Impacts of acculturation on depressive symptoms and activities of daily living of U.S. older Chinese immigrants.

BACKGROUND AND OBJECTIVES: Acculturation is a critical aspect of social experience for immigrants, including Asian immigrants. Existing literature has shown mixed findings on the health impacts of acculturation and largely relied on cross-sectional studies, preventing drawing definitive conclusions. This study aimed to examine the long-term effects of acculturation on depressive symptoms and activities of daily living (ADL) limitations in a large sample of older Chinese immigrants in the United States. RESEARCH DESIGN AND METHODS: Data were drawn from 2,811 older Chinese immigrants from the Population Study of Chinese Elderly in Chicago. Acculturation was assessed at baseline, and questionnaires on depressive symptoms and ADL limitations were completed at four assessments. RESULTS: Overall, results showed that acculturation was not associated with depressive symptoms at baseline but was associated with a faster decline in depressive symptoms over time. No associations were found between acculturation and ADL limitations. Stratified analyses showed that the significant relationship between acculturation and a faster decline in depressive symptoms was only evident among female participants. Also, acculturation was associated with a lower risk of reporting ADL limitations at baseline in female participants but a higher risk of reporting ADL limitations in male participants. DISCUSSION AND IMPLICATIONS: This study indicates the long-term benefits of acculturation on mental health among older Chinese immigrants in the U.S., particularly among females. Initiatives supporting the acculturation process need to consider sex disparities and individual preferences, aiming to foster sustained benefits for healthy aging in this population.

Prevalence and Risk Factors of Iron Deficiency and Anemia in Women of Reproductive Age in the Hispanic Community Health Study/Study of Latinos.

Background: Women of reproductive age are at elevated risk of iron deficiency (ID) and anemia; in the United States, those of Hispanic/Latino background are at especially high risk. Causes of ID and anemia and variations in risk within Hispanic/Latino women of reproductive age are not well described. Objectives: To characterize ID and anemia and their risk factors/markers in Hispanic/Latina women. Methods: Data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) were used. HCHS/SOL enrolled participants in 2008-2011 at 4 sites: Bronx, Chicago, Miami, and San Diego; 5386 were non-pregnant women ages 18-49 y. Primary outcomes were ID (ferritin <30 µg/L) and anemia (hemoglobin <12 g/dL). Predictors were background/heritage, Short Acculturation Scale for Hispanics scores, years lived in the United States, and interview language, diet summarized in the Alternate Healthy Eating Index 2010, sociodemographic covariates, and study site. Main analyses used survey log binomial regressions adjusted for age, site, and smoking. Results: Almost half (42%) of participants were of Mexican background, 15% of Cuban background, and <15% each were of Puerto Rican, Dominican, Central American, or South American background. ID prevalence was 34.4% overall but differed by site-background pairings. The lowest and highest prevalence were 26% and 42% among women of Cuban background in Miami and women of Mexican background in Chicago, respectively. Anemia prevalence was 16% and ranged from 8.9% (Central American background/Miami) to 22% (Dominican background/Bronx). Acculturation, sociodemographic, and diet variables examined did not explain observed prevalence differences by site/background. Conclusions: Prevalence of ID and anemia were high among HCHS/SOL women and differed by field center and background. These differences highlight the importance of characterizing nutritional risk by background within Hispanic/Latino women.

Having, making and feeling home as a European immigrant in the United Kingdom post-Brexit referendum: An interpretative phenomenological study.

Migrants' subjective sense of home deserves further research attention. In the particular context of the United Kingdom's (UK's) decision to leave the European Union ('Brexit'), we interviewed 10 European citizens living in the UK about their sense of home, using interpretative phenomenological analysis (IPA). In our analysis, we identified themes of (1) having more than one home, (2) making and finding a new home, (3) being permanently different from the non-migrant population and (4) a concern about feeling safe and welcome. Migration and sense of home involved building and rebuilding personal and social identity. Making a new home was effortful, and neither the old home nor the difference from the native population ever disappeared psychologically. This adds an experiential aspect to the idea of 'integration' in acculturation. Different notions of home were linked to different experiences of the impact of the Brexit referendum. We discuss the connections between acculturation, sense of home and lived experience and propose lived identity as a fruitful subject matter for social psychology.

The Role of Acculturative Stress on the Mental Health of Immigrant Youth: A Scoping Literature Review.

Acculturation after settlement has been identified as a risk factor affecting the mental health of immigrant youth. Increasing rates of immigration and expanding populations of immigrant youth mean that addressing their mental is a priority. Acculturative stress is the stress-response resulting from the effects of multiple stressors that result from the need to acculturate. Among youth within the developmental stages of late adolescence and emerging adulthood, increased sensitivity to stress, and developmental demands, impact their mental health. The effects of acculturative stress place an additional burden on the mental health of immigrant youth. This scoping review examined existing literature that investigated a variety of relationships between acculturative stress and youth mental health. A comprehensive search strategy that focused on studies involving youth, mainly aged between 15-24, with a proximal history of international migration, published between 2012-2022, resulted in a collection of fifty-three studies. This review examined significant relationships between acculturative stress and major depression, anxiety disorders, eating disorders, substance misuse, behavioural problems and poor psychological wellbeing. This scoping review was truly explorative as it included youth from immigrant minorities, had no geographical limits, and included various study designs. Acculturative stress continues to be an important contributor to the mental health of youth who have a proximal history of international migration. This review provided an exploration of the state of research, identified the importance of the settlement context, and provided recommendations for the direction of future studies, supportive policies, and practice considerations, related to the mental health of immigrant youth.

Executive function tests: Normative data for Spanish-speaking adults in the United States.

BACKGROUND: Normative data for Spanish-speaking populations, particularly Hispanics in the U.S., is notably scarce. OBJECTIVE: This study aims to establish normative data for executive function tests (Modified Wisconsin Card Sorting Test and Stroop Color and Word Test) among Spanish-speaking Hispanics in the U.S. METHODS: We assessed 245 individuals aged 18-80 from eight U.S. states (California, Connecticut, Florida, Indiana, New Jersey, Oregon, Virginia, and Wisconsin) and employed Bayesian regression to estimate norms, considering various sociodemographic factors influencing performance. RESULTS: The posterior distribution suggests a high probability that age impacts SCWT performance, with older adults likely to show greater declines, particularly among those with high proficiency in Spanish. The posterior distribution suggests a stronger effect of age on M-WCST performance among individuals with longer U.S. residency. Educational attainment demonstrates a robust positive impact on M-WCST outcomes, with lower levels of education associated with a higher probability of increased errors. An interaction between education and Spanish proficiency was observed, influencing SCWT scores differently across proficiency levels. Sex and acculturation levels interact to affect SCWT performance, with distinct patterns observed between men and women. This suggests that the impact of acculturation on cognitive test performance may vary by gender. CONCLUSION: Establishing culturally sensitive normative data can enhance accurate identification of executive dysfunction and reduce misdiagnosis risks. This study underscores the importance of considering sociocultural factors including acculturation and language proficiency in neuropsychological assessments to better serve diverse populations.

The associations between self-construal, emotional expressivity and acculturation among Arab immigrants.

This contribution investigates differences in self-construal and emotional expressivity among Arab immigrants and non-immigrants. Furthermore, it examines the role of acculturation styles and perceived emotional acculturation in predicting these outcomes among Arab immigrants. Using a sample of 1249 self-identified Arabs (629 immigrants in Western Europe and North America; 620 non-immigrant Arabs in the Mashriq and Maghrib regions), we found that collectivist self-construal was significantly lower, and positive emotional expressivity was significantly higher among immigrant, than non-immigrant, Arabs. High home country acculturation (also in combination with high host country acculturation) was the strongest predictor of collectivist self-construal. Immigrants' perception of the positive emotional expressivity of people in their host culture was the strongest predictor of their personal positive emotional expressivity. These results were replicated using the Euclidean distance method to measure acculturation. Hence, the study provides valuable insights into the relationships between self-construal, emotional expressivity and acculturation styles, specifically among Arab immigrants.

Acculturating to multiculturalism: a new dimension of dietary acculturation among Asian American, Native Hawaiian, and Pacific Islander women in the San Francisco Bay Area, USA.

BACKGROUND: Dietary acculturation is the process by which diet and dietary practises from the environment of origin are retained or changed and/or those prevalent in a new environment are adopted. Despite rapid population growth the U.S., knowledge gaps exist on characterising dietary acculturation among Asian American, Native Hawaiian, and Pacific Islander communities (AANHPI). This study characterise dietary patterns in a sample representative of AANHPI on key demographic characteristics. METHODS: Data were from a 2013-2014 population-based case-control study in the San Francisco Bay Area, U.S. Survey items were adapted from dietary acculturation scales developed for AANHPI populations. Validated measures assessed social capital, social standing, discrimination and immigration experiences. A principal components factor analysis was conducted to characterise dietary patterns of acculturation. RESULTS: Three dietary patterns were identified: "Asian," "Western," and a distinct "Multicultural" factor. Respondents reporting a high-Asian diet tended to also report smaller social networks, higher levels of stress, and, among those born outside of the U.S., an educational standing that was better before immigration. Respondents reporting a high-Western diet tended to also report the highest level of discrimination. Those reporting a high-Multicultural diet tended to report higher neighbourhood collective efficacy. CONCLUSIONS: The finding of a distinct "Multicultural" factor beyond the typical "Asian" and "Western" factors may reflect the multidirectional relationships between culture, diet, and dietary behavior, in which origin and destination cultures interact in complex ways and where foods from multiple ethnicities intermix.

Do Acculturative Gap Conflicts Impact Parenting Practices and Youth E-Cigarette Use? Tests of Moderated Mediation.

BACKGROUND: Latino/a youth are at increased risk of electronic (e)-cigarette or electronic nicotine delivery systems (ENDS) use; thus, identifying factors impacting initiation is critical. Parenting practices reflecting warmth (e.g., relationship quality) and control (e.g., parental monitoring) and substance use-specific parenting (e.g., reactions to use, parenting self-efficacy) may influence youth substance use. For Latino/a youth, tensions from intergenerational acculturative differences are linked to substance use. We investigated ENDS use-specific parenting as a mediator between general parenting and youth ENDS use, examining whether acculturative gap conflict moderated the association between general and ENDS use-specific parenting. We expected mediation among families experiencing low acculturative gap conflicts. METHOD:  Data were analyzed over two waves from a predominantly White and Latino/a sample of caregiver-child dyads (N = 143) who identified with a culture in addition to or distinct from American. Youth (Mage = 14.9 years, SD = 0.67; 62.9% female) reported relationship quality, parental monitoring, caregiver ENDS attitudes and reactions, acculturative gap conflicts, and ENDS use. Caregivers reported on ENDS use-specific parenting self-efficacy. Two moderated multiple mediator regression models (i.e., relationship quality, parental monitoring) were estimated. RESULTS:  Among youth reporting low and mean levels of acculturative gap conflict, ENDS use-specific parenting self-efficacy mediated the association between relationship quality and reduced ENDS use. There was no evidence for an interaction in the parental monitoring model. CONCLUSIONS:  In families experiencing low levels of acculturative gap conflict, relationship quality may impact ENDS use through caregivers' confidence in their ability to prevent child ENDS use.

Acculturation, Enculturation, Culture-Specific Emotional Distress, and Parenting Among Korean Immigrant Mothers.

This study examined how Korean immigrant mothers' cultural orientations (i.e., acculturation and enculturation) were related to their mental health, specifically depression and the culturally specific syndrome of Hwa-byung (HB), and had direct and indirect relations to their parenting practices (i.e., authoritative, authoritarian, acceptance, rejection). In a sample of 412 Korean immigrant mothers (99.5% foreign-born; Mage = 45.31), a path analysis was conducted by using the maximum-likelihood and bootstrapping methods. Results revealed that mothers' cultural orientations were indirectly related to parenting practices via depression and HB. Specifically, mothers' acculturation and enculturation had positive indirect relationships to authoritative parenting and acceptance versus a negative relationship to rejection, via their links to depression. Mothers' acculturation had a negative relationship to rejection via its link to HB, while enculturation was not related to HB. Additionally, cultural orientations were directly associated with parenting. Overall, the current findings highlighted that HB holds a unique role in parenting after controlling for the effects of depression, which suggests the importance of assessing culture specific syndrome, above and beyond depression, to have a better understanding of Korean immigrant mothers' mental health and its relation to parenting. Implications for research and practice are discussed.

Interplay of sociocultural factors, health literacy and well-being among African asylum seekers and refugees in Asia: A systematic review.

Background: There are many African asylum seekers and refugees (AAR) in Asia. However, little research has been conducted on their well-being within the sociocultural milieu. This systematic review explores the characteristics of AAR's psychological and mental well-being and how their acculturation practices, social networks and support (i.e. social capital), health-related knowledge and skills (i.e., health literacy) influence their psychological and mental well-being. Methods: The study included relevant peer-reviewed articles from any Asian country/region, published in English. No date restriction was applied. Five databases (i.e. Scopus, PubMed, Web of Science, PsycINFO, and CINAHL) were searched for studies conducted about AAR from any of the 54 African countries and residing in any of the 51 Asian countries. Following a predefined inclusion criteria and quality assessment, nine articles were included in this study. Narrative synthesis approach was used to analyse the articles. Results: It was found that AARs face significant challenges that culminate in poor psychological and mental well-being, including conditions such as depression and discontent with their lives. Notwithstanding, being in a safe place made some of them optimistic about their future. However, many AARs had difficulties adjusting to the host culture. They had limited awareness of the prevailing health system and services and faced restrictions on their rights to social services, partly because of difficulty obtaining appropriate information. The few social bonds and bridges they possessed enabled them to develop a sense of belonging and protected them from psychological distress. However, problematic social relationships increased the chances of poor health-related outcomes. Conclusion: The psychological and mental well-being of AAR in Asia is concerning. Hence, more research on how critical health determinants (i.e. social capital, health literacy and acculturation processes from this study) directly and interactively influence their well-being across age cohorts. Given their roles in promoting AAR's well-being, appropriate interventions to improve those critical health determinants are also sorely needed.

Out of pocket health-care services in Germany during pregnancy under consideration of migration and acculturation.

PURPOSE: More than a quarter of the German population has a migration background (MB). As various studies in the healthcare sector have already shown, ethnic background and migration status can have an influence on individual patient care. The aim of our study was to evaluate whether there are differences in utilization of out of pocket health-care services and the consultation situation in the context of prenatal care, taking into account migration status, acculturation and socio-demographic aspects. METHODS: In the period from 01.03.21-01.03.22, a total of 511 women in childbed at the University Women's Hospital Ulm were interviewed in a retrospective survey using a standardized questionnaire translated into 9 languages and asked about their prenatal care. Due to the COVID pandemic, the study had to be terminated after one year. RESULTS: Women with MB-particularly 1st generation migrant women-used significantly fewer out of pocket prenatal care services (p < 0.001) and felt less informed and counselled regarding costs and benefits of possible prenatal care examinations (p < 0.001) compared to women without MB. Consistent with these results, there were associations between the assimilation index (AI) of patients with MB and both utilization and perception of individual healthcare services. CONCLUSION: Our study indicates that even today there are still differences in the treatment and perception of various health services in the context of prenatal care between women with and those without MB.

Cultural Perceptions of Health in Asian Indian Adults.

OBJECTIVE: To gain an understanding of the cultural perceptions of health among Asian Indian adults in an urban setting. DESIGN: Qualitative semistructured interviews. SETTING: Midwest urban community PARTICIPANTS: Asian Indian adults (n = 20) aged ≥25 years, who self-identified as 100% Asian Indian descent. PHENOMENON OF INTEREST: Individual interviews were conducted by a trained interviewer to assess cultural perceptions of health. ANALYSIS: Transcript analysis was performed by 2 independent coders using verbatim transcripts. Content analysis was used to identify themes using a grounded theory approach. RESULTS: The salient themes that emerged were a cultural definition of health, acculturation, mental health, and health information. Participants believed good health was associated with the ability to perform daily activities, regular exercise, and eating well. There was a lack of awareness of Asian Indian-specific body mass index categories and that overweight and obesity were an important risk factor for chronic diseases. CONCLUSION AND IMPLICATIONS: These data provide a context for health promotion efforts and underscore a gap in awareness of risk factors risk for chronic diseases among the Asian Indian community. Culturally specific interventions targeted at the Asian Indian population, considering their worldview and perceptions of health, will help address this important public health concern.

The Role of Inflammation and Psycho-Behavioral Factors as Mediators Between Acculturation and Time to Incident Dementia Among Older Mexican Americans.

Background: The mechanisms through which acculturation influences the onset of cognitive impairment and dementia are not well understood, especially among older Hispanics. Objective: To investigate whether inflammation and psycho-behavioral factors mediate the relationship between acculturation and incident dementia among older Mexican Americans. Methods: We analyzed the Sacramento Area Latino Study on Aging (1998-2007, SALSA), a longitudinal study (N = 1,194) with 10 years of follow-up, and used g-computation for mediation analysis with pooled logistic regression to evaluate whether acculturation (assessed by the Revised Acculturation Rating Scale for Mexican Americans [ARSMA-II]) affected dementia or cognitive impairment but not dementia (CIND) through inflammation (i.e., interleukin 6 [IL-6], tumor necrosis factor-α (TNF-α), high-sensitivity C-reactive protein [hs-CRP]), smoking, alcohol consumption, and depressive symptoms. The potential mediators were assessed at baseline. Results: The 10-year average adjusted risk ratio (aRR) for the effect of high U.S. acculturation and dementia/CIND was 0.66, 95% CI (0.36, 1.30). The indirect effects were: IL-6 (aRR = 0.98, 95% CI (0.88, 1.05)); TNF-α (aRR:0.99, 95% CI (0.93, 1.05)); hs-CRP: (aRR = 1.21, 95% CI (0.84, 1.95)); current smoking: aRR = 0.97, 95% CI (0.84, 1.16); daily/weekly alcohol consumption (aRR = 1.00, 95% CI (0.96, 1.05)); and depressive symptom score (aRR = 1.03, 95% CI (0.95, 1.26)). hs-CRP yielded a proportion mediated of -26%, suggesting that hs-CRP could suppress the potential effect of high U.S. acculturation. The other factors explored resulted in little to no mediation. Conclusions: The effect of acculturation on time to incident dementia/CIND varied over time. Our study suggests that inflammation could suppress the effect between high U.S. acculturation and dementia risk.

Cultural intelligence and acculturation among non-native Arabic learners: the impact of learning apps.

Background: Learning apps can be helpful to non-native language learners in learning Arabic, which includes speaking, writing, and speaking exercises. When learners become better in the language, they become more confident in interacting with the community, thus affecting their Cultural Intelligence (CQ) and Acculturation (AC). This study aimed to explore the relationship between the CQ and AC among non-native learners of Arabic. Additionally, the study aimed to investigate the potential impacts of learning apps and gender. Methods: This study used a correlational approach, involving a sample of 102 non-native Arabic language learners in Jordan. To assess these factors, this study used the Cultural Intelligence Scale and the Acculturation Survey. Results: The findings of this study revealed a positive correlation between the CQ and AC. Furthermore, the use of apps can provide CQ and AC levels. In addition, the study determined that gender did not play a significant role in influencing learners. Conclusion: the utilization of educational apps has been shown to enhance both CQ and AC. Thus, it is imperative to encourage learners to engage with these apps, as they foster cultural awareness, thereby facilitating the process of learning Arabic.

Genotype-by-Environment Interactions in Nonalcoholic Fatty Liver Disease and Chronic Illness among Mexican Americans: The Role of Acculturation Stress.

This study examines the complex interplay of genetic and environmental interactions that shape chronic illness risk. Evidence is mounting for the role of genetic expression and the immune response in the pathogenesis of chronic disease. In the Rio Grande Valley of south Texas, where 90% of the population is Mexican American, chronic illnesses (including obesity, diabetes, nonalcoholic liver disease, and depression) are reaching epidemic proportions. This study leverages an ongoing family study of the genetic determinants of risk for obesity, diabetes, hypertension, hyperlipidemia, and depression in a Mexican American population. Data collected included blood pressure, BMI, hepatic transaminases, HbA1c, depression (BDI-II), acculturation/marginalization (ARSMA-II), and liver health as assessed by elastography. Heritability and genotype-by-environment (G×E) interactions were analyzed, focusing on the marginalization/separation measure of the ARSMA-II. Significant heritabilities were found for traits such as HbA1c (h2 = 0.52), marginalization (h2 = 0.30), AST (h2 = 0.25), ALT (h2 = 0.41), and BMI (h2 = 0.55). Genotype-by-environment interactions were significant for HbA1c, AST/ALT ratio, BDI-II, and CAP, indicating that genetic factors interact with marginalization to influence these traits. This study found that acculturation stress exacerbates the genetic response to chronic illness. These findings underscore the importance of considering G×E interactions in understanding disease susceptibility and may inform targeted interventions for at-risk populations. Further research is warranted to elucidate the underlying molecular pathways and replicate these findings in diverse populations.

Decoding the Dynamics of Cultural Change: A Cultural Evolution Approach to the Psychology of Acculturation.

PUBLIC ABSTRACT: Acculturation describes the cultural and psychological changes resulting from intercultural contact. Here, we use concepts from "cultural evolution" to better understand the processes of acculturation. Cultural evolution researchers view cultural change as an evolutionary process, allowing them to borrow tools and methods from biology. Cultural evolutionary mechanisms such as conformity (copying the numerical majority), anti-conformity (copying the numerical minority), prestige bias (copying famous individuals), payoff bias (copying successful people), and vertical cultural transmission (copying your parents) can cause people to adopt elements from other cultures and/or conserve their cultural heritage. We explore how these transmission mechanisms might create distinct acculturation strategies, shaping cultural change and diversity over the long-term. This theoretical integration can pave the way for a more sophisticated understanding of the pervasive cultural shifts occurring in many ethnically diverse societies, notably by identifying conditions that empower minority-group members, often marginalized, to significantly influence the majority group and society.

Cultural, demographic, and other non-demographic factors associated with cancer genetic counseling patients' appointment accompaniment preferences in the United States.

Although the presence of companion(s) in a genetic counseling session can positively influence session dynamics, research has found that some patients prefer to attend their appointments alone. To date, no studies have examined patient accompaniment preferences across different cultural groups in the context of genetic counseling. This quantitative study aimed to identify factors associated with individual preferences in accompaniment at cancer genetic counseling appointments in a sample (N = 130) of Hispanic/Latine (n = 29) and non-Hispanic/Latine White (n = 101) participants at a large academic medical institution. Variables examined included demographics, horizontal and vertical collectivism, and Hispanic and American acculturation. A link to an online questionnaire was emailed to patients who met four criteria: (1) identified as either Hispanic/Latine or non-Hispanic/Latine White; (2) had attended a cancer genetic counseling appointment at UCLA Health to discuss genetic testing options between October 2020 and December 2022; (3) were at least 18 years of age at the time of their appointment; and (4) indicated they were comfortable reading in Spanish or English; responses were anonymous. Logistic regression analyses identified four significant variables in the model associated with accompaniment preferences: individuals with at least one parent born outside of the US, those who attended their appointment in-person, and those with a higher horizontal collectivism score were less likely to want to attend their cancer genetic counseling appointment alone, while the converse was true among those with a higher American acculturation score. These findings highlight cultural and demographic factors that are associated with patient accompaniment preferences unrelated to ethnicity, indicating genetic counselors should not make assumptions regarding accompaniment preferences based solely on cultural or racial/ethnic background. Genetic counselors should incorporate this understanding when assessing patients' accompaniment preferences.

Acculturation and Depression Help-Seeking Intentions in a Majority Mexican American College Student Sample.

Work has not examined if acculturation or enculturation may predict endorsed benefits, barriers, and intentions to seek mental health services for depression, specifically among Latino students enrolled in a rural and majority Latino immigrant institution of higher education. An improved understanding of factors informing mental health help-seeking is needed to identify possible intervention points to address gaps in accessing depression treatment. Participants (N = 406) read a vignette depicting a person with depressive symptoms. Participants were asked if they would seek help for depression if in the situation described in the vignette. Participants provided text responses about their preferences for managing depression symptoms and their mental health help-seeking history. Additionally, participants completed a self-report depression symptom screener, demographic surveys, acculturation assessment, and questionnaires on perceived benefits and barriers to seeking mental health services. Path analysis was used to test the link between acculturation status and intent to seek services for depression, with benefits and barriers as mediators. The results revealed that higher perceived benefits and lower barriers were directly associated with greater intentions to seek help. Furthermore, an indirect effect of acculturation on help-seeking intentions via higher perceived benefits of seeking care was observed. These findings persisted after controlling for age, gender, depression, and history of seeking care for depression. Future work should test the replicability of this finding with diverse college students living in predominantly immigrant communities. Universities might consider tailoring outreach initiatives to provide information on the range and accessibility of mental health services, the location of mental health service centers, and the procedures for accessing such services.

Dietary Acculturation Is Associated With Altered Gut Microbiome, Circulating Metabolites, and Cardiovascular Disease Risk in US Hispanics and Latinos: Results From HCHS/SOL.

BACKGROUND: Dietary acculturation, or adoption of dominant culture diet by migrant groups, influences human health. We aimed to examine dietary acculturation and its relationships with cardiovascular disease (CVD), gut microbiota, and blood metabolites among US Hispanic and Latino adults. METHODS: In the HCHS/SOL (Hispanic Community Health Study/Study of Latinos), US exposure was defined by years in the United States (50 states and Washington, DC) and US nativity. A dietary acculturation pattern was derived from 14 172 participants with two 24-hour dietary recalls at baseline (2008-2011) using least absolute shrinkage and selection operator regression, with food groups as predictors of US exposure. We evaluated associations of dietary acculturation with incident CVD across ≈7 years of follow-up (n=211/14 172 cases/total) and gut microbiota (n=2349; visit 2, 2014 to 2017). Serum metabolites associated with both dietary acculturation-related gut microbiota (n=694) and incident CVD (n=108/5256 cases/total) were used as proxy measures to assess the association of diet-related gut microbiome with incident CVD. RESULTS: We identified an empirical US-oriented dietary acculturation score that increased with US exposure. Higher dietary acculturation score was associated with higher risk of incident CVD (hazard ratio per SD, 1.33 [95% CI, 1.13-1.57]), adjusted for sociodemographic, lifestyle, and clinical factors. Sixty-nine microbial species (17 enriched from diverse species, 52 depleted mainly from fiber-utilizing Clostridia and Prevotella species) were associated with dietary acculturation, driven by lower intakes of whole grains, beans, and fruits and higher intakes of refined grains. Twenty-five metabolites, involved predominantly in fatty acid and glycerophospholipid metabolism (eg, branched-chain 14:0 dicarboxylic acid** and glycerophosphoethanolamine), were associated with both diet acculturation-related gut microbiota and incident CVD. Proxy association analysis based on these metabolites suggested a positive relationship between diet acculturation-related microbiome and risk of CVD (r=0.70, P<0.001). CONCLUSIONS: Among US Hispanic and Latino adults, greater dietary acculturation was associated with elevated CVD risk, possibly through alterations in gut microbiota and related metabolites. Diet and microbiota-targeted interventions may offer opportunities to mitigate CVD burdens of dietary acculturation.

Predictors of Toxic Metal/Metalloid Exposures Among Mexican Americans in Starr County, Texas.

BACKGROUND: Arsenic, cadmium, and lead are toxic elements that widely contaminate our environment. These toxicants are associated with acute and chronic health problems, and evidence suggests that minority communities, including Hispanic/Latino Americans, are disproportionately exposed. Few studies have assessed culturally specific predictors of exposure to understand the potential drivers of racial/ethnic exposure disparities. OBJECTIVE: We sought to evaluate acculturation measures as predictors of metal/metalloid (hereafter "metal") concentrations among Mexican American adults to illuminate potential exposure sources that may be targeted for interventions. METHODS: As part of a longitudinal cohort, 510 adults, aged 35 to 69 years, underwent baseline interview, physical examination, and urine sample collection. Self-reported acculturation was assessed across various domains using the Short Acculturation Scale for Hispanics (SASH). Multivariable linear regression was used to assess associations between acculturation and urinary concentrations of arsenic, cadmium, and lead. Ordinal logistic regression was utilized to assess associations between acculturation and a metal mixture score. Lastly, best subset selection was used to build a prediction model for each toxic metal with a combination of the acculturation predictors. RESULTS: After adjustment, immigration factors were positively associated with arsenic and lead concentrations. For lead alone, English language and American media and food preferences were associated with lower levels. Immigration and parental heritage from Mexico were positively associated with the metal mixture, while preferences for English language, media, and food were negatively associated. CONCLUSION: Acculturation-related predictors of exposure provide information about potential sources of toxic metals, including international travel, foods, and consumer products. The findings in this research study provide information to empower future efforts to identify and address specific acculturation-associated toxicant exposures in order to promote health equity through clinical guidance, patient education, and public policy.