Findings from the present study show that Latina subgroups living in the same geographical area have substantially different nutrient and food group serving intake patterns. We showed that non-Puerto Rican Latinas compared with Puerto Ricans consumed more fruit and vegetables and fewer processed grains (i.e. breakfast cereals, crackers), processed meat, cheese, artificial beverages (i.e. regular soft drinks, sweetened fruit drinks) and sweet baked goods. Consistent with this, non-Puerto Rican Latinas had higher intakes of key vitamins, minerals and fibre but lower intakes of fats (saturated, monounsaturated and trans
fats) compared with Puerto Ricans. One explanation may be the differences in acculturation level between the ethnic groups. In our study, non-Puerto Rican Latinas compared with Puerto Ricans were significantly more likely to be born outside the USA, to live for less duration in the USA and to speak only Spanish. On the basis of these differences in baseline characteristics of the accepted proxy measures for acculturation, the non-Puerto Rican Latinas in the present study were much less acculturated. This conclusion of acculturation was strongly supported through the multivariate logistic regression analyses we conducted, which showed that the acculturation proxies and Latina subgroups were strongly related. Reviews by Ayala et al
and by Pérez-Escamilla and Putnick(27)
on studies examining the link between acculturation and diet among Latinos concluded that acculturation affects dietary quality negatively. Both found that less acculturation was related to higher consumption of fruit, rice and beans and to lower consumption of sugar and sugar-sweetened beverages. Although both included studies conducted among men and/or women, these overall findings, as well as others that specifically focused on pregnant women of Mexican descent(16)
, support our findings. In our study, non-Puerto Rican Latinas had nutrient and food group serving intake patterns that reflected healthier dietary behaviours compared with their more acculturated Puerto Rican counterparts.
Compared with the national study by Abrams and Guendelman(17)
, which was published 16 years ago, mean intakes in our study for energy (10 349 υ. 8091·9 kJ, respectively), carbohydrates (345 υ. 220 g, respectively) and Fe (18·7 υ. 12·2 mg, respectively) were higher, but intakes of dietary folate (285 υ. 287 µg, respectively) and Ca (1034 υ. 952 mg, respectively) were almost identical. Compared with other studies, energy from saturated fat and protein intakes from the present study were similar to those reported by Harley et al
and carbohydrate and cholesterol intakes were similar to those reported by Guiterrez(22)
. Among food groups, the mean dairy serving intakes from our study were similar to those reported by Guendelman and Abrams(21)
(2·7 υ. 2·4, respectively) and by Harley et al
. for Mexican-born women, whereas protein serving intakes were much higher among our groups compared with the intakes reported by Guendelman and Abrams (5·8 v
. 2·8, respectively). Mean fruit serving intakes were higher in our sample compared with those reported by Guendelman and Abrams and by Harley et al
. (5·0, 1·7 and 2·5–2·8, respectively) as were grain serving intakes (7·9, 2·6 and 4·1–4·6, respectively). Differences in nutrient and food group intakes between our study and others may be due to the following reasons: extremely small sample sizes of pregnant women in other studies(17,21)
; different ways in which similar food groupings were defined(21)
; different dietary intake methods (24 h recall υ. FFQ)(16)
; or differences in the recruited population characteristics (i.e. adult υ. an adolescent sample)(22)
. In addition, most of the previous studies were conducted over a decade ago.
Our study is unique because it examined intakes for over fifty nutrients and food groups to develop a comprehensive description of contemporaneous dietary intake patterns among pregnant Latina subgroups. The study published by Bowering et al
three decades ago was limited in scope as it reported intake differences for only nine nutrients. Both Bowering et al
.’s study and ours found that a higher proportion of Puerto Rican Latinas consumed more energy and Ca, whereas more non-Puerto Rican Latinas consumed higher levels of vitamin C. However, Bowering et al
. found that a significantly higher proportion of Puerto Ricans had higher intakes of protein, whereas our study found no between-group differences in total protein intake. Thirty years later, we have expanded upon the study by Bowering et al
., providing an extensive, complete, contemporary profile of nutrient and food group serving intakes and nutrient adequacy among low-income pregnant Latina subgroups living in the same geographical area.
The present study has several limitations. First, it documented and compared nutrient and food group intake patterns between Puerto Rican and non-Puerto Rican Latinas. Non-Puerto Rican Latinas came from Mexico, Central America, South America and the Caribbean. Unfortunately, our sample size was too small for expanding the number of ethnic subgroups modelled in the statistical analyses. Second, our study was not specifically designed to measure prenatal supplement use. Thus, we were unable to estimate their contribution towards overall nutrient intakes. Third, our results are only generalizable to those populations that have characteristics similar to those of the sample in the present study. Finally, results from our multivariate logistic regression analyses showed that the acculturation proxy variables and ethnicity were strongly related and consequently could not be entered together in the same model. These findings suggest that the associations between ethnicity and nutrient/food group intakes were mediated by acculturation proxies. This hypothesis needs to be confirmed through future longitudinal studies.
The documented differences in prenatal dietary intake based on Latina ethnicity that were found in the present study provide insights that may aid clinicians and dietitians working with these populations. If length of time spent in and acculturation to the USA erode the traditional, healthier eating patterns of Latinas, it is important that clinicians and dietitians focus on encouraging their less-acculturated Latina clients to retain their healthy cultural eating habits and educate those who are more acculturated about culturally appropriate healthy recipes and menus. Traditional eating patterns have been linked to more optimal birth weight(28)
; therefore, educating clients on the benefits of traditional eating patterns may play an important role in facilitating an optimal birth outcome.