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

项目总结/摘要 美国膳食指南（USDG）是联邦营养计划和政策的基础， 为卫生倡议和行业提供宝贵的指导。更新后的2015年USDG从一个 从关注个体营养素到更关注饮食模式。USDG指出，健康饮食的目标 可以通过各种饮食模式来满足，但目前健康的饮食主要有三种方式：1）健康的美国- 风格饮食模式，2）健康的地中海式饮食模式，3）健康的素食主义者饮食模式。 目前，美国成年人的营养建议（水果/蔬菜摄入量，绿色/豆类， 全谷物等）由USDG提出，并由健康饮食指数（HEI）衡量。虽然USDG 是营养指南的基础，为这些饮食模式建议提供信息的研究主要是 这些数据来自于对大多数白色人群的观察性研究。此外，还有很多 这些饮食模式的文化定制有限，这将确保这些饮食是可以接受的， 人口，特别是生活在南方的非洲裔美国人（AAs），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（T2DM）。目前，美国成年人不符合营养 建议（水果/蔬菜，全谷物等）由美国政府提出，并由健康的测量 进食指数（HEI）。 在本研究中，将对超重/肥胖和≥ 3个T2DM风险因素的AA成人受试者进行 被招募参加以下活动： 目的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）Vegs]使用USDG的现有材料，并检查饮食差异 质量（HEI）和T2DM风险因素（体重，HbA1c）。 目标2：利用参与者在目标1中的经验，开展定性工作， 为戒酒会的听众量身定制饮食模式干预。 目标3：根据目标2的调查结果，使用经修订的文化定制的 研究随机化参与者（n = 198）中HEI和T2DM风险因素差异的材料 三种饮食模式之一 这将导致以社区为基础的战略，围绕提出饮食指南的方式， 有效满足营养建议，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.