Background
Nearly 30% of all Americans are now either first- and second-generation immigrants, a population of 84.8 million Americans expected to comprise 36% of the country by 2065. Hispanic/Latino and Asian Americans constitute the majority of this expanding population (constituting 44% and 27% respectively), with Asian Americans representing the fastest growing racial and ethnic minority in the US, growing by 81% between 2000–2019 1,2. In parallel, there has been an alarming surge in immigrant health disparities in the US, including a complex and disproportionate non-communicable disease (NCD) burden 3–6. Despite this, recent literature has demonstrated that immigrant and racial/ethnic minority communities have not been reached by funding nor implementation of nutrition-related initiatives in recent years 7–9.
Diet is a major contributor to the NCD burden, with 45% of all cardiometabolic mortality attributable to dietary behaviors 10. There is a growing realization that the assumptions forming some broadly applied concepts in dietary research fail to appropriately consider the unique and complex multi-dimensionality of immigrant dietary experiences. Even when included in dietary health research, data from racial and ethnic populations is often aggregated, masking crucial health disparities across subgroups as well as important nuances in the dietary behaviors across diverse communities 5,11. It is important to acknowledge that the mainstream understanding of dietary experiences has been informed by decades of dietary research in populations in which racial and ethnic minority or immigrant populations were either underrepresented, aggregated, or excluded altogether. The implicit and explicit centering of these oversimplistic and selectively convenient understandings of food-related experiences has meant that researchers are often unable to appropriately consider the complexity of the immigrant dietary experience. Scholarship produced from such a lens ultimately provides researchers with methodological tools or concepts which lack the capacity to effectively intervene in immigrant dietary behaviors, a direct result of the underlying assumptions and principles underlying some of contemporary dietary research.
There has been a growing call to acknowledge and address how historic and structural biases have elevated the dietary experiences of white and European populations in both dietary research and, subsequently, nutritional standards.12,13 An excellent example of this is the emergence of the Mediterranean diet in nutritional guidance; although various positive health outcomes have been associated with components of a Mediterranean diet,14 it’s important to consider that much of the research which helped establish its prominence underrepresented many populations around the world,14,15 lacking a comprehensive cross-cultural lens to compare its healthfulness with a variety of different non-European dietary patterns. Although efforts have since been made to adapt components of the Mediterranean diet to fit foods more prominent in non-Mediterranean contexts,16 concerns have emerged related to the transferability of the diet in populations with a high diversity of traditional cooking practices, food environments, or socioeconomic contexts,17,18 and whether other types of non-European or non-white centric dietary patterns also warrant greater promotion (e.g., the Okinawan diet).19,20 For too long the unique complexity of the immigrant experience has been missing from the mainstream dietary research paradigm, often sidelined as a niche or circumstantial consideration when applying dietary “gold standards” rather than as a factor worth centrally integrating into the very foundation of these approaches. With the pressing need to promote greater equity in how the scientific community understands and intervenes in the dietary behaviors of immigrant populations to address growing diet-related NCD morbidity, this paper aims to identify specific facets of the immigrant dietary experience that are often not considered within the existing landscape of dietary health research and, informed by recent developments in community-based dietary research in immigrant and ethnically diverse populations, provide actionable recommendations to promote immigrant inclusivity and the innovation of current theoretical and methodological tools. These considerations have been displayed in Figure 1, and recommendations have been summarized in Table 1.
Figure 1:
Dietary experiences of immigrants which often lack consideration in contemporary dietary measures, concepts, and definitions.22–40,42–47,49–50,52–58
Table 1:
Recommendations to promote greater inclusivity of the dietary experiences of immigrants within research.22–40,42–47,49–50,52–58
Domain | Consideration | Challenge | Recommendations |
---|---|---|---|
Food Environment | Purchasing from streetside food vendors (particularly fresh produce) | Lack of reliable data on informal produce vendors, which are often localized, seasonal, and less established 22,23 | Using geo-spatial imagery, online data, and regular community-based field assessments to better capture informal produce vendor environment 22,24 |
Traveling long distances for ethnic foods | Overreliance on proximity as measure of food environment; Distant yet significant food vendors may be missed when assessing local food environments 25–29 | Incorporating state and regional level data on ethnic food outlets, and leveraging geospatial and empirical methods to disaggregate relationships between ethnic and non-ethnic retail environments 30–31 | |
Urban foraging and consumption of wild foods | Sources of ‘wild foods’ not reflected within the scope of the food environment 32,33 | Conducting community-engaged surveillance research to document the types and locations of wild foods consumed, as well as social, cultural, nutritional implications of urban foraging 32,34 | |
Family dynamics | Dependency on and prioritization of familywide dietary behaviors | Interdependent dietary patterns driven by collectivism and familism are not considered in individualized understandings of diet 35–40 | Exploring the measurement of interdependency of dietary behaviors and collectivist approaches to assessing dietary behaviors and attitudes 36,40,42,43 |
Distinct dietary influences between family members | Inability to generalize intra-household eating patterns due to drastic differences in dietary acculturation 36,40,45,46 | Expanding the measurement of dietary acculturation to inform more tailored interventional approaches that reflect the realities of household eating behaviors 40,45–47 | |
Eating Patterns | Consuming foods from larger, mixed, shared plates | Difficulties in measuring individualized food consumption and the intake of specific food groups 49,50 | Leveraging both household-level and individual-level dietary consumption data to better triangulate dietary intake from more group-based styles of eating 52–54 |
Meal patterns changing dramatically during the year | Dietary assessments are unable to appropriately consider these short-term yet consistent, impactful changes in food behaviors 55–57 | Tailoring dietary assessment tools to better capture specific variations in dietary behaviors throughout the year, and considering the socio-cultural and religious significance of certain food behaviors 58 |
Challenging the definition of the food environment: informal and distant food sources
Streetside food vendors
The food environment has been a dynamic concept within dietary research but is generally understood as the physical, social, and economic space and context in which individuals purchasing, prepare, and consume foods 21. While this expansive concept has fostered methodological innovations to ensure that a wide range of socio-ecological variables relevant to the food environment can be appropriately captured, there remain crucial facets of the immigrant dietary experience that may be missing. For example, small, community-oriented, informal streetside fresh fruit and vegetable (FV) vendors can play crucial role as a source of fresh produce in the urban food environment, particularly within ethnically diverse neighborhoods 22,23, yet have remained elusive to study due to often being less established, localized, and more seasonal. However, the expansion of longitudinal, publicly available geospatial data (e.g., Google Street View (GSV), Apple Look Around) provides researchers a novel tool to begin systematically analyzing streetside vendors within communities of interest 22. In 2021, these platforms were used for the first time to document changes in streetside FV vendors across 6 neighborhoods in New York City (NYC), revealing the disproportionate impact the COVID-19 pandemic had on FV vendors in Chinese ethnic neighborhoods 22,24. Such methods warrant exploration in other immigrant communities to better document this often-overlooked facet of the food environment.
Ethnic food outlets
Moreover, the characterization of local food environments is fundamentally based on assumptions of the geographical confines of the term “local” and whether it truly encompasses all relevant food establishments. Indeed, while Americans on average report traveling 2.6 miles to access food 25, Hispanic Americans in central Texas reported traveling 1.6 miles more than Non-Hispanic White Americans 26. Similarly, some Chinese Americans in NYC may travel 1.5 miles further to shop exclusively at ethnic grocery stores 27. The importance of ethnic grocery stores lies in their ability to cater to unique cuisines (e.g. produce, products) and languages (e.g., signage, language of clerks) of ethnically diverse communities, despite often being less geographically proximal than mainstream grocery outlets. It is thus crucial that food environment assessments which rely upon identifying stores within a certain radius of a community – a paradigm which has already been challenged in recent years 28,29 – do not miss the crucial presence of these often-distant ethnic food outlets. Moreover, it is imperative to also disaggregate the cuisines and communities’ different ethnic grocery stores serve; for example, while ethnic grocery stores may be highly prevalent in a local community, if they primarily cater to cuisines of Asian immigrant communities, then Latin or African immigrants may still travel further distances for food. Considering differences in the clientele of ethnic grocery stores can help researchers better understand the types of communities that are (and are not) served by these local outlets.
There are important lessons to be learned from recent advancements in the study of the ethnic food retail environment. In their 2020 study, Rzbarczyk et al. describe the innovative use of state-level food vendor data, standard industrial classification codes, and publicly available online data (including internet imagery, GSV, and Bing maps) to identify ethnic food retailers serving the cities of Flint and Grand Rapids, Michigan 30. Importantly, authors developed an index to measure the accessibility of ethnic food retailers and geospatial statistical modeling to comprehensively analyze the ethnic food retail environment, providing insights on which communities faced barriers to accessing these outlets. Additionally, novel dietary assessment methods such as Ecological Momentary Assessment (EMA) hold enormous potential to enhance the rigor or comprehensive of dietary research, particularly in measuring determinants of diet, yet remain underexplored within immigrant settings. These innovations should be the focus of future research to better understanding how immigrants interact with their unique food environments 31.
Urban foraging
Finally, beyond both the informal and formal food retail environment, there is a longstanding and growing tradition of urban food foraging across diverse immigrant communities: that is, the harvesting or collection of non-cultivated, naturally growing vegetation within urban landscapes for food, medicinal, or other social purposes 32,33. Urban food foraging can have important nutritional implications and is practiced for a variety of reasons, ranging from the supplementation of food supplies to saving food expenses, preparing traditional cuisines, recreation, or to better connect with nature and one’s community 32,33.
In a 2022 study among Russian immigrants in NYC, participants described consuming 18 different species of plants foraged from the NYC urban landscape, with many describing foraged foods as better-tasting, and perceived as both cleaner and more nutritious 32. However, while emerging efforts using self-reported data and qualitative methodologies have helped better document food foraging behaviors and sources of “wild” foods, 34 there is now also need for broader population-wide surveillance of the prevalence, characteristics, and impact – both social and nutritional – of urban food foraging (e.g., the types of wild foods consumed and where they are located, as well as the nutrient profiles of these wild foods and their implications for health). Such efforts can pave the way for more a nuanced, culturally sensitive understanding of the significance of foraged foods in lives of immigrants.
Challenging the positioning of family: interdependent, complex household food behaviors
Interdependent and family-centered food behaviors
A hallmark of many immigrant communities is the intergenerational transmission of collectivist values, or the prioritization of group-level interests (such as interpersonal, communal, or societal interests) over those of the individual. A common manifestation of collectivist thinking is familism, which emphasizes the importance of interpersonal family relationships (including among extended family) through mutual interdependence and collaboration 35, such as through living in multigenerational households and family-centered decision making, which is observed in Latin and Asian American communities 36–39. However, the presence of familism and collectivist values adds an important yet often overlooked degree of complexity. For example, Asian American young adults have reported eating certain foods out of courtesy or obligation to respect the desires of family members, or changing their eating behaviors to align with the preferences of other family members 36,40. Similarly, East Asian Americans with diabetes have reported refraining from dietary modifications to avoid being a burden to others in the household, where dietary behaviors are often interdependent due to shared food purchasing and preparation 41.
It is thus crucial to consider interdependent dietary behaviors to better capture immigrant experiences (e.g., measuring food-related dependency on family members) and integrate collectivist value systems into the understanding of dietary dynamics. This follows in the footsteps of similar innovations in the measurement of happiness and wellbeing, where an interdependent, collectivist approach to understand happiness has helped develop survey instruments which assess perceptions of wellbeing at both the individual- and group-levels 42,43.
Dietary acculturation and intra-household dietary differences
Especially in immigrant settings, surveilling and intervening in family-wide food behaviors often fails to appropriately consider the high level of heterogeneity in the dietary landscape of each family member. Much of this heterogeneity lies in differences in dietary acculturation, or the experience of integrating mainstream (i.e., host-country) with minority culture (i.e., region of ethnic origin) eating patterns and foods 44. Dietary acculturation has been observed to have a significant impact on eating patterns in diverse immigrant communities 45,46, but even within immigrant sub-groups, the exact nutritional implications of dietary acculturation on eating behaviors can significantly differ. Within households, dietary acculturation may significantly differ by age and degree of exposure to US and non-US dietary influences, which ultimately drives intra-family differences in food consumption patterns 36,40,46. As a result, assumptions about shared socio-ecological drivers of eating patterns within a household may not hold within immigrant settings where acculturative, generational, and migration differences may result in a unique dietary landscape for each family member.
It is thus imperative to identify methods of systematically assessing dietary acculturation within immigrant families to ensure that tailored household-level dietary interventions can be developed which reflect the realities of immigrant household eating behaviors,47 while also being respectful to deeply rooted cultural and family traditions related to food. Indeed, this intra-familial dietary heterogeneity is also nested within important differences even among immigrants sharing common ethnicities or countries of origin (e.g., the dietary patterns of Indian Americans from the North versus the South of India, or the diets of Latin Americans from Central America versus South America); thus, the reductionist approach often taken in understanding immigrant dietary experiences also warrants critical consideration.
Challenging assumptions behind eating patterns: a foundation to improve assessment tools
Consuming from shared, large, and mixed plates of food
Aside from the food environment and household dynamic, unique considerations regarding eating patterns must be considered within the immigrant context. Much of mainstream dietary health research is premised on the assumption of individualized eating patterns, (i.e., having an individualized plate filled with often separated foods). This understanding of eating behaviors is best evidenced by the portioned, individualized MyPlate visual developed by the US Department of Agriculture (USDA) 48. Indeed, 24-hour dietary recalls and other mainstream dietary assessment tools are also structured under this assumed eating style in which individuals consume separated portions of vegetables, meats, and grains as part of meals. However, a survey of diverse Asian American communities revealed that only 13.2% reported eating meals from individualized plates, with many instead reporting eating ‘family-style’ in which food is served in large platters and consumed incrementally in smaller dishes and bowls 49. A similar study of Latino families revealed the popularity of large, one-pot dishes in which different foods are all cooked together 50.
It is crucial to challenge these assumptions regarding eating styles in order to enhance the understanding and obtain appropriate measurements of immigrant dietary behaviors. In this regard, important lessons can be learned from nutritional research around the world. For example, the China Health and Nutrition Survey (CHNS), which launched in 1982 and was informed by the National Health and Nutrition Survey (NHANES),51 has annually documented the health of the Chinese population for almost 40 years 52. While both NHANES and CHNS use 24-hour recalls to measure individual dietary intake, CHNS uses changes in household food inventories to calculate household-level food consumption, which is then integrated into the individual-level intake data by determining the portion of household meals consumed by each person 53. Indeed, aside from China, analyzing the implementation of population-wide nutritional surveillance in countries with significant racial and ethnic diversity may also hold important lessons (e.g., the Brazilian Food and Nutrition Surveillance System (SISVAN)).54 Such innovations in global settings deserve greater exploration in the US to better reflect the dietary experience of immigrants.
Seasonal and culturally significant fluctuations in dietary patterns
Finally, the measurement of dietary intake often assumes a certain degree of regularity in eating behaviors year-round that fails to encompass seasonal variance in diet. Although variability in weekday vs. weekend diets are considered in some measurement methods (e.g., 24-hour recalls), most dietary screeners are still premised on weekly, monthly, and yearly consistency in eating habits. However, the socio-cultural and religious drivers of immigrant diets often foster eating patterns which involve dramatic changes in eating behaviors during certain times of the year. For example, the observance of Ramadan in Islam, practiced widely across Asian and African immigrant communities, involves fasting daily from sunrise until sunset for approximately 30 days each year. Dietary research from diverse Muslim communities has revealed significant dietary and health implications of the observance of Ramadan 55,56, as this time period is also associated with the consumption of many traditional and celebratory foods consumed less during other times of the year. However, the seasonality of these eating patterns presents a significant obstacle for dietary instruments which may dilute these crucial dietary patterns. For instance, consuming dates has particular religious significance during Ramadan, and dates may be eaten daily during this month but not at all during the rest of the year 57; a food-frequency questionnaire (FFQ) may average this yearly intake out to 2–3 times a month, although the reality may hold very different nutritional implications. Aside from religiously driven food consumption, the seasonality of certain culturally significant meals, fruits, or vegetables can also play a significant role across diverse immigrant communities.
Improving dietary instruments to better consider seasonal variations in dietary intake will allow more precise assessment of immigrant dietary experiences; here, too, lessons can be learned from global settings. In 2021, researchers in Pakistan used 24-hour recall data collected during Ramadan to develop a Ramadan-specific FFQ comprised of 80 distinct, common foods consumed during the month 58; developing such tailored and seasonal dietary instruments may improve the assessment of immigrant eating patterns.
Conclusion
With the pressing need to better understand and intervene in dietary risk factors contributing to the immigrant NCD crisis, the scientific community must reflect upon the conceptual and methodological capacity of mainstream dietary health research to stand up to this challenge. In considering the heterogeneity of immigrant dietary experiences, researchers should also look beyond simply nativity; many of the complex norms and behaviors discussed in this paper apply equally to the US-born children of immigrants (i.e. second-generation immigrants) 59. The movement towards precision nutrition is promising, with the potential to allow researchers to holistically consider a systems approach to an individual’s nutrition profile and health risks. This is further reinforced by the assertion that the most commonly recommended diets in the US tend to take a reductionist focus on physical health, crucially forgoing in some cases context and setting 60.
Through a critical examination of food environments, household dynamics, and eating patterns, this paper has outlined immigrant-specific experiences which are currently not captured or accounted for in the existing paradigms of dietary research. In doing so, the outlined recommendations provide researchers and public health practitioners the opportunity to begin enhancing the inclusivity of dietary research by expanding the conceptual understanding of eating behaviors and socio-ecological contributors to diet, as well as innovating in the methodological tools needed to capture the unique complexity of food experiences in diverse populations. Importantly, efforts to better understand and intervene in immigrant dietary behaviors must also consider how this work is contextualized within the broader array of socio-ecological factors driving these nutritional and health disparities. Systemic and multi-sectoral marginalization, exclusion, and discrimination have contributed enormously to the social and economic disparities behind the immigrant disease burden. As such, improving the inclusion of immigrant experiences in nutritional research represents just one important step in efforts needed to better address the complex, structural forces that impact immigrant health.
Funding/financial disclosure:
This publication is supported by grant numbers U54MD000538 from the National Institutes of Health (NIH) National Institute on Minority Health and Health Disparities (NIMHD), R01HL141427 from the National Heart, Lung and Blood Institute (NHLBI) and R01MD018204 from NIMHD. The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.
Footnotes
Conflicts of interest disclosure: None.
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Contributor Information
Shahmir H. Ali, Department of Population Health, NYU Grossman School of Medicine. Address: 180 Madison Ave, New York, NY, USA, 10016..
Nelson Lin, Department of Population Health, NYU Grossman School of Medicine. Address: 180 Madison Ave, New York, NY, USA, 10016..
Stella S. Yi, Department of Population Health, NYU Grossman School of Medicine. Address: 180 Madison Ave, New York, NY, USA, 10016..
References
- 1.Budiman A, Ruiz NG. Key facts about Asian Americans, a diverse and growing population. Pew Research Center. Published 2021. Accessed December 16, 2021. https://www.pewresearch.org/fact-tank/2021/04/29/key-facts-about-asian-americans/ [Google Scholar]
- 2.Batalova JBCE and J. Frequently Requested Statistics on Immigrants and Immigration in the United States. migrationpolicy.org. Published March 15, 2022. Accessed March 5, 2023. https://www.migrationpolicy.org/article/frequently-requested-statistics-immigrants-and-immigration-united-states [Google Scholar]
- 3.Agyemang C, van den Born BJ. Non-communicable diseases in migrants: an expert review. J Travel Med. 2019;26(2):tay107. doi: 10.1093/jtm/tay107 [DOI] [PubMed] [Google Scholar]
- 4.Quiñones AR, Botoseneanu A, Markwardt S, et al. Racial/ethnic differences in multimorbidity development and chronic disease accumulation for middle-aged adults. PLoS One. 2019;14(6):e0218462. doi: 10.1371/journal.pone.0218462 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5.Gordon NP, Lin TY, Rau J, Lo JC. Aggregation of Asian-American subgroups masks meaningful differences in health and health risks among Asian ethnicities: an electronic health record based cohort study. BMC Public Health. 2019;19(1):1551. doi: 10.1186/s12889-019-7683-3 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 6.LeCroy MN, Suss R, Russo RG, et al. Looking Across and Within: Immigration as a Unifying Structural Factor Impacting Cardiometabolic Health and Diet. Under Review. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 7.Russo R, Li Y, Chong S, Siscovick D, Trinh-Shevrin C, Yi S. Dietary policies and programs in the United States: A narrative review. Prev Med Rep. 2020;19:101135. doi: 10.1016/j.pmedr.2020.101135 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8.Yi SS, Lee M, Russo R, Li Y, Trinh-Shevrin C, Kwon SC. Dietary Policies and Programs: Moving Beyond Efficacy and Into “Real-World” Settings. Health Equity. 2021;5(1):194–202. doi: 10.1089/heq.2020.0050 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 9.Brown AGM, Shi S, Adas S, et al. A Decade of Nutrition and Health Disparities Research at NIH, 2010–2019. Am J Prev Med. 2022;63(2):e49–e57. doi: 10.1016/j.amepre.2022.02.012 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 10.Micha R, Peñalvo JL, Cudhea F, Imamura F, Rehm CD, Mozaffarian D. Association Between Dietary Factors and Mortality From Heart Disease, Stroke, and Type 2 Diabetes in the United States. JAMA. 2017;317(9):912–924. doi: 10.1001/jama.2017.0947 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 11.Ali SH, Parekh N, Islam NS, Merdjanoff AA, DiClemente RJ. Evaluating the healthfulness of Asian American young adult dietary behaviors and its association with family structure: Disaggregated results from NHIS 2015. Nutr Health. Published online January 23, 2023:02601060231151986. doi: 10.1177/02601060231151986 [DOI] [PubMed] [Google Scholar]
- 12.Burt K.The whiteness of the Mediterranean Diet: A historical, sociopolitical, and dietary analysis using Critical Race Theory. Critical Dietetics. 2021;5(2):41–52. [Google Scholar]
- 13.Duggan CP, Kurpad A, Stanford FC, Sunguya B, Wells JC. Race, ethnicity, and racism in the nutrition literature: an update for 2020. Am J Clin Nutr. 2020;112(6):1409–1414. doi: 10.1093/ajcn/nqaa341 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 14.Guasch-Ferré M, Willett WC. The Mediterranean diet and health: a comprehensive overview. J Intern Med. 2021;290(3):549–566. doi: 10.1111/joim.13333 [DOI] [PubMed] [Google Scholar]
- 15.Keys A, Menotti A, Aravanis C, et al. The seven countries study: 2,289 deaths in 15 years. Prev Med. 1984;13(2):141–154. doi: 10.1016/0091-7435(84)90047-1 [DOI] [PubMed] [Google Scholar]
- 16.Woodside J, Young IS, McKinley MC. Culturally adapting the Mediterranean Diet pattern – a way of promoting more ‘sustainable’ dietary change? Br J Nutr. 2022;128(4):693–703. doi: 10.1017/S0007114522001945 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 17.Martínez-González MÁ, Hershey MS, Zazpe I, Trichopoulou A. Transferability of the Mediterranean Diet to Non-Mediterranean Countries. What Is and What Is Not the Mediterranean Diet. Nutrients. 2017;9(11):1226. doi: 10.3390/nu9111226 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 18.Tsofliou F, Vlachos D, Hughes C, Appleton KM. Barriers and Facilitators Associated with the Adoption of and Adherence to a Mediterranean Style Diet in Adults: A Systematic Review of Published Observational and Qualitative Studies. Nutrients. 2022;14(20):4314. doi: 10.3390/nu14204314 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 19.Willcox BJ, Willcox DC, Todoriki H, et al. Caloric Restriction, the Traditional Okinawan Diet, and Healthy Aging. Ann NY Acad Sci. 2007;1114(1):434–455. doi: 10.1196/annals.1396.037 [DOI] [PubMed] [Google Scholar]
- 20.Willcox DC, Scapagnini G, Willcox BJ. Healthy aging diets other than the Mediterranean: A focus on the Okinawan diet. Mech Ageing Dev. 2014;136–137:148–162. doi: 10.1016/j.mad.2014.01.002 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 21.Downs SM, Ahmed S, Fanzo J, Herforth A. Food Environment Typology: Advancing an Expanded Definition, Framework, and Methodological Approach for Improved Characterization of Wild, Cultivated, and Built Food Environments toward Sustainable Diets. Foods. 2020;9(4):532. doi: 10.3390/foods9040532 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 22.Ali SH, Imbruce VM, Russo RG, et al. Evaluating Closures of Fresh Fruit and Vegetable Vendors During the COVID-19 Pandemic: Methodology and Preliminary Results Using Omnidirectional Street View Imagery. JMIR Form Res. 2021;5(2):e23870. doi: 10.2196/23870 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 23.Imbruce V.From farm to canal street. In: From Farm to Canal Street. Cornell University Press; 2016. [Google Scholar]
- 24.Yi SS, Ali SH, Russo RG, et al. COVID-19 Leads to Dramatic Changes in the Food Retail Environment in New York City: May–July 2020. J Immigrant Minority Health. 2022;24(1):31–37. doi: 10.1007/s10903-021-01230-7 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 25.Liu JL. Beyond Neighborhood Food Environments: Distance Traveled to Food Establishments in 5 US Cities, 2009–2011. Prev Chronic Dis. 2015;12. doi: 10.5888/pcd12.150065 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 26.Janda KM, Salvo D, Ranjit N, et al. Who shops at their nearest grocery store? A cross-sectional exploration of disparities in geographic food access among a low-income, racially/ethnically diverse cohort in central Texas. J Hunger Environ Nutr. 2022;0(0):1–21. doi: 10.1080/19320248.2022.2128962 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 27.Yi SS, Russo RG, Liu B, Kum S, Rummo P, Li Y. Characterising urban immigrants’ interactions with the food retail environment. Public Health Nutr. 24(10):3009–3017. doi: 10.1017/S1368980020002682 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 28.Tomer CG and A.Beyond ‘food deserts’: America needs a new approach to mapping food insecurity. Brookings. Published August 17, 2021. Accessed March 10, 2023. https://www.brookings.edu/research/beyond-food-deserts-america-needs-a-new-approach-to-mapping-food-insecurity/ [Google Scholar]
- 29.Chen X, Kwan MP. Contextual Uncertainties, Human Mobility, and Perceived Food Environment: The Uncertain Geographic Context Problem in Food Access Research. Am J Public Health. 2015;105(9):1734–1737. doi: 10.2105/AJPH.2015.302792 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 30.Rybarczyk G, Taylor D, Brines S, Wetzel R. A Geospatial Analysis of Access to Ethnic Food Retailers in Two Michigan Cities: Investigating the Importance of Outlet Type within Active Travel Neighborhoods. Int J Environ Res Public Health. 2020;17(1):166. doi: 10.3390/ijerph17010166 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 31.Maugeri A, Barchitta M. A Systematic Review of Ecological Momentary Assessment of Diet: Implications and Perspectives for Nutritional Epidemiology. Nutrients. 2019;11(11):2696. doi: 10.3390/nu11112696 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 32.Marquina T, Emery M, Hurley P, Gould RK. The ‘quiet hunt’: the significance of mushroom foraging among Russian-speaking immigrants in New York City. Ecosyst People. 2022;18(1):226–240. doi: 10.1080/26395916.2022.2055148 [DOI] [Google Scholar]
- 33.Sardeshpande M, Hurley PT, Mollee E, et al. How People Foraging in Urban Greenspace Can Mobilize Social–Ecological Resilience During Covid-19 and Beyond. Front Sustain Cities. 2021;3. Accessed March 3, 2023. https://www.frontiersin.org/articles/10.3389/frsc.2021.686254 [Google Scholar]
- 34.Berggreen-Clausen A, Hseing Pha S, Mölsted Alvesson H, Andersson A, Daivadanam M. Food environment interactions after migration: a scoping review on low- and middle-income country immigrants in high-income countries. Public Health Nutr. 25(1):136–158. doi: 10.1017/S1368980021003943 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 35.APA Dictionary of Psychology. Familism. Published 2020. Accessed December 19, 2021. https://dictionary.apa.org/familism
- 36.Ali SH, Gupta S, Tariq M, et al. Mapping drivers of second-generation South Asian American eating behaviors using a novel integration of qualitative and social network analysis methods. Ecol Food Nutr. 2022;61(4):503–521. doi: 10.1080/03670244.2022.2056166 [DOI] [PubMed] [Google Scholar]
- 37.Katiria Perez G, Cruess D. The impact of familism on physical and mental health among Hispanics in the United States. Health Psychol Rev. 2014;8(1):95–127. doi: 10.1080/17437199.2011.569936 [DOI] [PubMed] [Google Scholar]
- 38.Ruiz ME. Familismo and filial piety among Latino and Asian elders: Reevaluating family and social support. Hisp Health Care Int. 2007;5(2):81. [Google Scholar]
- 39.Sharma P, Kaushi M, Ali SH, et al. How we live: Characteristics of Multigenerational Asian American Households. Under Review. [Google Scholar]
- 40.Ali SH, Cai J, Kamal F, et al. A multi-stage dyadic qualitative analysis to disentangle how dietary behaviors of Asian American young adults are influenced by family. Under Review. [DOI] [PubMed] [Google Scholar]
- 41.Li-Geng T, Kilham J, McLeod KM. Cultural Influences on Dietary Self-Management of Type 2 Diabetes in East Asian Americans: A Mixed-Methods Systematic Review. Health Equity. 2020;4(1):31–42. doi: 10.1089/heq.2019.0087 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 42.Krys K, Haas BW, Igou ER, et al. Introduction to a Culturally Sensitive Measure of Well-Being: Combining Life Satisfaction and Interdependent Happiness Across 49 Different Cultures. J Happiness Stud. 2023;24(2):607–627. doi: 10.1007/s10902-022-00588-1 [DOI] [Google Scholar]
- 43.Uchida Y, Oishi S. The Happiness of Individuals and the Collective. Jpn Psychol Res. 2016;58(1):125–141. doi: 10.1111/jpr.12103 [DOI] [Google Scholar]
- 44.Satia-Abouta J.Dietary acculturation: definition, process, assessment, and implications. Int J Hum Ecol. 2003;4(1):71–86. [Google Scholar]
- 45.AYALA GX, BAQUERO B, KLINGER S. A Systematic Review of the Relationship between Acculturation and Diet among Latinos in the United States: Implications for Future Research. J Am Diet Assoc. 2008;108(8):1330–1344. doi: 10.1016/j.jada.2008.05.009 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 46.Ali SH, Yi SS, Kranick J, Lee M, Thorpe LE, Rummo PE. Disentangling the roles of generational status and acculturation on dietary behaviors in disaggregated Asian American subgroups. Appetite. 2022;171:105903. doi: 10.1016/j.appet.2021.105903 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 47.Ali SH, Mohsin FM, Rouf R, et al. Family Involvement in Asian American Health Interventions: A Scoping Review and Conceptual Model. Public Health Rep. Published online December 22, 2022:333549221138851. doi: 10.1177/00333549221138851 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 48.Levine E, Abbatangelo-Gray J, Mobley AR, McLaughlin GR, Herzog J. Evaluating MyPlate: an expanded framework using traditional and nontraditional metrics for assessing health communication campaigns. J Nutr Educ Behav. 2012;44(4):S2–S12. [DOI] [PubMed] [Google Scholar]
- 49.Garcia V, Sklyar L, Caldwell JI, Shah D, Prudencio JM, Kuo T. MyPlate and urban low-income Asian Americans in the United States: a study to improve nutrition education. J Public Health Policy. 2022;43(4):621–639. doi: 10.1057/s41271-022-00377-3 [DOI] [PubMed] [Google Scholar]
- 50.Martínez AD. Comiendo Bien: The Production of Latinidad through the Performance of Healthy Eating among Latino Immigrant Families in San Francisco. Symb Interact. 2016;39(1):66–85. doi: 10.1002/symb.218 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 51.NHANES - National Health and Nutrition Examination Survey Homepage. Published May 30, 2023. Accessed June 15, 2023. https://www.cdc.gov/nchs/nhanes/index.htm
- 52.Popkin BM, Du S, Zhai F, Zhang B. Cohort Profile: The China Health and Nutrition Survey—monitoring and understanding socio-economic and health change in China, 1989–2011. Int J Epidemiol. 2010;39(6):1435–1440. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 53.Zhai F, Du S, Wang Z, Zhang J, Du W, Popkin B. Dynamics of the Chinese Diet and the Role of Urbanicity, 1991–2011. Obes Rev. 2014;15(0 1): 10.1111/obr.12124. doi: 10.1111/obr.12124 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 54.Departamento de Atenção Básica (Brasil). Sistema de Vigilância Alimentar e Nutricional - SISVAN. Published 2023. Accessed May 20, 2023. https://sisaps.saude.gov.br/sisvan/
- 55.Benaji B, Mounib N, Roky R, et al. Diabetes and Ramadan: review of the literature. Diabetes Res Clin Pract. 2006;73(2):117–125. [DOI] [PubMed] [Google Scholar]
- 56.Salim I, Al Suwaidi J, Ghadban W, Alkilani H, Salam AM. Impact of religious Ramadan fasting on cardiovascular disease: a systematic review of the literature. Curr Med Res Opin. 2013;29(4):343–354. [DOI] [PubMed] [Google Scholar]
- 57.Assaad Khalil S, Gaber Amin N, Mohamed Ibrahim A, Zakaria Zaky D, Mounir Bishay M. Glycemic indices of dates “Ramadan Symbolic Food” in patients with type 2 diabetes using continuous glucose monitoring system. Diabetes Res Clin Pract. 2021;172:108563. doi: 10.1016/j.diabres.2020.108563 [DOI] [PubMed] [Google Scholar]
- 58.Gul R, Khan I, Alam I, Uddin Z, Iqbal Z. Development of an Innovative Tool for Assessment of Dietary Intake in the Fasting Month of Ramadan- A Ramadan-Specific Food Frequency Questionnaire. J Innov Sci. 2021;7(2). doi: 10.17582/journal.jis/2021/7.2.206.214 [DOI] [Google Scholar]
- 59.Ali SH, DiClemente RJ, Parekh N. Changing the landscape of South Asian migrant health research by advancing second-generation immigrant health needs. Transl Behav Med. 2021;11(6):1295–1297. doi: 10.1093/tbm/ibaa084 [DOI] [PubMed] [Google Scholar]
- 60.Wang VHC, Foster V, Yi SS. Are recommended dietary patterns equitable? Public Health Nutr. 2022;25(2):464–470. doi: 10.1017/S1368980021004158 [DOI] [PMC free article] [PubMed] [Google Scholar]