Perceived Multi-Level Diabetes Protective and Risk Factors Associated with Food and Dietary Acculturation Patterns Among East African Immigrants in the United States

Background

Upon arrival in a new country, immigrants have lower body mass index (BMI), and are less likely to be overweight and obese than natives. However, longer residence is associated with higher BMI, partly attributed to adoption of unhealthy diets and dietary habits. Overweight and obesity (primary risk factors for diabetes) have been associated with food acculturation-the process by which immigrants adopt food practices of their new country. In particular, unfamiliar food cultures and food purchasing environment, lack of knowledge on how to prepare and incorporate new foods in traditional diets, perceptions towards food in new countries, all limit immigrants' food choices and access. However, very few food acculturation studies have focused on African immigrants, specifically from eastern Africa. Yet, this group reports high rates of overweight, obesity, and higher prevalence of diabetes and pre-diabetes. Using the socioecological framework, this study explored the multi-level facilitators and barriers associated with food and dietary acculturation patterns and perceived diabetes-related health risks among East African immigrants and refugees in the Twin Cities Metro Area, Minnesota, United States.