A cultural adaptation to improve metabolic health outcomes in Mexican adults (MEXIMEDI diet): a randomized controlled pilot study

Barragan, Maribel

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https://hdl.handle.net/2142/122256 Copy

Description

Title

A cultural adaptation to improve metabolic health outcomes in Mexican adults (MEXIMEDI diet): a randomized controlled pilot study

Author(s)

Barragan, Maribel

Issue Date

2023-11-30

Director of Research (if dissertation) or Advisor (if thesis)

• Teran-Garcia, Margarita
• Donovan, Sharon M

Doctoral Committee Chair(s)

Holscher, Hannah

Committee Member(s)

Hernandez, Rosalba

Department of Study

Nutritional Sciences

Discipline

Nutritional Sciences

Degree Granting Institution

University of Illinois at Urbana-Champaign

Degree Name

Ph.D.

Degree Level

Dissertation

Keyword(s)

Mediterranean diet Noncommunicable diseases Dietary patterns Cultural adaptation

Abstract

Noncommunicable diseases (NCDs) affect six in ten US adults. Finding a “one-size-fits-all” solution to these conditions is challenging due to their complex and multifactorial etiologies. Healthy dietary patterns are critical modifiable lifestyle factors to help prevent or manage NCDs. The Mediterranean dietary (MedDiet) pattern has evidence-based benefits in managing NCDs. However, interventions that assess the effect of a MedDiet on the metabolic health of populations outside of the Mediterranean region are sparse. Therefore, we conducted a 5wk, randomized, parallel-arm controlled trial to determine if it was feasible to implement a MedDiet among Mexican-born adults living in the U.S. and determine the health implications of this dietary pattern. Another objective was to identify barriers and facilitators to participating in the intervention. Adults (n=42) were randomized to two arms, one with (MEXIMEDI, n=21) or without (MedDiet, n=21) cultural adaptations. Thirty-four participants completed the study, 20 in the MEXIMEDI and 14 in the MedDiet group. Recruitment rates, retention rates, and acceptability of the meals were used to assess feasibility. All participants were provided with eucaloric personalized meal plans that included ingredient quantities and instructions to prepare breakfast, lunch, dinner, and a snack each day for 35 days. Participants prepared their meals individually, and if they had questions, a registered dietitian would assist them. Meal plans followed a macronutrient distribution with a minimum of 35% of calories from fat, (17-20% MUFA, 7-8% PUFA, <10% SFA), 18-20% from protein, and a maximum of 46% of calories from carbohydrates. Fasting blood samples were collected at baseline, wk 3, and wk 5 to assess changes in lipid panel, glucose, and liver enzymes. Additionally, we assessed skin carotenoids by reflection spectroscopy using a Veggie Meter® and measured blood pressure at all time points. Implementation of a Mediterranean-style dietary pattern was deemed feasible. Recruitment and retention rates were 55.2% and 81.0%, respectively. There were no significant differences in the acceptability of the meals between the MED and MEXIMEDI group. Individuals with greater adherence to either diet significantly decreased their systolic (P=0.02) and diastolic (P=0.04) blood pressure at wk 5. Greater adherence resulted in a significant increase in Veggie Meter scores at wk 5 (P=0.05). Semi-structured interviews were conducted to identify barriers and facilitators to the intervention. Food costs, unsupportive environments, and criticism from friends and family were significant barriers that had to be overcome to finish the study. Meanwhile, family support, familiarity with foods, and intrinsic and extrinsic motivators aided individuals. The outcomes of this research suggest that it is feasible to implement a short-term Mediterranean-style dietary pattern among Mexican adults, and it can help improve blood pressure and increase skin carotenoids.

Graduation Semester

2023-12

Type of Resource

Thesis

Copyright and License Information

Copyright 2023 Maribel Barragan

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