Diet Quality Among U.S.-Born and Foreign-born Non-Hispanic Blacks: NHANES 2003-2012 Data

This study uses the Alternative Healthy Eating Index-2010 (AHEI-2010) and Dietary Approach to Stop Hypertension (DASH) scores to compare diet quality between U.S.-born (n=3,837) and foreign-born (n=406) non-Hispanic Black adults aged 22-79y, based on pooled nationally representative data (NHANES 2003-2012); as well as by length of U.S. residency. Association between nativity and diet quality was done using multivariable-adjusted linear regression for the continuous total diet quality scores and their components, or multinomial (polytomous) logistic regression for categorical tertiles (low, medium, or high) of the total scores and their components. The study found that foreign-born Blacks had significantly higher AHEI-2010 and DASH scores compared to U.S-born Blacks, and more favorable intakes for many of the score components. Among foreign-born Blacks, diet quality did not significantly differ by length of residency. Foreign-born Blacks were more likely to be in the high than low tertile for fruit (including and excluding fruit juice), vegetables (excluding starchy vegetables), percent whole grains, and omega-3 fatty acids. Overall, the study suggests that foreign-born Blacks have better diet quality compared to their U.S.-born counterparts. Considering nativity among U.S. Blacks in nutrition research and public health efforts may therefore improve accuracy of characterizing dietary intakes and facilitate development of targeted nutrition interventions to reduce diet-related diseases in the diverse Black population in the U.S.