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Abstract
Background: People of Mexican descent are the biggest Hispanic population in the US, representing over 11% of the entire US population. Addressing health disparities by improving the dietary intake and the health and well-being of this large Hispanic group would benefit the entire US due to the large population impact. Currently, the Dietary Guidelines for Americans (DGAs) have not been evaluated for effectiveness among people of Mexican descent.
Objective: It is necessary to evaluate whether the DGAs, including the USDA-provided Spanish translation, are effective for adopting and maintaining a healthy diet aimed at improving health outcomes in this population, or if a more culturally tailored approach might be warranted.
Design: First- and second-generation healthy women of Mexican descent (n=20) were randomly assigned to two parallel arms where one arm used study staff to provide instruction on the 2015 Dietary Guidelines for Americans (including the Spanish translations) and the other arm was staff-provided instruction on an adaptation of the DGA to include traditional Mexican foods and cultural aspects of diet (MexD). Participants received instruction on foods but purchased and prepared all their own foods. Metabolic response was measured through glucose, insulin, CRP, lipid panel (Cholesterol, HDL, LDL, VLDL, triglycerides and free fatty acids), and the homeostasis model assessment of insulin resistance (HOMA-IR) at the beginning and end of the intervention. Dietary intake was assessed through validated Food Frequency Questionnaires. For comparison of the effects of each arm on biomarkers and diet, generalized estimating equation (GEE) was used and adjusted for age and BMI. A qualitative analysis was also performed based on an end-of-study survey.
Results: GEE models (n=20) showed that serum FFAs was the only biomarker with a significant difference in pre- and post-intervention values, both before and after adjusting for age and BMI (p=0.004, and p=0.0001, respectively). Serum FFA changes amounted to a total of 35% difference favoring the DGA arm. Between baseline and the 3-month follow-up (n=18), carbohydrate consumption differences between each group amounted to 29% (p=0.028), with the DGA group having a 31% reduction. Participant feedback showed overall positive reception of both arms.
Conclusion: Participants gave positive feedback about both study arms and some minor health improvements were noted on both arms. Therefore, healthcare workers could potentially offer either option to their patients or have them choose their preferred option between traditional DGAs or the MexD.
