Ensuring the cultural relevance of Dietary Guidelines diet patterns among African Americans: Increasing dietary quality and reducing type 2 diabetes risk

项目摘要/摘要 美国膳食指南(USDG)构成了联邦营养计划和政策的基础， 为卫生倡议和行业提供有价值的指导。更新的2015年USDG从 把重点放在个别营养素上，更注重饮食模式。美国农业部声明，健康饮食目标 可以通过各种饮食模式来满足，但主要通过三种方式呈现健康饮食：1)健康的美国- 健康饮食模式，2)健康地中海饮食模式，3)健康素食模式。 目前，美国成年人没有达到营养建议(水果/蔬菜摄入量、蔬菜/豆类摄入量、 全谷物等。)由美国农业部提出，并以健康饮食指数(HEI)衡量。而美国农业部 是营养指南的基础，通知这些饮食模式建议的研究在很大程度上 是从以白人为主的人群中进行的观察研究得出的。此外，还有非常多的 对这些饮食模式进行有限的文化调整，以确保这些饮食可以为不同的人所接受 人口，特别是生活在南方的非裔美国人，他们经历了不成比例的 慢性疾病的负担，特别是2型糖尿病(T2 DM)。目前，美国成年人没有达到营养水平 推荐(水果/蔬菜、全谷物等)由美国农业部提出，由健康的 饮食指数(HEI)。 在这项研究中，AA成年参与者有超重/肥胖和≥三个T2 DM危险因素将是 被招募参加以下目标： 目标1：在AA中进行为期3个月的随机试验，比较3种饮食模式的采用情况 [1]US，2)Med，或3)Vegg]使用USDG的现有材料，并检查饮食差异 质量(HEI)和T2 DM危险因素(体重、糖化血红蛋白)。 目标2：借鉴参与者在目标1中的经验，进行质化工作，以完善和文化 为AA观众量身定做饮食模式干预。 目标3：根据目标2的结果，进行为期一年的干预，使用修改后的文化定制 随机对照研究受试者(n=198)中高血压和2型糖尿病危险因素的差异 三种饮食模式中的一种。 这将导致以社区为基础的策略，以一种方式展示饮食指南 有效地满足营养建议，从而对AA成年人的健康产生重大影响。

Project Summary/Abstract The U.S. Dietary Guidelines (USDG) form the basis of federal nutrition programs and policy and provide valuable guidance to health initiatives and industries. The updated 2015 USDG moved away from a focus on individual nutrients to a greater focus on dietary patterns. The USDG state that healthy eating goals can be met through a variety of dietary patterns, but present healthy diet in three main ways: 1) Healthy U.S.- Style Eating Pattern, 2) Healthy Mediterranean-Style Eating Pattern, and 3) Healthy Vegetarian Eating Pattern. Currently, US adults are falling short of the nutrition recommendations (fruit/vegetable intake, greens/beans, whole grains, etc.) set forth by the USDG and measured by the Healthy Eating Index (HEI). While the USDG are the basis of nutrition guidelines, the research informing these dietary pattern recommendations has largely been drawn from observational studies among mostly white populations. In addition, there has been very limited cultural-tailoring of these dietary patterns that would ensure that these diets are acceptable to diverse populations, in particular, African Americans (AAs) living in the south, who experience a disproportionate burden of chronic disease, especially type 2 diabetes (T2DM). Currently, US adults are not meeting nutrition recommendations (fruit/vegetable, whole grains, etc.) set forth by the USDG and measured by the Healthy Eating Index (HEI). For this study, AA adult participants with overweight/obesity and ≥three T2DM risk factors will be recruited to participate in the following aims: Aim 1: Conduct a 3-month randomized trial among AAs comparing adoption of the 3 dietary patterns [1) US, 2) Med, or 3) Veg] using existing materials from the USDG and examine differences in diet quality (HEI) and T2DM risk factors (weight, HgbA1c). Aim 2: Drawing on participants’ experiences in Aim 1, conduct qualitative work to refine and culturally tailor the dietary pattern intervention for an AA audience. Aim 3: Based on the findings of Aim 2, conduct a one-year intervention using revised culturally tailored materials to examine differences in HEI and T2DM risk factors among participants (n=198) randomized to one of the 3 dietary patterns. This will result in community-based strategies around presenting dietary guidelines in a way to effectively meet nutrition recommendations leading to significant impacts on health among AA adults.