Estimated regression coefficients | p value | Predictor variables “best” fitting model | Estimated regression coefficients | p value |
---|---|---|---|---|---|
Constant | 1.135 | 0.0000 | Constant | 1.031 | 0.0000 |
Centered age | 0.0026 | 0.1982 | Father born in U.S. | −0.1454 | 0.0099 |
Age at migration | −0.0101 | 0.0000 | Grandmother (mother) born in U.S. | 0.1720 | 0.0432 |
Education | 0.0059 | 0.0970 | $ from food stamps | −0.0005 | 0.0353 |
Family Income | 0.0430 | 0.0269 | Work status | 0.0607 | 0.0113 |
Food stamps $ | −0.0004 | 0.0266 | Education | 0.0069 | 0.0455 |
Family size | 0.0169 | 0.0068 | Age at migration | −0.0095 | 0.0000 |
Work status | 0.0596 | 0.0201 | Family size | 0.0159 | 0.0068 |
Type of family | −0.0310 | 0.2411 | Family income | 0.0402 | 0.0183 |
Grandmother (mother) born in U.S. | 0.1586 | 0.0731 | |||
Grandfather (mother) born in U.S. | −0.0094 | 0.8667 | |||
Grandmother (father) born in U.S. | −0.0341 | 0.6767 | |||
Grandfather (father) born in U.S. | 0.0446 | 0.6118 | |||
Father born in U.S. | −0.1475 | 0.0274 | |||
Mother born in U.S. | 0.0314 | 0.7533 | |||
Family size when in Mexico | −0.0030 | 0.4425 | |||
Perceived discrimination | −0.0391 | 0.1656 | |||
Work status when in Mexico | −0.0190 | 0.4056 | |||
Husband born in U.S. | 0.0196 | 0.3936 | |||
R2 = 0.415 Sig. F = 0.0000 | R2 = 0.387 Sig. F = 0.0000 |
Also, if a mother works, education increases, the family has income, and they are likely to be more acculturated. Surely, these variables could have an impact on the magnitude of social interactions and consequently on the extent of exposure to the U.S. culture.
Regarding dietary risk factors, this study suggests that they were higher in the population of migrant women when compared to non-migrant women. Findings also suggest that careful attention should be paid to a potential decrease in the consumption of complex carbohydrates among migrant women, which could potentially imply a “substitution effect” of an increase in consumption of fat, and perhaps saturated fat. According to the overall data from the multiple regression analysis, consumption of calories from saturated fat and BMI seem to be significantly higher in migrant women, compared to non-migrant women, even after adjusting for other weight and diet related variables such as smoking, lactation and pregnancy. There are other variables that in addition to energy are associated with BMI in migrant women, for example physical activity level. This may indicate that in addition to diet, lifestyle characteristics of migrant women contribute to the differences found in BMI. This difference could well be related to a better economic situation of migrant families and consequently more access to often expensive foods such as beef.
Differences in dietary patterns among migrant and non-migrant women seem to be related to social and cultural ways within the host country. Even when lunch is still the main meal of the day, dinner could become the main meal for those women that follow the American meal pattern. This is true especially when they and their families follow a work schedule in the U.S. This cultural adaptation could have strong consequences for dietary change since women could end up consuming two elaborate meals instead of one.
These changes in meal patterns that affect nutrient consumption have been reported by Sanjur (1995) [
In the context of dietary risk and protective factors, it is worth noting that dietary change carries the presence of both components during the process of change. Increase in the consumption of basic foods, such as vegetables and fruit, could mean a positive change and a contribution to the presence of protective food components as vitamins, minerals, and fiber. On the other hand, increased consumption of foods with a high content of fat, sugar, and sodium, increases health risk factors. The presence of these components can be particularly noted in the higher consumption of whole milk, ice cream, instant soup, and canned fruit, whose consumption is reported as being increased by migrant women. Similar results have been reported by, Dewey et al., (1984), Romero et al., (1993), and Sanjur (1995) [
It is also important to highlight the continued consumption of beans and tortillas, whose supply of complex carbohydrates and fiber to Mexicans is well recognized. These findings are consistent with the apparent similarities of meal patterns among migrants and non-migrants, the largest percentage of calories coming from carbohydrates, and with the high consumption of fiber among both groups. From our own participant observation study we learned that even after migration, Mexican American families continue to consume Mexican food at home. They find the food ingredients from grocery stores in Yuma County, or they bring the indigenous ingredients from the closest Mexican border town (San Luis, Mexico).
According to Pelto (1981) [
Overall, acculturation seems to be associated mostly with access to food rather than with change in consumption of dietary risk components. This is supported by the data relative to dietary change and from ethnographic fieldwork in the migrant community. Although there is an increase in consumption of processed foods and basic foods, traditional foods such as beans and tortillas are kept in the diets of migrant women. Informants reported having an increase in total consumption of foods after migration, while keeping their Mexican cooking customs. Finding ingredients was not a constraint to their dietary practices given the closeness to their home country and the frequent interaction with relatives in Mexico. Furthermore, acculturation was positively associated with socioeconomic status, indicating that interplay of socioeconomic and cultural variables is associated with food behavior in this group of Mexican immigrants. A study by Gregory-Mercado et al. (2006) [
On the other hand, several studies have reported contrasting results on the relationship of acculturation and BMI. Khan et al. (1997) [
In this study, the relationship of acculturation with BMI was positive, but women in the sample were by design first generation Mexican immigrants exclusively; they represent a group that is located in the first part of the curve of acculturation and BMI. Moreover, we found that immigrant women had higher BMI than non-migrant women living in Mexico.
For this study sample, there is better access to food than there was in Mexico. It is, still, however, a low income population whose closeness to its country of origin, together with its primarily Mexican cultural heritage, allows it to keep, to a large extent, traditional food consumption patterns, while having better access to food in general. Their socioeconomic status, while low to U.S. standards, may still signify an improvement over what they previously had in Mexico.
Some implications of the findings of this study for future sensitive and culturally appropriate nutritional interventions follow. There are subgroups of population living in the US region that based on their cultural heritage and socioeconomic characteristics should be thought of more as a native Mexican population than as a bicultural or acculturated population. The overall behavioral health and nutrition promotion programs should continue encouraging to reduce smoking and alcohol consumption, as well as the consumption of fiber-rich traditional foods as part of good health practices. Physical exercise should be part of the same programs since the data from this study supports the association between physical activity level and BMI. Physical exercise should also be promoted since both groups of women expressed a desire to lose weight.
Some study limitations should be noted. Collection of data was performed in the mid-late nineties; however, published research data on the study matter is limited in such border region, as well as studies that include comparison data from migrant’s country of birth. Sampling locations in both study sites differ; in Yuma County the WIC clinic offered nutritional counseling and food aid to immigrant women, but in Hermosillo, Mexico, women attended a doctor’s appointment which did not include any nutritional guidance.
Finally, it is recommended that in the same areas of the United States, the intergenerational food-related behavior should be studied. For research purposes, the collection and analysis of information within these groups living close to Mexico can improve understanding of food-related behavior and acculturation of future generations. For community-based studies, understanding dietary change and examining points for interventions that differ from those needed by first generation Mexican Americans will greatly improve the effectiveness of strategies for nutritional interventions.
The authors of this study wish to acknowledge the contributions of Dr. Diva M. Sanjur, as project director, doctoral thesis adviser and as main co-author of this research. This study has benefited from the financial support of CSRS/US Department of Agriculture Grant No. 94-34324-0987.
Ortega-Velez, M.I. and Castañeda-Pacheco, P.A. (2017) Acculturation and Dietary Change in Mexican-American Immigrant Women. Open Journal of Social Sciences, 5, 211-243. https://doi.org/10.4236/jss.2017.57014
INTERVIEWER___________ CODE____________ DATE____________
SOCIODEMOGRAPHICS
1. How many persons are now living in your house?
Circle: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15+
2. Household composition
24-HOUR RECALL QUESTIONNAIRE
1. Do you usually eat like this? Yes: ____ No: ____
2. Why? _________________________________________________________
3. Are you taking any supplement or vitamin? Yes: ____ No: ____
4. Type _________________________________________________________
5. How often do you take it? Daily ____ Weekly____ Rarely ____
6. Are you on a special diet? No____ Weight loss ____ Low salt ____ Medical condition ______ Vegetarian______ Low Cholesterol______ Weight gain_______
ANTHROPOMETRIC MEASURES
7. Are you pregnant? ______________ 1. Yes______ 2. No______
8. Are you breastfeeding? ___________ 1. Yes_____ 2. No______
FOOD FREQUENCY QUESTIONNAIRE
Note: This questionnaire will be available by the authors upon request.
ACCULTURATION
9. Which language do you prefer to use in daily life?
___1.Spanish all the time
___2.Spanish mostly
___3.Spanish/English equally
___4.English mostly
___5.English all the time
10. What language do you speak:
11. In what language are:
12. Can you read Spanish? ___1.Yes ____2.No
13. Can you read English? ___1.Yes ____2.No
14. Which do you read better?
___1.Spanish better than English
___2.Spanish and English equally
___3.English better than Spanish
15. Can you write in English? ___1.Yes ___2. No
16. Can you write in Spanish ___1.Yes ___2. No
17. Which do you write better?
___1. Spanish better than English
___2. Spanish and English equally
___3. English better than Spanish
18. In which country were you and relatives born?
19. How do you identify yourself?
___1. Mexican or Mexicano ___5. Latino
___2. Chicano ___6. Spanish American
___3. Mexican American ___7. American
___4. American of Mexican descent
20. If you were born in Mexico, at what age moved permanently to U.S.?
________________yrs.
21. Are your friends mostly of Mexican or American descent?
___1.Only Mexican ___4.Mostly American ___2.Mostly Mexican ___5.Only American
___3.Equally Mexican and American
22. Are your neighbors mostly of Mexican or American descent?
___1.Only Mexican ___4.Mostly American
___2.Mostly Mexican ___5.Only American
___3.Equally Mexican and American
23. Are the people at the places where you go to have fun and to relax (at parties, dances, picnics) mostly Mexican or American?
___1.Only Mexican ___4.Mostly American
___2.Mostly Mexican ___5.Only American
___3.Equally Mexican and American
24. What do you think about the following American institutions?
Public schools____________________________________________
Why?___________________________________________________
Religion_________________________________________________
Why?___________________________________________________
Family__________________________________________________
Why?___________________________________________________
25. Have you ever been discriminated against because you are of Mexican descent? Yes___ No___
26. In what ways have you been discriminated against?
________________________________________________________________
DIETARY CHANGE AND FOOD PREPARATION
27. Was there any change in the way you cook and prepare foods in the last year? Yes___ No___ or five years? Yes___No___
28. Why did you change?___________________________________________
29. Which of these methods do you usually use to cook foods?
Frying ____ Boiling____ Grilling____ Baking ____
30. If frying, what kind of fat do you use?
Lard ____ Margarine____ Vegetable oil____
Butter____ Beef lard____ Vegetable lard____
O_______________
31. How often do you...?
32. If you trim the fat off your meat or remove the skin from chicken, what is the reason?
__________________________________________________________________
33. Could you tell me if after you came to the United States you eat more, less, the same or never tried the following foods?
Comments_______________________________________________________
MIGRATION HISTORY AND SOCIOECONOMIC INFORMATION
34. What year did you first come to the U.S.?______________________
35. Have you:
___1. Stayed in the U.S. since then
___2. Moved back to Mexico for a while and then returned to the U.S.
36. Why did you come to U.S.?____________________________________
37. How many family members were in your family when you were in Mexico?
Circle: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 +15
38. Did you work in Mexico? ___1.Yes ___2.No
39. What was your last job there?_______________________________
40. Do you work now? ___1.Yes ___2.No
41. What kind of work do you do?_________________________________ __________________________________________________________________
42. In what range is your family weekly income?
___1. 100 - 200 dlls. ___3. 401 - 600 dlls
___2. 201 - 400 dlls. ___4. +600 dlls
43. What other jobs have you had, and where?__________________________
44. What is your highest grade you completed at school?
Circle: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15+
45. Was it in: ___1. Mexico ___2. U.S.
LIFESTYLE
46. Have you smoked at least 100 cigarettes in your entire life?
Yes___ No___
47. If yes in number 46: about how old were you when you first started smoking cigarettes fairly regularly?_____________________
48. On the average of the entire time you smoked, how many cigarettes did you smoke per day?__________________
49. Do you smoke cigarettes now? Yes___ No___
50. If not: How old were you when you stopped smoking? _______yrs.
51. If yes: On the average, about how many cigarettes a day do you smoke now? _________ cigarettes
52. Do you exercise regularly? Yes___ No___
53. If yes: What kind of exercise?
________________________________________________________________
54. If not, why not?
________________________________________________________________
55. Which are your usual activities in a normal day?
___1. Light housework ___4. Walking
___2. Medium housework ___5. Aerobics
___3. Heavy housework ___6. Agricultural work
56. Do you think your current weight is:
___1. Too high ___2. Too low ___3. About right
57. Would you like to:
___1. Gain weight ___2. Lose weight ___3. Stay the same
58. When was the last time you saw a doctor?
________________________________________________________________
59. Which was the reason(s) to see the doctor?
_______________________________________________________________
60. Do you have medical insurance? Yes___ No___
61. If yes: What type?
________________________________________________________________
STRESS
62. Is not having enough money to live a serious problem?
Yes___ No___
63. Are medical bills a serious problem for you/your family?
Yes___ No___
64. During the past two weeks, did you get together socially (including eating) with friends and neighbors?
Yes___ No___
65. Have you talked with or received any news/letters from relatives in Mexico in the last month? Yes___ No___
66. Have you argued seriously with your children recently?
Yes___ No___
67. Are you frequently worried about your children’s behavior?
Yes___ No___
68. In the past few weeks, have you felt depressed and very unhappy? Yes___ No___
69. Is being anxious and worried a serious problem?
Yes___ No___
70. In the last few weeks, have you felt that things were going your way? Yes___ No___
Comments: ____________________________________________________
EATING OUT
71. How often do you eat out?
B: Breakfast D: Dinner D: Daily M: Monthly
L: Lunch S: Snack W: Weekly R: Rarely
72. Weekly mean Expenses when eating out _____________________ dlls.
73. Reason (s) for eating out: _______________________________________
Comments _____________________________________________________
FOOD PURCHASING
74. Where do you usually buy your food/groceries? ______________________
________________________________________________________________
75. Why do you buy there?
___1. Inexpensive ___4. Quality of foods
___2. Closer ___5. Variety
___3. Convenient ___6. Other_________________
76. What foods do you almost always buy? _____________________________
________________________________________________________________
________________________________________________________________
77. Have you changed the foods you buy in the last year? Yes___ No____ Or five years? Yes___ No____
78. In what way have you changed?__________________________________
79. Are you eligible for food stamps Yes___ No___
80. Do you get and use food stamps? Yes___ No___
81. How much do you receive in food stamps?__________ dlls/week
FOOD PREFERENCES
82. Could you tell me how much do you and your child like the following foods?
83. Which are you and your child’s five favorite, most disliked, and never tasted foods?
84. Does your child speak English? ___Yes ___No
85. What programs does he/she watch on T.V. _______________________
86. Are your child’s friends from Mexican or American descent?
___1.Only Mexican ___4.Mostly American ___2.Mostly Mexican ___5.Only American
___3.Equally Mexican and American
Comments____________________________________________________