Hispanic attitudes about health, nutrition, and food ... - handouts and recording… ·...

FCP Webinar – April 15, 2011

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Sylvia Melendez-KlingerMS, RD, LDN, CPT

April 15, 2011

American Dietetic Association

Food and Culinary Professionals DPG

Presentation Outline

� Describe the Hispanic community

� Hispanic attitudes about health, nutrition, and food

� General characteristics of the Hispanic diet

� Key Hispanic diet issues

� How to reach your Hispanic customers

Hispanic Population

50.5

million

Hispanic

population in the

U.S. (Based on the 2010

Census)

The Hispanic population grew 43% between 2000 and 2010

US Census Bureau 2011http://www.census.gov/prod/cen2010/briefs/c2010br-02.pdf

Hispanic Population

2nd

Ranking of the

size of the U.S.

Hispanic

population

worldwide

(Only Mexico has a larger Hispanic population)

US Census BureauUS Census Bureau News, July 15, 2010

CB10-FF.17

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Hispanic Population

27.4

years

Median age of

the Hispanic

population in the

U.S. in 2009

(Compared to 36.8 years for the U.S. population as a whole)

US Census BureauUS Census Bureau News, July 15, 2010

CB10-FF.17

Population Characteristics

White

69%

Asian

4%

African

American

13%

Hispanic

13%

2000

U.S. Census Bureau, 2000

White

50%

Asian

8%

African

American

15%

Hispanic

24%

2050

Distribution of Hispanics Across StatesStated as percent share of total U.S. Hispanic population, 2009

� California (28.3%)

� Texas (18.9%)

� Florida (8.2%)

� New York (6.8%)

� Arizona (4.2%)

� Illinois (4.1%)

� New Jersey, Colorado, New Mexico, Georgia (8.7%)

� Other States (20.8%)

Pew Hispanic Centerhttp://pewhispanic.org/factsheets/factsheet.php?FactsheetID=70

Table 15

Red=state lost share since 2000Green=state gained share since 2000

Arizona and New Mexico do not rank high with respect to total U.S. Hispanic

population, however...

Pew Hispanic Centerhttp://pewhispanic.org/factsheets/factsheet.php?FactsheetID=70

Table 13

A significant portion of their

state’s population is

Hispanic

Hispanic Population, By State

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Hispanic Subgroups – Who’s Living Where?

� Mexican American

� California, Texas, New Mexico, Arizona, Illinois

� Central/South Americans

� California, Florida, New York, Texas

� Puerto Rican

� New York, Florida

� Cuban and Caribbean

� Florida (Miami), New York, New Jersey

Pew Hispanic Centerhttp://pewhispanic.org/factsheets/factsheet.php?FactsheetID=59

Table 13

What’s In a Name? Hispanics vs. Latinos

� Generally the terms are used interchangeably

� “Hispanic” refers to geographic origin or ethnicity, NOT race

� Hispanic: Describes any person, regardless of race, creed, or color, whose origins are Mexican, Puerto Rican, Cuban, Central or South American, or of some other Hispanic origin

� Latino: Describes persons of Latin American origin

Use “Latino” when referring to a man

Use “Latina” when referring to a woman

Acculturation and Assimilation

� Terms often used (incorrectly) interchangeably

� Acculturation: the process of acquiring a second culture� Keep some aspects of first culture (bicultural)

� Blending of values

� More acculturation seen with more recent immigrants

� May be evaluated by socioeconomic status, English speaking at home, or years living in the U.S.

� Assimilation: the process of replacing one’s culture with another� Effective loss of first culture

� Seen with earlier immigrants

Language Preference

� 35 million U.S. residents age 5 and older spoke Spanish at home in 2008 � 12% of U.S. residents

� More than half spoke English “very well”

� Number has more than doubled since 1990

� 76% of Hispanics age 5 and older spoke Spanish at home in 2008

US Census BureauUS Census Bureau News, July 15, 2010

CB10-FF.17

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Emerging Latino Identity

Younger

Higher birth rates

Longer life expectancy, but higher morbidity

Hispanic Attitudes about

Health and Food

Hispanics and Health

� Worry about their health on behalf of family� A life-threatening illness can affect their ability to

provide for their family

� More focus on wellness, prevention� Versus usual focus on treatment in the U.S.

� Broad definition of health that includes� Mainstream medicine� Tradition� Traditional healing� Strong religious component

� Less likely to receive healthcare services compared to non-Hispanic whites

Cultural Values

Familiarismo Family/group emphasis

ConfianzaTrust

Confidence

PersonalismoImportance of personal relationships

Face to face contact

RespetoRespect based on age, gender,

social position, economic status

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Key Health Issues

� Obesity

� Higher prevalence in Hispanics vs. non-Hispanic whites1

� Higher rates of obesity-related diseases• Heart disease, hypertension

• Diabetes

• Cancer

� Heart disease the leading cause of death among Hispanics2

1. CDC. Summary Health Statistics for US Adults: 2009. Table 31. 20102. National Center for Health Statistics. 2007 data. 2011

Age-adjusted percentage of persons 18 years and over who are obese (BMI≥30), 2009 (National Health Interview Survey)

Hispanic/Latino (%) Non-Hispanic White (%)

Men 32.6 26.8

Women 30.6 24.4

Total 31.7 25.6

Food and Diet

Food = Love

But Mom interested in

trying to cook healthier

Cook from scratch

Source of pride and self-expression

Longer time spent in U.S. generally =

more unhealthy diet

Although not all studies

support this

Superstitions or myths

about food

Foods may be considered hot or cold -

meals need to be balanced

The Hispanic Diet

and Food Spending Patterns

Diet and Lifestyle Characteristics

• Acceptance of over-eating, large portions

• Lack of exercise

• Cultural isolation

• Acceptance of larger body size = wealth, health, strength

• Perceptions/view of healthy weight

• Traditional dishes high in calories, fat

• Cultural celebrations centered around food

• Poor eating habits

• Lack of nutrition education

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Characteristics of the Hispanic Diet

� Influenced by the core elements of their county of origin

� Core elements of traditional Hispanic diet revolve around

� Grains

� Beans

� Fresh fruits and vegetables

� Move away from traditional diet with more time in the U.S. and better economic status

Heise, D. USDA, ARSwww.nal.usda.gov/outreach/HFood.html

Food Differences by Hispanic Subgroup

� Grains

� Corn, amaranth (Mexicans)

� Wheat, quinoa, potatoes (South Americans)

� Rice (Caribbean, coastal regions of Latin America)

� Beans

� Black (Cubans, southern Mexicans, Central Americans, Venezuelans)

� Pinto (Northern Mexicans, Dominicans, Puerto Ricans)

� Red kidney (Cubans, Central South Americans, Hispanic Caribbeans)

� Pigeon peas (Puerto Ricans, Dominicans)

� Chick peas/garbanzos (Venezuelans, Brazilians) Heise, D. USDA, ARS

www.nal.usda.gov/outreach/HFood.html

Food Differences by Hispanic Subgroup

� Differences in heat, spiciness, pungency and sweetness

� Sofrito – used to flavor many dishes � Spanish: made from tomatoes and is sweet

� Puerto Rican: made from cilantro and is pungent

� Cuban: made from parsley and is mild

� Heat or spiciness� Cooks from the Caribbean (e.g., Cuba, Puerto

Rico and Dominican Republic) tend not to use chilies in their cooking (maybe only as a condiment)

Heise, D. USDA, ARSwww.nal.usda.gov/outreach/HFood.html

Characteristics of the Hispanic Diet

1. CDC. Advance Data. #395, May 20, 20082. What We Eat in America. NHANES 2007-2008. Tables 2 and 34

� Mexican American vs. non-Hispanic white

� Lower overall HEI, but not statistically significant

� Less dietary variety

� Lower intakes of dairy, fruits, vegetables, dietary cholesterol

� Higher intakes of sodium

� Higher intakes of fat, but not statistically significant

Healthy Eating Index (HEI) scores, age 60 and older, NHANES 1999-20021

� Hispanics less likely to consume three meals per day, but more likely to eat any two meals vs. non-Hispanic whites

� Hispanics consumed lower mean amounts of total fat, saturated fat, vitamin A, folate, vitamin E, calcium vs. non-Hispanic whites

What We Eat in America, age 2 and older, NHANES 2007-20082

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Hispanic Shopping Trends

Mintel 2008 Nielsen Multicultural, 2010

U.S. Bureau of Labor Statistics, Consumer Expenditure Survey, 2008US Census 2009 ACS

The Futures Company, Yankelovich Monitor Minute. 01/26/09

� 10% of total Latino expenditures are for food and beverage

� Households are larger, more children

� Younger

� Cultural attitudes (importance of meals, family)

� May be willing to pay more for organic, pesticide-free and healthy foods

� More worried about their health

� Meals represent an act of love toward family

� Diet from country of origin often healthier than typical U.S. diet

� Spend more in traditional mass merchandisers and warehouse clubs

� Spend more on categories for babies/children

� Spend more of their income on food consumed at home - 8.2% of total income vs. 5.9% for all U.S. households

� Spend 23% more on grocery items vs. total U.S.

� Very brand loyal

Hispanics Spend More than the Average U.S. Household

Geoscape

Beef34% more

Poultry35% more

Fresh Fruits

33% more

Fats & Oils23% more

Past Market Growth

Latinum, April 2010Geoscape (AMDS), October 2010

� Between 2005 and 2008, Hispanics accounted for $52 billion in new inflation-adjusted spending versus $40 billion by non-Hispanics

� Hispanics represent 16% of the population, but accounted for nearly 50% of the consumer spending growth in 2010

Growth and Opportunity

� By 2050 Hispanics are projected to be 24% of total U.S. population

� Their buying power is $978 billion today and projected to be $1.3 trillion by 2012

� Due to younger age and longer life expectancy, acquiring them as your customer means more spending over their life span vs. non-Hispanic whites

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Key Dietary Issues in

Hispanic Populations

The Hispanic Diet: Effects of Acculturation

1. Duffey KJ, et al. J Nutr. 20082. Eamranond PP, et al. Pub Health Reports. 2009

3. Fitzgerald N, et al. J Am Diet Assoc. 2008

� Compared to U.S.-born Hispanics, foreign-born Mexicans and other Hispanics more likely to consume legumes, fruits, vegetables and less likely to consume fast food, snacks and desserts

NHANES 1999-2004, Hispanic adults1

� Low acculturation associated with higher LDL cholesterol in those with hypercholesterolemia

NHANES 1999-2004, Hispanic adults2

� Less acculturated were less likely to consume regular soft drinks and salty snacks compared to highly acculturated

Latina women in Connecticut (most from Puerto Rico)3

The Hispanic Diet: Effects of Acculturation

1. Montez JK, et al. J Am Diet Assoc. 20082. Ghaddar S, et al. Rev Panam Salud Publica. 2010

3. Ayala GX, et al. J Am Diet Assoc. 2008

� U.S.-born Mexican American women consumed less fiber, beans, fruit, 100% juice, and whole grain breads and a higher percentage of energy from fat vs. Mexican-born women

� Greater use of English was associated with lower intakes of fiber and declines in fruit and vegetable intake in U.S.-born women

National Health Interview Survey 2000, Mexican American women1

� Lower acculturation associated with significantly higher fruit and vegetable intake and Healthy Habits Scale score

Alliance for a Healthy Border survey 2006-2008, Hispanics living on the U.S.-Mexico border2

� Lower acculturation associated with more healthful levels of nutrient consumption (except studies in Cuban Americans)

� Higher acculturation was associated with higher intakes of fast food and lower intakes of fruits and vegetables, rice, beans, fried foods/foods prepared with lard

Systematic review of literature (studies from 1965-2007)3

Juice Confusion

� Hispanics tend to have higher intakes of fruit juice and juice drinks and beverages (not 100% juice)

� “Juice Confusion” – Important to distinguish between 100% fruit juice and juice drinks/beverages/ades� 100% fruit juice more nutrient dense –

has more and a wider variety of nutrients per calorie

� 100% fruit juice counts as a fruit serving for MyPyramid

� 100% juice has naturally-occurring phytonutrients, which may be beneficial for health

� “Drinks” and “beverages” have added sugars, very little fruit juice

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Juice Confusion

� Read the label� Look for “100 Percent Juice”

� Words like “drink”, “beverage”, “cocktail”, “ade” and “punch” indicate a beverage that is NOT 100% juice

� Check serving size

� Check for beneficial nutrients such as vitamins and minerals

� Check ingredients� Shorter the list the better� High fructose corn syrup, sucrose, cane

sugar indicates an added-sugar product and likely not 100% juice

1. Colon-Ramos U, et al. J Am Diet Assoc. 20092. CDC. Advance Data. #395, May 20, 20083. August KJ, et al. J Gen Intern Med. 2010

Intakes of Fruits, Vegetables and Dairy

� Intake of total fruits and vegetables (cup equivalents) significantly higher in Hispanic women vs. non-Hispanic whites and blacks

� No difference in fruit and vegetable intake among Hispanic subgroups (6)

California Health Interview Survey 2005, Hispanic adults1

� Mexican Americans had lower Healthy Eating Index sub-scores for dairy, fruits, and vegetables vs. non-Hispanic whites

NHANES 1999-2002, adults age 60 and older2

� Compared to middle-aged (45-64 yrs) non-Hispanic whites, middle-aged English-proficient Latinos were less likely to consume recommended amounts of fruits and vegetables on a daily basis

� Compared to older (65-85 yr) non-Hispanic whites, older limited English-proficient Latinos were less likely to consume recommended amounts of fruits and vegetables on a daily basis

California Health Interview Survey 2007, adults age 45 and older3

How to Reach and

Meet the Needs

of Your Hispanic Customers

Reaching Your Hispanic Customer

�Get to know the Hispanic community in your area

� What are the dominant subgroups?

� What is the general level of acculturation?

� What is the prevalent socioeconomic situation?

� What is the age group – many young Hispanics?

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Reaching Your Hispanic Customer

� Create culturally-relevant topics to deliver messages that resonate

� Overall wellness and family health, disease prevention

� Prevention of overweight/obesity

� Home and from-scratch healthy cooking

� Family meal time

� Reference culturally relevant food items, recipes

Reaching Your Hispanic Customer

� Acknowledge/embrace cultural nuances and differences. Build trust by customizing messages and acknowledging challenges.

� Learn about the diet and food habits of your Hispanic customers (ask them!)

� Learn the foods and brands preferred by Hispanics (high brand loyalty) and explore expanding the variety of brands you provide

� Personalize messages, focus on their family lifestyle (children, extended family)

Reaching Your Hispanic Customer

� Focus on positives (“hero” foods and simple substitutions) that can have impact while maintaining cultural relevance

� Make culturally-relevant foods or recipes more healthful

� Lower fat dairy, milk, and yogurt

� Leaner cuts of meat and poultry

� Fruits and vegetables

� 100% fruit juices instead of sugar-added juice drinks and beverages

Reaching Your Hispanic Customer

� Do the research – learn about goods and services that cater to Hispanic tastes and preferences in cuisine and lifestyle

� Investigate and stock brands that Hispanics prefer – use information available on brand websites (recipes, menu ideas, etc.)

� Restaurants

� Media

� Organizations, clubs, recreation areas, malls

� Faith-based organizations

� Partner with a professional who works with the Hispanic community

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Reaching Your Hispanic Customer

� Embrace their culture – watch Spanish TV, read their magazines, read and use their favorite cookbooks, etc.

� Telemundo, Univision (National)

� Contact and partner with local Hispanic-focused groups or organizations (health fair, cooking demonstrations, supermarket tour focused on needs of Hispanic customers)

� Partner with local Hispanic focused TV, radio, or print media

� Learn a little Spanish!

Summary

� Hispanics represent a growing percentage of the U.S. population

� Great diversity among Hispanics based on country of origin and level of acculturation –cannot generalize

� Hispanics experience similar health issues as non-Hispanics but prevalence may be higher

� Interested in healthy food purchases and spend a higher percentage of income on food compared to the U.S. population as a whole

� Diets tend to be less healthy based on level of acculturation and time spent in the U.S.

� Advantageous to address the needs and wants of your Hispanic customer

Thank you!

Questions?