Dietary patterns and quality in West-African immigrants in Madrid

Background: Eating patterns of immigrants deserve to be better documented because they may reflect the extent of acculturation and associated health risks. The study assessed dietary patterns and quality in Bubi immigrants (from Equatorial Guinea) using cluster analysis and comparing different diet quality indexes. Methods: A random sample of 83 Bubi men and 130 women living in Madrid were studied. A 99-item food frequency questionnaire was administered, body weights and heights were self-reported and socio-demographic and health information was collected during interviews. Usual intakes were collapsed into 19 food groups. Cluster analysis of standardized food intakes per 1000 kcalories was performed. Dietary quality was appraised using the Alternative Mediterranean Diet Score, the Alternative Healthy Eating Index and scores of micronutrient adequacy and prevention based on WHO/FAO recommendations. Results: Two dietary patterns were identified. The 'Healthier' pattern, so confirmed by two dietary quality indexes, featured a higher consumption of fish, fruits, vegetables, legumes, dairy products and bread while the 'Western' pattern included more processed meat, animal fat, and sweetened foods and drinks. One third of the subjects were in the 'Healthier' food cluster, with the same proportion of men and women. Age >= 30 and residence in Madrid >= 11 years were independently associated with the healthier diet. Consumption of traditional foods was unrelated to dietary pattern, however. Overall, Bubi diets were somewhat protective because of high intakes of fruits and vegetables and monounsaturated fat (olive oil), but not with respect to sugar, cholesterol, omega-3 fatty acids and fibre. Less than two thirds of subjects had adequate intakes of iron, calcium and folate in both dietary phenotypes. Body mass index, physical exercise, and self-reported health and cardiovascular disease condition showed no significant association with the dietary pattern. Conclusion: Cluster analysis combined with dietary quality assessment facilitates the interpretation of dietary patterns, but choosing the appropriate quality indexes is a problem. A small number of such indexes should be standardized and validated for international use. In the group studied, younger subjects and more recent immigrants were more likely to have a 'Western' pattern and should be a priority target for nutrition communication.