Sociodemographic Factors Influencing Island Food Consumption in the Pacific Islander Health Study

Abstract

This dissertation explores the relationships between island food consumption, sociodemographic variables, and cardiovascular risk using data from the Pacific Islander Health Study (PIHS). Chapter 1 explores the associations between self-reported level of island food consumption and key covariates. Island food consumption was modeled using Poisson regression and adjusted for demographic, socioeconomic, and cultural characteristics. Increased Pacific Island cultural affinity was the strongest predictor of increased island food consumption while being formerly married was associated with decreased island consumption. These results speak to cultural norms and lifestyle choices that influence dietary choice. Chapter 2 examines how the associations between Pacific Island cultural affinity and island food consumption is moderated by demographic covariates. Following exploratory factor analysis, two separate factors emerged. The scale was split into two subscales measuring cultural activity participation and culturally relevant media consumption. No significant interactions were found between the activity subscale and any of the covariates, but significant interactions were found between the media subscale and ethnicity and birth country. Differences in media consumption – and therefore food advertising or food portrayal – by birth country may drive the moderation seen in these interactions. Chapter 3 assesses the association between island food consumption and cardiovascular risk using linear regression. A 9-point cardiovascular risk score was constructed. After adjustment for four blocks of covariates island food consumption was not significantly associated with cardiovascular risk. In bivariate analyses, island food consumption was significantly associated with higher fruit and vegetable consumption, but not fast food or sugar sweetened beverage consumption. These findings suggest that the type of island foods consumed by PIHS participants may include high levels of fruits and vegetables that are part of a heart-healthy diet. This dissertation is a first step in understanding dietary patterns of Pacific Islander Americans and has generated several hypotheses that could be used to inform future work. Showing how island food consumption in this small, but growing population will one day inform both policy makers and targeted dietary interventions.