Methods: 28 foreign-born Hispanic (14 Mexican & 14 Dominican) women recruited from NYC Head Start-enrolled families who took part in a prior study of childhood asthma participated in 90 minute, semi-structured interviews. Analyses of dietary data collected from a larger sample of 345 Hispanic women from the asthma study were conducted to confirm the interview findings. Generalized estimating equations were used to determine whether individual and neighborhood socio-demographic characteristics and the neighborhood food environment within 0.5 Km of the home predicted women's diet. Results: Despite experience of nutritional education, interview respondents rarely discussed healthy food in terms of nutrient content. They consistently expressed a strong preference for fresh, “naturally” produced foods—fruits and vegetables “from the field” and freshly slaughtered meats—and expressed aversion to frozen, refrigerated, canned, and processed foods. These preferences were based on perceived health benefits and taste profiles, and appeared to reflect pre-immigration, home country diets. The respondents consistently reported using, whenever possible, fresh market venues (e.g., farmers' markets and livestock slaughterhouses) that most nearly replicated food sourcing in their countries of origin.
These retail preferences were confirmed in analyses of fruit and vegetable and meat consumption patterns in the larger sample. The presence of a farmers' market in the home neighborhood was associated with higher consumption of total fruit, vegetable, and juice and the presence of a famers' market or a livestock market was associated with higher meat consumption. Dietary patterns were not associated with the presence of a supermarket in the neighborhood.
Implications: The consumption preferences of our sample of low-income immigrant women are usually linked to the wealthiest and the least obese/overweight segments of the US population, and with elite consumer trends for local foods, natural farming, and artisanal food production, rather than “standardized foods typified by supermarkets.” But these retail practices serve a premium niche market; our respondents' consumption preferences are difficult to actualize in the low-income urban settings in which they live. Policy interventions to remove environmental and economic barriers (e.g. availability and cost) that prevent immigrants' embedded healthy preferences from being actualized and thus maintained, are indicated. The development of supermarkets, a policy focus in low-income and minority communities where retail food access remains limited, require reconsideration. Especially in immigrant-dense neighborhoods, increased development of farmers' markets, CSAs, and community gardens may be more appropriate. Dietary messages for immigrant populations should be built upon culturally relevant frameworks, utilizing imbedded beliefs about freshness, purity, and naturalness of healthy foods, rather than on nutritional content (e.g., fats, sugar, calories). Individual-level interventions should acknowledge and encourage the retention of an embedded tradition of healthy food beliefs and practices that immigrants often bring from their countries of origin.
