• SteeleEurídice MartínezEMDepartment of Nutrition, School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715-Cerqueira César, São Paulo 01246-904, Brazil; Center for Epidemiological Studies in Health and Nutrition (NUPENS), Faculty of Public H, Neha Khandpur, Qi Sun, and Carlos A Monteiro.
• Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715-Cerqueira César, São Paulo 01246-904, Brazil; Center for Epidemiological Studies in Health and Nutrition (NUPENS), Faculty of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715-Cerqueira César, São Paulo 01246-904, Brazil. Electronic address: emar_steele@hotmail.com.
• Prev Med. 2020 Dec 1; 141: 106261.

AbstractThis study examined the association between measures of acculturation to the US environment including place of birth, and language spoken at home and proportion of life in the US among foreign-born, in relation to the dietary contribution of ultra-processed foods. Ultra-processed foods, as defined by the NOVA food classification system, are formulations of macronutrients (starches, sugars, fats and protein isolates) with little, if any, whole food and often with added flavors, colors, emulsifiers and other cosmetic additives. We studied 14,663 participants from the National Health and Nutrition Examination Survey 2011-2016, aged 20+ years, who completed a 1-day 24-h dietary recall. Food items were classified using NOVA into ultra-processed or non-ultra-processed foods. Linear regression models adjusted for age, sex, family income, education and race/ ethnicity, showed significant associations between general acculturation measures and dietary contribution of ultra-processed foods. Foreign-born adults consumed less ultra-processed foods than US-born adults (45 vs. 58%, p < 0.001). Within foreign-born adults, ultra-processed food consumption increased with English permeation at home from 40% among individuals speaking non-English languages only to 50% among those speaking English only (p for linear trend <0.001). In addition, ultra-processed food consumption increased from 41% among foreign-born adults who spent less than 30% of their life in the US to 48% among those who lived in the US for more than 50% of their lives (p for linear trend <0.001). Race/ethnicity emerged as an important effect modifier for the observed associations.Copyright © 2020 Elsevier Inc. All rights reserved.

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