Nutrition and Oral Medicine (Nutrition and Health)

52 Part I / Nutrition and Health(T2DM). Of the African-American adult population, 34% are at a healthy weight, comparedto 42% of the overall US adult population (23). Secondary complications of T2DMsuch as end-stage renal disease, retinopathy, and amputations in the African-Americanpopulation are a major concern (24–26).Review of age-adjusted prevalence of hypertension for men from Nigeria, Jamaica,and the United States shows a pattern similar to that of obesity and T2DM (27). Researchhas focused on the extent to which this is genetic compared to environmental, althoughnutritional factors are considered to account for a majority of these cases (27–30).Although coronary heart disease (CHD) is the leading cause of death in the United Statesfor both the African-American and white populations, the African-American populationhas experienced less of a decline in mortality associated with CHD. This differentialmay be caused by lifestyle factors related to lipid levels, hypertension, smoking, andphysical activity.4.3. Mexican and Central American InfluencesIt is projected that by 2050, the US Hispanic population will be 96.5 million, or 24%of the total US population, with Mexican Americans constituting about 64% of the USHispanic population and the largest ethnic group in this country (31). Similar to manyother cultural and ethnic groups, there is a wide range of food habits in Hispanics relatedto the strength of cultural influences and degree of acculturation (32).Major contributions of this cuisine in terms of complex carbohydrate sources includethe popular tortillas (flat bread made from a variety of corns or flour), a one-dish mealaccompaniment (33,34). Flour tortillas are more popular in the United States than thecorn tortillas preferred in Mexico. Beans are a low-cost staple source of complex carbohydrate,fiber, water-soluble vitamins, and iron often combined with rice. The Mexicancuisine is rich in vegetables used as ingredients in many mixed dishes. Approximately100 varieties of chilies are used as the basic flavoring in many dishes (33,34) and salsasmade with fresh, raw chilies, tomatoes, tomatillos, onions, cilantro, citrus juice, or fruitaccompany meals.Mexican Americans are likely to adapt meal composition and cycle to the “typical”American pattern of a small breakfast and lunch with a large dinner compared to thetraditional Mexican meal pattern of four to five meals daily, with the largest in the earlyafternoon.Central America includes Belize, Guatemala, El Salvador, Honduras, Nicaragua, CostaRica, and Panama. The cuisine includes many similarities with that of Mexico but thereare specific regional differences in preferences for bean dishes.4.3.1. RELATED NUTRITION AND HEALTH ISSUESNutritional concerns in the diets of Hispanic Americans have been reported to includehigher intakes of fat, meat, cheese, sugar-sweetened beverages, butter, and dressingsand lower intakes of protein, fruit, vegetables (including beans), compared to non-Hispanics (2). Dixon et al. concluded that, in general, those born in Mexico consumedsignificantly less fat and more fiber; vitamins A, C, E, and B 6 ; folate; calcium; potassium;and magnesium than either group born in the United States (35). Similarly,Polednak found that education and level of acculturation were not associated with fatintake in Hispanic adults in New York and Connecticut; although the male gender and