Hispanic immigrant women's perspective on healthy foods and the New York City retail food environment: A mixed-method study

Much has been written about the role of dietary acculturation in the epidemic of obesity among Hispanic immigrants in the United States. Yet little is known about the role of beliefs and preferences in immigrants' dietary practices and their relationship to the retail food environment in which the practices occur. We conducted a mixed-methods convergence study of these issues. Twenty-eight foreign-born Hispanic adult women, recruited from families enrolled in a childhood asthma study and mainly living in New York City took part in 60-90 min, semi-structured interviews regarding their dietary beliefs, preferences, and practices. The findings were then used to formulate hypotheses for analyses of food frequency questionnaire (FFQ) data collected from the 345 New York Hispanic women enrolled in the asthma study. Generalized estimating equations were used to determine whether characteristics of the retail food environment within 0.5 km of the home predicted diet, adjusting for individual and neighborhood socio-demographic characteristics. In the interviews, healthy food was rarely discussed in terms of nutritional content. Instead, considerations of freshness, as indicated by time since harvest or slaughter and thus local sourcing; purity, as indicated by the absence of preservatives and processing; and naturalness, as indicated by chemical free farming practices, were the primary axes around which healthy food was defined. Quantitative results were consistent with the qualitative findings: 1) the presence of a farmers' market within the home neighborhood was associated with consumption of more total servings per day of fruit, vegetables, and juice, and 2) the presence of a farmers' market and/or a livestock market was associated with consumption of more servings per day of meat. Proximity to supermarkets or medium-sized grocery stores was not associated with consumption. The results suggest that the availability of fresh produce and meat from local farms may influence diet among Hispanic women in urban neighborhoods.