The Latino Diet as a Risk Factor for Developing Coronary Heart Disease
AUDIENCE
This web page is intended for those persons interested in learning about specific aspects of the Latino diet that places them at risk for Coronary Heart Disease (CHD). The information included was chosen for those who believe to be or have been told that they are at risk for CHD and can lower their risk by modifying their diet. INTENT
The goal of this web page is to give a brief explanation of how diet is linked to CHD risk and explain how foods common in Latino cuisine can be modified so as to lower one's risk for CHD. Also included on this page are recommended journal articles that expand on the topics covered in this site. Also included are links to other websites to asses one's risk for heart disease and how to measure the content of foods one consumes.
Fat and Cholesterol in the Diet
Modifying the Latino Diet
Factors Influencing Nutrition Habits of Latinos
Links
INTRODUCTION
Cardiovascular disease is the leading cause of death among all ethnic groups (Perez-Stable, 1994). High cholesterol levels have been linked to the development of Coronary heart disease (CHD). Several studies have shown that Latinos have high cholesterol levels in ranges that increase their risk for developing CHD (Kraus, 1980). Other studies show that Latinos have cholesterol levels higher than (Christensen, 1981) or comparable to (Stern, 1975) Whites and African American. Their blood cholesterol levels increase in men (Houston) and in those living in suburban areas as opposed to el barrio (Stern, 1984).
FAT AND CHOLESTEROL IN THE DIET
While total blood cholesterol levels have been used to assess CHD risk, Researchers found in the "Seven Countries Study " (Verschuren, 1994) that diet appears to be a stronger factor in preventing death from CHD. In comparing specific cholesterol levels between different cultures from seven countries over a twenty-five-year period, researchers found that mortality rates for CHD were higher in the United States and Northern European countries than in Mediterranean Europe and Japan. This is due to the high amounts of saturated fats consumed by Americans and Northern Europeans versus the fruits, vegetables, and fish that are the focus of Japanese and Mediterranean diets. These foods are beneficial because of their high antioxidant and flavonoid content.
Recommended Readings: Masley, 1998.
MODIFYING THE LATINO DIET
An examination of the Puerto Rican and Mexican-American diet was published (Samolsky, 1990) to assist dietitians in planning hospital diets for Latino patients. The article suggests simple modifications in food preparation and easy foods to incorporate into the diet. Some Latinos resist such substitution since they may sacrifice taste or authenticity, but they are essential if one wants to stay or become healthy. The easiest diet modification is to incorporate more fruits, vegetables, and fiber into the diet, and lower the consumption of cheese and eggs. In order to lower the fat content in food preparation, Latinos may substitute unsaturated fats for lard. To lower sodium intake one may use onion, garlic, thyme, oregano, mint, nutmeg, lemon, and parsley for salt.
FACTORS INFLUENCING NUTRITION HABITS OF LATINOS
Several studies have shown that various socioeconomic factors influence the nutrition and health of Latinos. Following is several journal articles, with their abstracts, that focus on education, income, and acculturation as factors influencing Latino health. Education
Title: Association of sociodemographic factors with barriers reported by patients receiving nutrition counseling as part of cardiac rehabilitation.
Authors: Lappalainen, Raimo; Kokkalainen, Merja; julkunen, Juhani; Saarinen, Timo; Mykkanen, Hannu
Source: Journal of the American Dietetic Association v98, n9 (Sept, 1998): p1026. Abstract: A study was undertaken to explain the relationship between gender, level of education, age and body mass index with difficulties experienced by patients after receiving nutritional counseling as part of their rehabilitation after a myocardial infarction. Nutritional counseling was done on patients with focus on the barriers affecting intake of the nutritional diet. Results revealed that patients having higher levels of education possessed more healthy diets than their less educated counterparts. Social factors affected the compliance of patients toward cardiac diets.
Income Levels
Title: A brief dietary assessment to guide cholesterol reduction in low-income individuals: design and validation.
Author: Ammerman, Alice S.; Haines, Pamela S.; DeVellis, Robert F.; Strogatz, David S.; Keyserling, Thomas C.; Simpson, Ross J.; Siscovick, David S.
Source: Journal of the American Dietetic Association, v91, n11 Nov., 1991:1385. Abstract: It is well established that diet plays an important role in heart disease, the leading cause of death in the US. Diets high in fat and cholesterol increase the amount of fat and cholesterol in the blood and increase risk of developing heart disease. Several studies have reported that Americans with low incomes have the greatest risk for heart disease. Effective programs for providing diet counseling to reduce blood cholesterol levels are needed for this population. These programs should consider specific needs of people with low income and education levels; acknowledge cultural preferences for specific foods; and should be easy to use by nutrition specialists and health care professionals with limited training in diet counseling. This article describes the development of a dietary risk assessment questionnaire designed to evaluate the dietary habits of low income families. The questionnaire provides a summary of individual dietary habits and analyzes the diet based on the frequency of consumption of different types of foods such as meats, dairy products, fruits and vegetables, breads and pasta, and fats. Each item is given a numerical value based on the number of times it is eaten in one week and the scores for each food item are added and classified as either 'doing well', 'needs work' or 'problem'. The test is easy to administer and score. The results of the test can be used to determine an individual's dietary risk of developing heart disease.
(Consumer Summary produced by Reliance Medical Information, Inc.)
Acculturation
Title: Understanding Hispanic Diet, Nutrition and Health
Source: Human Ecology Forum, v20, n3, Fall, 1992: 6. Abstract: Nutritional advice given to people of different culture must first take into consideration the traditional diet of that particular culture. The Hispanic diet, for instance, which varies with different cultural groups are already low in fat and consisting mostly of vegetables and carbohydrates. Once the Hispanic culture assimilates with the Western diet, the Hispanics tend to acquire the poor eating habits of the Americans. Consequently, they also contract the health problems of the Westerners and eventually become in need of sound nutritional advice.
Title: Dietary intake patterns and acculturation levels of Hispanic immigrant men: a pilot study
Author: Gardner, Christopher: Winkleby, Marilyn A.; Viteri, Fernando E.
Source: Hispanic Journal of Behavioral Sciences v17, n3 August, 1995: 347.
Abstract: A cross-sectional survey of 106 Hispanic males of Mexican or Central American heritage for food patterns to find the effect of migration and the percentage of traditional Hispanic foods in the diet shows the mean consumption level of all nutrients to be at or above 100% of the US Recommended Daily Allowances. After migration, higher intake of prepared foods rich in fat and sugar, sugared drinks, poultry and wheat was reported while lard, margarine, cheese, fish, poultry skin, and pork were eaten less. Nearly 50% of the subjects' energy intake was due to traditional foods. Acculturation levels did not have a major impact.
ADDITIONAL WEBSITES
A-Z Heart and Stroke Encyclopedia from the American Heart Association
Coronary Heart Disease Risk Calculator
Bibliography of Hispanic Health Research compiled by NIH
Applying US Dietary Guidelines to Hispanic Diets (Book Chapter)
Food and Nutrition Information Center
Enter a food to find the amount of calories, fat, vitamins, and minerals it contains using the Nutitional Analysis Tool.
