Sub-Saharan African Immigrants Living in the United States Maintain Healthy Diets Despite Dietary Acculturation: A Scoping Review.

The objective of this study was to conduct a scoping review and synthesize current evidence that examines post-immigration diets among adult and adolescent Sub-Saharan African people who have immigrated to the United States (US). In September 2022, PubMed, CINAHL, and Scopus databases were searched for studies published between 2000 and 2022. A total of 3,388 articles were found. After title, abstract, and full-text review, 31 articles were included in this review. A total of 24 articles reported on overall diet (incl. dietary quality, healthy diet, alcohol, and food security); 3 articles reported on food security and diet; and 4 articles evaluated alcohol use only. Only 10 articles included quantitative diet data. In the US, Sub-Saharan African immigrants continue to eat a variety of food groups and maintain low alcohol consumption. Traditional grains (e.g., teff, millet, sorghum), goat meat, and fried fish remain central to their diet. Immigrants report skipping meals when not hungry but noticed increased snacking in the US. Overall, Sub-Saharan African immigrants find it important to eat fresh fruits and vegetables, cook at home, and eat family meals. Qualitative evidence suggested that highly processed and fast food increased in the US, however, those findings were based on self-assessments which may overestimate the significance of relatively low and infrequent intake in the US compared to no intake in countries of origin. Fast food consumption should also be considered in the context of social networks, financial stress, and food environments. Refugees appear to be at a greater risk of food insecurity than other immigrant groups. Furthermore, no association was found between length of stay and food insecurity. Overall, alcohol consumption was low. Although age at immigration did not affect alcohol intake, religiosity and gender norms made alcohol consumption more acceptable among men than women living in the US. The very limited documentation of dietary intake among people from Sub-Saharan African countries living in the US is a serious shortcoming. Inadequate data may lead to incomplete and incorrect negative assessments of these populations' diets and health. Accurate assessment of dietary intake and a better understanding of the effect of dietary acculturation are fundamental to supporting healthy diets among people from Sub-Saharan African countries living in the US.