Association between Select Measures of Acculturation and Diet Quality in US Adolescents: Findings From the National Health and Nutrition Examination Survey, 2007 to 2018

OBJECTIVES: Acculturation is associated with decreased diet quality among non-United States (US)-born adults, but there is limited research among non-US-born adolescents. We investigated the associations between birthplace and length of time living in the US, two measures of acculturation, with diet quality among adolescents (12–19 years old). METHODS: Data are from the National Health and Nutrition Examination Survey (2007–2018), which included two 24-hour dietary recalls (n = 6,113) to calculate Healthy Eating Index-2015 (HEI-2015) total scores and component scores. Multivariate linear regression and generalized linear models were performed to compare HEI-2015 total scores and component scores between US-born adolescents (n = 5342) and foreign-born adolescents with < 5 years (n = 244) and ≥5 years (n = 491) of U.S. residency. RESULTS: Foreign-born adolescents with < 5 years (53.27 ± 0.71) and ≥5 years of US residency (50.45 + 0.71) had higher HEI-2015 total scores than US-born adolescents (46.99 ± 0.29, P < 0.0001) and higher total vegetables, greens and beans, total fruits, whole fruits, seafood and plant proteins, and added sugars scores (P < 0.0001). Foreign-born adolescents with < 5 years of US residency had higher total fruit and saturated fat scores than those with ≥5 years of US residency (P < 0.001). CONCLUSIONS: Being born outside the US and, to a lesser extent, living in the US for less time (among foreign-born adolescents) is associated with higher diet quality. Culturally informed health promotion programs may help to reduce diet-related disparities related to acculturation among adolescents. FUNDING SOURCES: No funding sources to report.