Unraveling the relationship between food insecurity, acculturation, and diet quality in Mexican Americans: What is the role of social networks?

Kayla de la Haye, Brooke Bell, Karen R. Flórez

Contact: delahaye@usc.edu

Among immigrant populations in the United States (U.S.), including Mexican Americans, diet quality declines with greater acculturation (e.g., more years in the U.S) while risk for diet-related diseases including Type 2 diabetes (T2D) and obesity increases. For example, among Mexican Americans, time spent in the U.S. is associated with lower fruit and vegetable consumption, and higher consumption of fast food, sugar, and sugar-sweetened beverages. This acculturation process contributes to the health inequities experienced by Mexican Americans. However, the mechanisms that explain why acculturation to the U.S. is linked to poorer diet and health are not well understood. Food insecurity may be one causal factor. Social networks may also be an important explanatory factor; they influence diet, obesity, and T2D risk, and are a source of interpersonal influence on eating via social norms, behavioral modeling, and through provision of resources and support. Also, social networks may change through the process of acculturation, and the acculturation orientation (e.g., more Mexican American vs. more American) of ones’ social network may play an important role in shaping diet quality. This study examines the role of Mexican American adults’ social networks on their diet quality, alongside experiences of food insecurity. We examine the role of acculturation as two level-phenomenon, which involves acculturation of the individual and the social network in which they are embedded. In parallel, we examine the relative importance social network dietary norms, nutritional health, and health-related support in predicting individual diet quality. Participants were 81 Spanish-dominant Mexican American adults (M(SD) age = 42.9(11.4) years, 69% female), recruited from a large Catholic Church congregation in New York City. They completed a survey that measured their personal social network, diet recall, food insecurity, demographics, and medical history. The personal social network measures enumerated 20 alters, alter characteristics (social role, demographics, indicators of acculturation, eating behaviors, and health-related social support), and social ties among the alters; which were used to compute composition and structural network statistics. Diet intake was measured via two Automated Self-Administered 24- hour recalls (ASA-24) and analyzed using the Nutrition Data System for Research to construct a Healthy Eating Index (HEI; where diet quality is scored on a 100-point scale). Validated measures were used to assess participant demographics, indicators of acculturation, and food insecurity. We present the results of correlations and multiple regression analyses showing that both individual and social network acculturation indicators are associated with diet quality, and that diet quality is also predicted by other structural and compositional features of Mexican American’s social networks. We discuss these findings in light of calls to integrate social network and community-based strategies into health interventions and policy that target food insecurity and nutritional health inequities.

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