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Journal of the American College of Nutrition, Vol. 21, No. 5, 372-380 (2002)
Published by the American College of Nutrition

Nutrient Intake of First Generation Gujarati Asian Indian Immigrants in the U.S.

Satya S. Jonnalagadda, PhD, RD and Sadhna Diwan, PhD, LCSW

Department of Nutrition (S.S.J.), School of Social Work (S.D.), Georgia State University, Atlanta, GA 30303

Address correspondence to: Satya S. Jonnalagadda, PhD, RD, Department of Nutrition, 140 Decatur Street, Room 839 Urban Life Building, Georgia State University, Atlanta, GA 30303-3083. Email: sjonn{at}gsu.edu


   ABSTRACT
TOP
 ABSTRACT
INTRODUCTION
 METHODS
 RESULTS
 ACKNOWLEDGMENTS
 REFERENCES
 
Objective: To examine the nutrient intake of Gujarati Asian Indian immigrants in the U.S. and the influence of length of residence in the U.S. and socioeconomic status (SES) on their macronutrient intake.

Methods: Subjects were male (n = 90) and female (n = 99) Gujarati Asian Indian immigrants over the age of 45. Each participant completed a 24-hour dietary recall. Dietary recalls were analyzed using Food Processor nutrient analysis software. Participants were classified into recent immigrants (<10 years length of residence in the U.S.) and long-term immigrants (>10 years length of residence in the U.S.) and into low, medium and high education groups, based on highest level of education achieved, to examine the influence of these variables on their macronutrient intake.

Results: The macronutrient contributions to the total energy intake of these Gujarati Asian Indian immigrants were as follows: carbohydrate 57%, protein 12% and total fat 33%. The diets were low in cholesterol (<100 mg/day) and high in dietary fiber (>=25 g/day). Reported intakes of vitamin D, calcium (women only), potassium (women only), copper and zinc were less than two-thirds of the recommendations. Significant differences (p < 0.05) in macronutrient intake were observed based on length of residence in the U.S. and SES. Regression analysis indicates age, total energy intake, length of residence in the U.S. and SES to have a significant influence on the nutrient intake of these Gujarati Asian Indian immigrants.

Conclusion: The nutrient intakes of these Gujarati Asian Indian immigrants indicate both inadequacies and excesses of select macro and micronutrients. These nutrient inadequacies and excesses can impact overall health and risk of chronic diseases of these individuals. Further investigation of the influence of the diets of these immigrants on their health is warranted.

Key words: macronutrient, micronutrient, nutrient density, socioeconomic status, Asian Indian


   INTRODUCTION
TOP
 ABSTRACT
 INTRODUCTION
METHODS
 RESULTS
 ACKNOWLEDGMENTS
 REFERENCES
 
The Asian and Pacific Islander (API) population, who numbered approximately 11.9 million in 2000, compose 4.2% of the total U.S. population [1]. Within the APIs, the number of Asian Indian immigrants has grown from 15,000 in 1965 to 1.6 million in 2000, witnessing a 6% growth rate in the past decade, making them the third largest group among the APIs [1–3]. A study of this ethnic group in the U.S. is merited as Asian Indian immigrants in several Western countries, such as United Kingdom (U.K.) and Canada, have been found to be at greater risk of morbidity and mortality as compared to the native and other immigrant populations [4–6]. Similarly, in the U.S., available data indicate that heart disease is the leading cause of death in both genders of the Asian Indian population, although the dietary risk factors that predispose this group to chronic disease are not clearly defined [7,8]. It is uncertain if the increased risk in this immigrant population is genetically predetermined before migration or is acquired as a consequence of migration through a process of dietary and behavioral adaptation.

In recent years, in addition to macronutrients, the role of micronutrients in chronic diseases has also been investigated extensively, and abundant evidence suggests antioxidant nutrients (vitamins C, and E, beta-carotene) may offer protection against chronic diseases by mediating a host of biological factors [9]. For example, inadequate consumption of folate, vitamins B12 and B6 has been associated with increased levels of homocysteine, a risk factor for coronary heart disease [10]. Likewise, low calcium intake has been associated with increased risk of both osteoporosis and hypertension among women of Asian origin [11]. Thus, sound nutrition practices are important not only for maintenance of good health but also for chronic disease prevention. A better understanding of the dietary habits and nutrient intakes of Asian Indian immigrants is required to enable an evaluation of their diet-related risk of chronic diseases.

In most Western countries morbidity and mortality due to chronic diseases are inversely related to socioeconomic status (SES) [12–14]; this has been attributed to variations in risk factors such as body weight and dietary intake [15–17]. High-energy intakes and low intakes of dietary fiber and antioxidant nutrients among individuals with low SES have also been observed [18–21]. Data from the U.S. Census Bureau indicate that, in general, the Asian Indian immigrant community is highly educated, with the average educational attainment being a bachelor’s degree, and is economically well off, with a median income higher than that of non-Hispanic whites [22]. Nonetheless, there are significant within-group differences in educational levels, socioeconomic status, language and diet among members of this ethnic minority group [23]. Dietary intake practices can be diverse within this group due to differences in the region of origin in India, recency of immigration, socioeconomic status and acculturation [23].

Gujarati’s are a sub-group of Asian Indians with a common language and cultural heritage originating from the western Indian state of Gujarat and form a large proportion of the Asian Indian immigrant community in the U.S. Data from the 1990 U.S. Census [24] indicate that Gujarati, the language spoken by individuals from the state of Gujarat, was the second most common Indian language spoken at home by foreign-born individuals in the U.S. (spoken by 18% of the Asian Indian immigrants). This community includes highly educated professionals, e.g., academicians, physicians and engineers; business owners, e.g., motel and ethnic grocery store owners; and blue-collar workers, e.g., grocery store and gas station clerks. Misra et al. [25], in a cross-sectional study of health promoting behaviors of Gujarati Asian Indian immigrants in the U.S., observed that 20% of these individuals were overweight and/or obese and 57.7% of these individuals reported changes in their diet since immigration. Thus, given the diversity and higher representation of this group among the immigrant Asian Indian community and the limited literature on their dietary intake, the present study was undertaken to examine the nutrient intakes of middle-aged and older, first-generation Gujarati Asian Indian immigrants in the U.S. Additionally, given the diversity in length of residence in the U.S. and SES within this ethnic sub-group, the impact of these variables on their macronutrient intake was also examined. This age group was chosen for the present study because it represents a first-generation immigrant group entering the life-stage when chronic diseases begin to manifest, but about whose diet-related risk little is known. Health care providers will be faced with an increasing need to develop and modify their practice guidelines and recommendations suited to the unique dietary practices of this aging ethnic minority group.


   METHODS
TOP
 ABSTRACT
 INTRODUCTION
 METHODS
RESULTS
 ACKNOWLEDGMENTS
 REFERENCES
 
Sample
The study protocol was reviewed and approved by the human subjects institutional review board. Gujarati Asian Indian men (n = 90) and women (n = 99) over 45 years of age living in two major U.S. cities (Atlanta and Detroit) were recruited for this study. The age range of the study participants was 45 to 84 years and the median age was 57 years. This sub-group of Asian Indian immigrants includes a diverse group of individuals based on their SES. Those who immigrated under the family preference provision of the immigration laws tend to have fewer skills, less fluency in English, lower SES and have lived in the U.S. for a shorter duration than those who immigrated for educational and professional reasons. Thus, within this single sub-group of Gujarati Asian Indian immigrants, considerable within-group diversity exists, and it is important to obtain a representation of this diversity in one’s sample in order to gain a better understanding of the nutrient intake of the group. The sampling strategy used for this study was purposive and non-random. Access to this ethnic group was obtained by contacting local community leaders and individuals at major places of worship and community organizations. Many older, first generation Gujarati Asian Indian immigrants belong to these ethnic community organizations, given the significance of these organizations in maintaining social, cultural and religious traditions. With the help of various individuals from within these organizations we identified potential participants who were 45 years or older. A trained interviewer contacted the participants via telephone to conduct the 24-hour dietary recall.

Dietary Assessment
A single 24-hour dietary recall was collected from each participant at a time convenient to the participant; this resulted in recalls being collected on both weekdays and weekends. The 24-hour dietary recall was conducted using the telephone interview process based on established protocols [26] to determine the mean macronutrient (carbohydrate, protein, fat, cholesterol and dietary fiber) and micronutrient (vitamins and minerals) intake of this group. The 24-hour dietary recall is a commonly used dietary assessment method to determine nutrient intake of various groups [26,27]. Interviewers were trained in collecting the recalls and instructions were provided on obtaining detailed descriptions regarding the foods and fluids consumed and portion sizes. Participants were asked to report all food, fluids and supplements consumed during the previous 24-hour period, starting with the time they woke up to the time they went to bed. Participants were instructed about appropriate portion size estimation and were provided with aids and various food-based cues to assist with portion size estimation. The first author reviewed all 24-hour dietary recall data for missing or incomplete information; any questions regarding the recalled intake were clarified with the participants and all dietary analysis was conducted by the first author. These procedures enabled uniform and standard decision-making regarding the data entry and analysis process. The Food Processor nutrient analysis software (Version 7.5, 2000, ESHA, Salem, OR) was utilized to analyze the 24-hour dietary recalls. The Food Processor consists of data entry and analysis software, and a comprehensive food database that includes the USDA standard release and manufacturers nutrient database. Additionally, it allows the addition of new items, such as ethnic foods and recipes into the database.

Macro and micronutrient intakes reported in the present paper are based exclusively on the contribution of food and fluids consumed. The contribution of vitamin and mineral supplements to the reported nutrient intake is not presented here since we were interested in examining the contribution of diet alone to the nutrient intake of this group of Gujarati Asian Indian immigrants. The nutrient densities (units of nutrients/1000 calories) of the participants’ diets were calculated to assess the quality of their dietary intake. To determine percent of under and/or over reporting, the participants’ reported energy intake was compared to their estimated energy requirements, which was calculated using the Harris-Benedict equation for estimating basal energy requirements and an activity factor of 1.375 (light activity) [28,29]. The use of a light activity factor was based on the self-reported activity patterns of the study participants, which was mainly sedentary. The reported nutrient intake data was compared to age- and gender- matched Recommended Dietary Allowances (RDAs) [30,31] to determine the adequacy of their dietary intakes. In order to examine how this ethnic minority immigrant group compares to the average U.S. population, the reported nutrient intake of this group was also compared to the gender- and age-specific reported intakes of the NHANES III survey population [32,33].

Demographic Information
Information about each participant’s age, gender, education, income and length of residence in the U.S. was also collected from the participant during the telephone interview. To examine the influence of length of residence in the U.S. on macronutrient intake of these immigrants, participants were classified into recent immigrants (<10 years) and long-term immigrants (>10 years). Income and occupation share some overlap with education [34], and since some of the study participants were not comfortable reporting their annual household income, education was used as a proxy indicator of SES in the present study. Using the highest level of education achieved, participants were classified into three groups to determine the impact of SES on macronutrient intake. The education categories created were: 1. Low, which included individuals with grade school and some high school education; 2. Medium, which included individuals with high school, vocational school or some college education, and 3. High, which included individuals with college and post-graduate education. Self-reported height and weight measures were also obtained. Body Mass Index (BMI) was calculated as the ratio of weight (kg) to height squared (m2) [35].

Data Analysis
Given the inherent physiological differences between men and women and hence differences in dietary intake, gender-specific data are reported here. Descriptive data (Mean ± SD and frequencies) were used to provide a profile of the sample. Chi-square analysis was used to examine differences in education and income levels of men and women. Independent t test was used to examine the differences in age, weight, height, BMI, length of residence in the U.S. between men and women. Independent t test was also used to examine the difference in mean reported energy intake and estimated energy requirements and differences in macronutrient intake based on length of residence in the U.S. within each gender group. Analysis of variance and Tukey’s post hoc tests were conducted to determine differences in macronutrient intake based on level of education within each gender group. Separate regression analyses were run for men and women to determine the influence of the independent variables (age, total energy intake, length of residence in the U.S. and highest level of education achieved) on each of the macronutrients (carbohydrate, fat and protein). All data analysis was conducted using the Statistical Program for Social Sciences (SPSS, Version 10.0, 2001, Chicago, IL). Significance was set at p < 0.05.


   RESULTS
TOP
 ABSTRACT
 INTRODUCTION
 METHODS
 RESULTS
ACKNOWLEDGMENTS
 REFERENCES
 
Table 1 presents the characteristics of the Gujarati Asian Indian immigrant participants in the present study. Ninety-eight percent of the men and 80% of the women were married. A greater percent of women were widowed (18%) compared to men (2%). The mean BMI of the men indicates normal weight status while that of the women is indicative of overweight [35].


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  		Table 1. Characteristics of Study Participants

 
Table 2 presents the reported macronutrient intake of the study participants. The estimated energy requirement for men was 7.8 (±0.74) MJ, and it was not significantly different from their reported energy intake (8.14 MJ). For women, the estimated energy requirement was 7.22 (±0.63) MJ, which was significantly different (p < 0.05) from their reported energy intake (6.58 MJ, 9% lower than estimated requirements). Carbohydrate and protein intakes fell within the recommended intake guidelines, whereas total fat intake was above the recommendation of <=30% energy from fat. The saturated fat (SFA) and polyunsaturated fat (PUFA) intake met the dietary recommendations, but the monounsaturated fat (MUFA) intake was below the recommendations. Interestingly, the total trans fatty acid intake of this group was less than 1 g/day, and total cholesterol intake was well below the recommendation of <=300 mg/day (Table 2). The total dietary fiber intake met the dietary recommendations of 25–30 g/day (Table 2).


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  		Table 2. Macronutrient Intake of Older Gujarati Asian Indian Immigrants in the U.S.

 
Table 3 presents the reported vitamin and mineral intake of men and women in the present study. The reported dietary intake of men contributed to mean vitamin intakes that were at or above recommended guidelines, except for vitamin A (72% of RDA), vitamin D (23% of RDA), vitamin B6 (66% of RDA) and pantothenic acid (75% of RDA). Likewise for women, the mean intake of most vitamins, except vitamin D (30% of RDA), vitamin B12 (81% of RDA), vitamin B6 (68% of RDA) and pantothenic acid (67% of RDA), met the recommendations. However, further examination of the data suggests that >=50% of the men did not meet at least two-thirds of the RDA for vitamin B6, vitamin B12, pantothenic acid, vitamin A, and vitamin D. Similarly, >=50% of the women did not meet at least two-thirds of the RDA for vitamin B6, vitamin B12, pantothenic acid, vitamin D and vitamin A. With respect of mineral intake, the diets of both men and women met only the phosphorus, iron and sodium recommendations. More than 50% of the men and women did not consume at least two-thirds of the RDAs for calcium, copper, magnesium, manganese, potassium, selenium and zinc.


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  		Table 3. Vitamin and Mineral Intake of Older Gujarati Asian Indian Immigrants in the U.S.

 
Table 4 presents the nutrient densities of the diets and a comparison of the reported intake of these Gujarati Asian Indian immigrants to that of the average U.S. population (NHANES III). The nutrient densities of the diets of these participants appear to be less than ideal. Likewise, compared to the average intake of the U.S. population, the nutrient intakes of these Gujarati Asian Indian immigrants were low, except for vitamin E, thiamin, folate and iron by men, and vitamin E, thiamin, niacin, folate, magnesium and iron by women.


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  		Table 4. Mean Nutrient Density and Comparison to NHANES III of the Diets of Older Gujarati Asian Indian Immigrants in the U.S.: Vitamins and Minerals

 
Based on length of residence in the U.S. (<10 years vs. >10 years) significant differences (p < 0.05) in macronutrient intakes of the study participants were observed. Among men, significant differences (p < 0.05) were observed between recent immigrants and long-term immigrants in percent of energy from carbohydrate (53% vs. 59%) and fat (39% vs. 32%). Likewise, among women significant differences (p < 0.05) were observed between recent immigrants and long-term immigrants in percent of energy from carbohydrate (53% vs. 58%), fat (38% vs. 32%) and protein (11% vs. 13%).

Examination of the influence of level of education, which was used as an indicator of SES, on macronutrient intakes of study participants revealed significant differences between education groups. Among men, significant differences (p < 0.05) between the medium and high education groups were observed in their protein (10% energy vs. 12% energy) and dietary fiber (23 g/day vs. 32 g/day) intakes. Likewise, among women significant differences (p < 0.05) were observed between low and high education groups in the percent of energy from carbohydrate (53% vs. 62%), protein (11% vs. 14%), fat (38% vs. 28%) and dietary fiber (21 g/day vs. 29 g/day) intakes.

In both men and women, the regression models examining the influence of age, total energy intake, length of residence in the U.S. and highest level of education achieved on macronutrient intake were significant. For men, the regression models were carbohydrate (r2 = 0.092, F = 3.228, p < 0.016), fat (r2 = 0.159, F = 5.158, p < 0.001) and protein (r2 = 0.223, F = 7.323, p < 0.0005). For women, the regression models were carbohydrate (r2 = 0.156, F = 5.354, p < 0.001), fat (r2 = 0.1787, F = 6.092, p < 0.005) and protein (r2 = 0.098, F = 3.542, p < 0.001). Additionally, for men, length of residence in the U.S. was a significant predictor of percent of energy from carbohydrate, while total energy intake and length of residence were significant predictors of percent of energy from fat and protein. On the other hand, in women, level of education was a significant predictor of percent of energy from carbohydrate and fat, and total energy intake was a significant predictor of percent of energy from protein.


   DISCUSSION
 
The results of the present study indicate inadequate intakes of select macro and micronutrients by this group of Gujarati Asian Indian immigrants in the U.S. In this section we will briefly discuss the limitations of the study, compare the results to the extant literature and discuss their implications.

The present study describes the nutrient intake of select sub-group of Asian Indian immigrants in the U.S., Gujaratis, recruited from two major U.S. cities, with a large representation of this group. The sampling strategy used in this exploratory study is non-random and purposive. Thus the generalizability of the findings is limited to the Gujarati Asian Indian group represented in this study sample. Other limitations of the study are the use of self-reported height and weight measures and one-day 24-hour dietary recall to determine nutrient intakes of study participants. Any form of self-reported data has limitations, and these are briefly discussed below as they relate to dietary assessment. However, the strength of this study is that it allows for an in-depth examination of the nutrient intakes of this select subgroup of Asian Indian immigrants and the factors influencing the group’s nutrient intakes. The diversity among the study participants is reflective of the diversity observed in the Gujarati Asian Indian immigrant community in the U.S. Similar studies are needed with larger samples and more diverse groups of Asian Indian immigrants to increase our understanding of the nutritional status of this first-generation immigrant group’s diet-related risk of chronic diseases.

The one-day 24-hour dietary recall as used in the present study is a common assessment method employed to obtain diet and nutrient intake information of a group and is used in several national surveys such as the USDA Continuing Survey of Food Intake of Individuals (CSFII) and NHANES [27]. The accuracy of estimates of energy and nutrient intakes based on 24-hour dietary recall interviews depends on complete recall of foods and beverages consumed, correct estimations of portion sizes and accurate recall of food type, ingredients or other relevant characteristics of the foods and beverages consumed [36]. Studies have shown that approximately 10% to 20% under or overestimation of energy intake can occur based on the group that this being studied [37–39]. These reporting errors were observed to be influenced by gender, weight status of individuals, age and SES [37–39]. Because of the day-to-day variability in dietary intake, a single 24-hour dietary recall, as used in the present study provides data for the group rather than an estimate of an individual’s dietary intake [26]. In the present study, trained interviewers with the same ethnic background who were familiar with the dietary habits of the study participants were used to collect the recalls. However, reporting errors may have occurred; it is therefore important to view the reported nutrient intake data as the best estimate of a group’s mean nutrient intake and to keep in mind that some individuals may have over or under estimated their intakes. Additionally, most commercially available databases are limited in the extent to which ethnic foods that are included. For the present study, the investigators created a supplemental database, which included nutrient information for ethnic food recipes based on the available nutritive value of Indian foods [40]. These inherent limitations in the available methodologies should be kept in mind when interpreting the study results.

The reported total energy intake of this group of Gujarati Asian Indian immigrant men was similar to their estimated energy requirements while a significant difference was observed between reported energy intake and estimated energy requirements for females. Body weight status of individuals has also been observed to play a significant role in their accuracy of reported intake, with overweight individuals typically under-reporting their intake and underweight individuals over-reporting their intake [37–39]. Although a single 24-hour dietary recall provides data for group intakes and cannot be used to evaluate adequacy of an individual’s intake [26], the reporting errors observed in the present study are similar to previous findings; deVries et al. [41], and Jonnalagadda et al. [42] reported 12% to 13% underestimation of energy intake required for weight maintenance by free-living healthy females. In NHANES III approximately 18% of men and 28% of women were classified as under reporters of energy intake [43]. This reporting error can influence reported macro and micronutrient intakes.

The macronutrient intake recommendations for the general population are 55% to 60% of total energy from carbohydrate, 15% of total energy from protein and <30% of total energy from fat [44]. In the present study, the carbohydrate intake of the group met the dietary recommendations, whereas the total fat intake was above the recommendations and protein intake was below the recommendations. The protein intake of the participants in the present study was mainly derived from selective vegetarian sources, suggesting that both the quality and quantity of intake may need to be improved. Although reported total fat intake was above the recommendations, the reported intakes of the individual fatty acids classes were at or below the recommendations, suggesting that the nutrient database may be missing individual fatty acid data. Typically, nutrient databases have about 20% missing data for fatty acids for various methodological and analytical reasons. Since 61% of the study participants were vegetarians, it is not surprising that the dietary cholesterol intake was well below the recommendations (<300 mg/day). It is important to note that these individuals have maintained their vegetarian status despite living in this country for an average of 18 to 21 years, and nutritional professionals working with these individuals need to be conscious of these dietary practices when making dietary recommendations.

Based on the reported mean intakes, both men and women in the present study had adequate intakes of most vitamins, except vitamin D, vitamin B6 and pantothenic acid (women only). Vitamin D intake of this group is probably low given its limited distribution in the food supply. The low vitamin B6 intake could be reflective of the low protein intake and the predominantly vegetarian diets of this group. Given that 61% of the study participants were vegetarians, the reported mean intake of vitamin B12 appears to be higher than expected [45,46]; further evaluation of the reported intakes to assess their nutritional status is warranted.

The low vitamin D intake along with the low calcium intake observed in the present study can have long-term implications with regard to bone health in this ethnic group given its increased risk of osteoporosis [11]. With respect to mean mineral intake, these Gujarati Asian Indian immigrants met only the recommended intakes for phosphorus, iron and sodium, while intake of all other minerals were less than 100% of the RDA. These intake patterns are probably reflective of the vegetarian dietary habits of this group. The high dietary fiber intake and the low intake of micronutrients by these Gujarati Asian Indian immigrants raise questions about the bioavailability of these nutrients [47]. Bioavailability of nutrients such as calcium, iron and zinc from vegetarian diets may also be limited given the presence of oxalates and phytates in plant-based diets [47]. The results of the present study also suggest that although the mean micronutrient intakes of a group may appear adequate, in-depth examination of the nutrient intake distribution is necessary to determine adequately the nutritional status of a group.

Compared to national surveys, such as NHANES III [32,33], the reported nutrient intake of this ethnic minority immigrant group differs from the intake of the average U.S. adult. This suggests that the nutrient intakes of subgroups within the same age groups can vary significantly, and careful distinctions should be made when generalizing the results of national surveys. Data from national surveys such as CSFII and NHANES are used to establish health and nutrition policies, track progress towards achieving health and nutrition objectives, provide reference data on nutrient intakes, develop dietary guidelines and study diet-health relationships. Although national surveys attempt to provide dietary intake estimates from samples that represent the national population with respect to age, gender and ethnicity, usually ethnic minority groups are underrepresented in these surveys. Thus a comparison with such national data is useful not only to compare the status of individual ethnic groups in the U.S., but also to identify their specific nutrient needs.

Both similarities and differences appear to exist when comparing the macronutrient intake of the current study participants to that reported in earlier studies of this immigrant community [48–51] and Indians living in India [52–54]. For example, immigrants in the U.K. were observed to consume diets low in fat (<30% energy) [52]; the fat contribution in the diets of immigrants in the U.S. [46–48] was similar to that observed in the present study (>30% energy). On the other hand, in general, the dietary fat intake of these immigrants was higher than that observed to be consumed by Indians living in India (>30% energy vs. <30% energy) [52–54]. These differences in intake suggest that these immigrants may be making some changes in their dietary patterns as they adjust to their new environment and acculturate into the culture of their host country. This is further supported by the observation in the present study of differences in macronutrient intake of recent immigrants compared to long-term immigrants. These changes in dietary intake need to be considered when evaluating risk of chronic disease of these ethnic minority groups.

Although the Dietary Guidelines for Americans [44] stress dietary balance, variety and moderation, generally dietary intake is influenced by a variety of social and cultural factors. The 1989–1991 CSFII nutrient intake data of individuals over 60 years of age showed that nutrient intake was influenced by education, income, urbanization, race, age and gender [55]; a similar trend was observed in the present study with respect to SES. Similar to the observations of van Rossum et al. [15], protein as a proportion of total energy and dietary fiber intakes were lower among low SES Gujarati Asian Indian immigrants. Additionally, the low SES women consumed a higher proportion of energy from fat. Intake of certain micronutrients by these Gujarati Asian Indian immigrants was also observed to be influenced by SES, suggesting that it may impact on the intake of certain food groups, such as fruits and vegetables [20]. The observed impact of SES on nutrient intake can be associated with differences in attitudes towards healthful foods, limited knowledge about healthful diets, decreased awareness of the benefits of eating a healthful diet, the cost of nutritious food and a limited food budget [15,56,57].

One of the overarching goals of Healthy People 2010 [58] is to eliminate health disparities among segments of the population, including differences that occur by gender, race or ethnicity, education or income. Additionally, the nutrition objective of Healthy People 2010 is to promote health and reduce chronic disease associated with diet and weight, since nutritional factors contribute substantially to the burden of preventable illnesses [58]. In order to achieve such national nutritional and health goals, it is important first to gain an understanding of the dietary intakes of the various ethnic minority communities in the U.S., which will enable the identification of nutritional factors that may predispose individuals to poor health. Thus, the results of the present study provide a preliminary assessment of the nutrient intake of a sub-group of the Asian Indian immigrant community. Although the present study focused on a single sub-group of Asian Indian immigrants in the U.S., the macro and micro nutrient intake data suggest that the diets of these Gujarati Asian Indian immigrants may need to be enhanced in order to improve their nutritional and health status. Since nutritionally inadequate diets can contribute to or exacerbate chronic health conditions and hasten the development of degenerative diseases associated with aging, it is imperative that a better understanding of the dietary intakes of this immigrant group is achieved. The nutrient intake data observed in the present study need to be confirmed with a larger, more diverse group of Asian Indian immigrants. Additionally, biochemical and physiological assessments are needed to determine the nutritional and chronic disease risk of this group. A closer examination of the cultural and religious influences on the dietary intakes of these immigrants and the impact these have on their health is also warranted in order to develop appropriate and effective dietary recommendations.


   ACKNOWLEDGMENTS
TOP
 ABSTRACT
 INTRODUCTION
 METHODS
 RESULTS
 ACKNOWLEDGMENTS
REFERENCES
 
This study was supported by a grant from the National Institute of Aging, RO3-AG19049. The authors thank the study participants for participating in the study and the research assistants who helped collect the data.

Received February 12, 2002. Accepted May 3, 2002.


   REFERENCES
TOP
 ABSTRACT
 INTRODUCTION
 METHODS
 RESULTS
 ACKNOWLEDGMENTS
 REFERENCES
 

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