Acculturation and healthy lifestyle among Latinos with diabetes

PURPOSE Latinos have a high prevalence of diabetes and disproportionately experience diabetic complications. We sought to examine the association of acculturation on healthy lifestyle habits among the Latino population in the United States with diabetes. METHODS We studied Latino adults (aged >= 20 years) with previously diagnosed diabetes in the 1999-2004 National Health and Nutrition Examination Survey (unweighted N = 467; weighted N = 1,957,778). Healthy lifestyle habits were those consistent with recommendations of the American Diabetes Association (ADA) regarding exercise, smoking, obesity, and diet. Acculturation was measured with the Short Acculturation Scale, a validated 5-item scale assessing use of the Spanish language. Logistic regression analyses of acculturation and healthy behaviors were computed controlling for access to care, demographics, and disease characteristics. RESULTS In bivariate analyses, compared with their less-acculturated counterparts, individuals who were more-acculturated to any extent were less likely to have a higher fiber intake (9.4% vs 35.4%, P =.001) and lower saturated fat intake (17.2% vs 46.5%, P =.03). More-acculturated individuals were more likely to report leisure time exercise (59.2% vs 19.3%, P <.001), whereas the proportion of individuals who smoked did not differ. In logistic regression analyses using the 1994 ADA dietary guidelines, more-acculturated individuals were less likely than their less-acculturated counterparts to meet dietary criteria for saturated fat consumption (odds ratio, 0.13; 95% confidence interval [CI], 0.04-0.41). When using the stricter 2006 ADA dietary guidelines, more-acculturated individuals were less likely to have recommended consumption of both saturated fat (odds ratio, 0.06; 95% CI, 0.02-0.20) and fiber (odds ratio, 0.19; 95% CI, 0.08-0.48). Acculturation did not significantly influence exercise and smoking status in logistic regression analyses. CONCLUSIONS These results suggest that acculturation among diabetic Latinos to the general US culture is associated with adoption of some less desirable dietary habits.