RESEARCH
Current Research
Dietary Pattern Change and Acculturation
of Chinese Americans in Pennsylvania
NAN LV, MS; KATHERINE L. CASON, PhD, RD
ABSTRACT
Objective To obtain information about dietary pattern
change of Chinese Americans in Pennsylvania and its
relationship with demographic characteristics and accul-
turation indicators.
Design A cross-sectional self-administered survey.
Subjects A convenience sample of 399 Chinese Americans.
Statistical Analyses Performed t Tests, analysis of variance
with Tukey post-hoc tests, Spearman rank correlation,
and ␹2 test.
Results After immigration, Chinese Americans increased
consumption frequency of all seven food groups (grains,
vegetables, fruits, meat/meat alternatives, dairy prod-
ucts, fats/sweets, and beverages) and Western foods while
consumption frequency of traditional Chinese foods de-
creased. Dietary variety also increased after immigra-
tion. Higher education and higher income levels were
associated with a larger increase in consumption fre-
quency of grains, vegetables, and fruits. Persons who
resided in the United States for a longer period of time
shared a greater increase in their consumption frequen-
cies of vegetables, fats/sweets, and beverages. Persons
with better English proficiency had a greater increase in
their consumption frequency of grains, fruits, meat/meat
alternatives, and fats/sweets.
Conclusions This study can help nutrition educators design
appropriate educational programs for first-generation
Chinese Americans that can facilitate the adoption of
more healthful dietary practices. Nutrition educators
should consider the dietary changes of Chinese-American
participants, such as skipping breakfast and increased
consumption frequency of fats, sweets, and soft drinks,
which were observed in this study. For example, accul-
turated first-generation Chinese Americans should be
encouraged to decrease fats, sweets, and soft-drink con-
sumption. Less-acculturated persons should be encour-
N. Lv is a graduate research assistant with the Depart-
ment of Food Science, The Pennsylvania State Univer-
sity, University Park, PA. K. L. Cason is with the De-
partment of Food Science and Human Nutrition,
Clemson University, Clemson, SC.
Address correspondence to: Nan Lv, MS, Department
of Food Science, 8L Borland Laboratory, The Pennsylva-
nia State University, University Park, PA 16802.
E-mail: nql105@psu.edu
Copyright © 2004 by the American Dietetic
Association.
0002-8223/04/10405-0011$30.00/0
doi: 10.1016/j.jada.2004.02.032
© 2004 by the American Dietetic Association
aged to maintain their healthful dietary pattern and in-
crease consumption of vegetables and fruits.
J Am Diet Assoc. 2004;104:771-778.
I
n 2000, there were approximately 2.4 million Chinese
Americans, the largest Asian population in the United
States (1). Chinese Americans have higher rates of
chronic diseases such as diabetes, heart disease, and cer-
tain kinds of cancers than Chinese persons in Asia (2-4).
Research indicates that the differences in disease rates
among people from different countries are partly due to
differences in dietary patterns (5-8).
Improving the health of minority groups is critical for
progression toward a more healthful US population (9).
Special preventive efforts are needed to improve the
health of these population groups. These efforts require
understanding the particular needs of minority groups at
national and state levels. However, this kind of informa-
tion is limited (9). Because of this lack of information
about population food consumption, and factors affecting
food choices, many educational initiatives may not be
culturally appropriate for the specific minority group
(10).
Ethnic Chinese are very culturally and linguistically
diverse and therefore present a distinct challenge to ed-
ucators (10). For thousands of years, the yin-yang princi-
ple has been influencing Chinese persons’ health-seeking
behaviors and dietary habits, especially among Chinese
elders (11). “The traditional Chinese diet is well-bal-
anced, high in fiber and low in saturated fats” (12). It
includes a carbohydrate staple, usually rice, noodles, or
steamed buns, as well as accompanying vegetable stir
fries and soups that represent other food groups. Hot tea,
fresh fruit, and nuts—instead of sweets—are typically
served after the meal. After Chinese persons immigrate
to the United States, they adopt Western eating habits
while maintaining traditional Chinese eating habits,
rather than rejecting either one of them (13). Researchers
indicate that acculturation is associated with changes in
dietary behaviors within the Chinese-American popula-
tion (10,14-17). However, few current studies used large
sample size to obtain information on the changes in di-
etary patterns and their relation with acculturation
among Chinese Americans in the eastern United States.
The objective of this research was to obtain informa-
tion about dietary pattern change of Chinese Ameri-
cans in Pennsylvania and its relationship with demo-
graphic characteristics and acculturation factors. The
results of this study may be used to develop appropri-
ate nutrition education programs for Chinese Ameri-
cans.
Journal of THE AMERICAN DIETETIC ASSOCIATION 771
METHODS
A cross-sectional, self-administered questionnaire was
administered to a convenience sample of 399 first-gener-
ation Chinese Americans in Pennsylvania who were aged
18 years or older and were permanent residents or citi-
zens of the United States, or were applying for a green
card. This study was approved by the Behavior and Social
Science Committee of the Institutional Review Board at
The Pennsylvania State University. Subjects provided an
informed consent form prior to the survey. The question-
naire contained three parts. Section A consisted of 11
questions assessing sociodemographic and acculturation
characteristics. Basic personal background questions
were adapted from previous studies (18,19).
Acculturation was measured using three acculturation
indicators: length of residency in the United States (20-
22), English proficiency (14,18,23), and number of conge-
nial American friends (18). These indicators were consid-
ered to be associated with acculturation and were used in
the previous studies.
Section B included 10 questions about general food
habits. Section C, a food frequency questionnaire (FFQ),
was used to obtain information on consumption frequency
of 97 food items 1 year before immigration and within the
past 12 months in the United States. The FFQ used in
this study was modeled after a study of Chinese immi-
grants by Newman and Linke (22), which was tested for
content validity and reliability. Five frequency categories
(daily, weekly, monthly, yearly, and never) were used in
the FFQ to measure food consumption frequencies and
their definitions were given. The food items included in
the FFQ were selected mainly from the FFQ developed by
Newman and Linke (22) and revised based on previous
relevant Chinese food habit studies (18,19,24-26); direct
observation of food items in Chinese food stores in Phil-
adelphia, PA, Pittsburgh, PA, and State College, PA; and
informal interviews with 10 Chinese persons about food
items they commonly consume. This method was also
used by Lee and colleagues (27) to select food items.
For this survey, participants were asked to provide
information on consumption frequency for grain prod-
ucts, vegetables, fruits, animal products, dairy products,
fats/sweets, and beverages before and after immigration.
Participants were required to use their memory to re-
trieve and report consumption information before immi-
gration. Categorical food frequency indicators were used
because participants were better at measuring relative
frequencies than absolute frequencies (28). The purpose
of this study was not to obtain nutrient intake of Chinese
Americans but to measure the trend in changing their
dietary pattern.
The questionnaire was provided in English, simplified
Chinese, and traditional Chinese. Respondents could se-
lect whichever version they preferred. The Chinese ver-
sions were translated by the researcher and were re-
viewed for translation content accuracy by a Chinese
American who has resided in the United States for 10
years and is fluent in both English and Chinese.
The survey was pilot tested with 30 Chinese Americans
residing in State College, PA. The questionnaire was
revised according to comments received from the pilot
test participants. Various Chinese organizations in Penn-
sylvania were the main sources for recruiting partici-
772 May 2004 Volume 104 Number 5
pants in the final study. The survey was administered to
399 Chinese Americans utilizing two different methods.
For the Chinese organizations, the presidents were pro-
vided copies of the instrument and consent form, and
were asked to distribute questionnaires to their mem-
bers. Each participant obtained a package containing the
consent forms, questionnaire, and an envelope with pre-
paid postage. After the participants mailed back the com-
pleted questionnaires, they would receive an $8 check.
The other method of survey administration was utilized
in the Chinese schools. The principals of Chinese schools
agreed to offer the study to parents as an activity to
participate in while they waited for their children to
finish their classes. The researcher went to the schools
and provided eligible, interested parents with a package
containing the consent forms, the questionnaire, and a
pen. The participants completed the questionnaire in the
waiting room and were provided an $8 cash incentive
when the survey was completed. No significant difference
existed between these two different methods of adminis-
tration of questionnaires. Because it was assumed that
the dietary patterns of people residing in the same house-
hold would be similar, only one person per household was
allowed to complete the questionnaire.
STATISTICAL ANALYSIS
Changes on dietary pattern and dietary variety were
assessed. In the food frequency section, consumption fre-
quencies of 97 food items were coded using 5⫽daily,
4⫽weekly, 3⫽monthly, 2⫽yearly, and 1⫽never. Con-
sumption frequency of the food items within each group
was summed and divided by the number of food items in
this food group to calculate mean consumption frequency
of each food group before immigration and after immigra-
tion. The scores of the respondents who had missing data
on one of these food items were deleted when calculating
the mean consumption frequencies of each food group.
French fries were excluded from the vegetable group when
the mean consumption frequency of vegetable group was
calculated. Mean consumption frequency of each food group
did not indicate real consumption frequency, but it was used
as a means to estimate the trend of the change. Mean
consumption frequency difference of each food group was
obtained by subtracting mean consumption frequency be-
fore immigration from that after immigration.
Dietary variety was measured using a similar method
as in a study of Lee and coworkers (23). Dietary variety
score was determined by total number of food items con-
sumed weekly or more in the FFQ (possible maxi-
mum⫽97). Dietary variety scores calculated from FFQs
are usually higher than those calculated from food
records or dietary recalls (29).
SPSS statistical software (version 10.0 for Windows,
1999, SPSS Inc, Chicago, IL) was used to conduct t tests,
analysis of variance with Tukey post-hoc tests, Spearman
rank-order correlation (r), and ␹2 test. Analysis of vari-
ance and Tukey post-hoc tests were used to test the
relationships between nominal level demographic vari-
ables and change in consumption frequency of each food
group. Spearman’s rank-order correlation statistic (r)
was used to test the relationship between ordinal level
demographic variables/three acculturation indicators and
change in consumption frequency of each food group.
 Table 1. Demographic characteristics of Chinese Americans in Table 2. Acculturation indicators of Chinese Americans in Pennsyl-
Pennsylvania vania
Variable n % Variable n %

Age Length of residency in the United States

18-24 years 19 4.8 0-5 years 79 19.8
25-34 years 52 13.0 6-10 years 115 29.0
35-44 years 223 55.9 11-15 years 109 27.5
45-54 years 84 21.1 ⬎15 years 94 23.7
55-64 years 14 3.5 Total 397 100.0
Above 65 years 7 1.8 English level
Total 399 100.0 Poor 25 6.3
Sex Fair 158 39.8
Male 145 36.3 Good 162 40.8
Female 254 63.7 Excellent 52 13.1
Total 399 100.0 Total 397 100.0
Marital status No. of congenial American friends
Never married 38 9.5 None 77 19.4
Married, not separated 343 86.2 Some (1-5) 219 55.3
Divorced 9 2.3 Many (⬎5) 100 25.3
Widowed 5 1.3 Total 396 100.0
Separated 3 0.8
Total 398 100.0
Last grade of school completed
Less than 12th grade (third grade in high school) 15 3.8 General Food Habits Change
Graduated high school 28 7.1 About one fifth (22.6%) of participants reported decreas-
Some college or vocational training 18 4.5 ing the number of meals consumed daily and 64.6% re-
Graduated vocational/technical college 33 8.3 ported skipping breakfasts. About one fifth (16.0%) in-
Graduated college (4-year bachelor’s degree) 70 17.6 creased the number of meals consumed.
Graduate or professional school (masters, PhD, When asked if their eating habits changed since immi-
MPA, lawyer) 233 58.7 grating to the United States, more than half (56.9%)
Total 397 100.0 reported yes. The main explanations provided for why
Annual income per household this change occurred were not having time to prepare
Under $10,000 21 5.4 Chinese traditional foods (32.6%) and access to tradi-
$10,000-$24,999 52 13.3 tional Chinese foods was limited (30.8%).
$25,000-$49,999 53 13.6 Chinese Americans reported significantly decreasing
$50,000-$100,000 153 39.1 their grocery shopping frequency after immigration
Above $100,000 112 28.6 (␹24⫽20.107; P⬍.001). The places where Chinese persons
Total 391 100.0 reported going to shop for groceries significantly changed
Children in household from independent vendors in open markets (66.9%) and
Yes 342 85.7 large supermarkets (36.1%) before immigration to large
No 57 14.3 supermarkets (83.0%) and Asian markets (71.4%) after
Total 399 100.0 immigration.
Place of origin Participants were asked to provide their perception of
Mainland China 276 69.2 the healthfulness of their overall diet. One third (33.3%)
Taiwan 90 22.6 and 10.8% of the participants indicated that their overall
Hong Kong 17 4.3 diet in the United States was more healthful and much
Other 16 4.0 more healthful, respectively, compared with before immi-
Total 399 100.0 gration. One third (33.8%) thought their overall diet
Involved in US educational programs about stayed the same. About one fifth of the subjects (19.5%)
nutrition and food safety believed their diet was less healthful. Only 1.5% reported
Yes 29 7.3 that their current diet was much less healthful.
No 367 92.7
Total 396 100.0
Dietary Pattern Change
The consumption frequency of food items from all seven
food groups increased after Chinese immigrated to the
United States. Grain products had the highest level of
RESULTS consumption frequency increase, followed by dairy prod-
Sociodemographic characteristics and three accultura- ucts, fats/sweets, beverages, fruits, vegetables, and meat/
tion indicators of the respondents are summarized in meat alternatives. Within each food group, consumption
Tables 1 and 2, respectively. frequency of traditional foods decreased whereas con-

Journal of THE AMERICAN DIETETIC ASSOCIATION 773

 Table 3. Food items with significantly increased consumption frequency by Chinese Americans in Pennsylvania after immigration: paired t tests resultsa
Food group n Before immigration meanb After immigration meanb Mean differencec

Grains
Bagels 308 1.30 2.81 1.51
Pizza 386 1.45 2.89 1.44
Breakfast cereal 374 1.69 3.06 1.37
Sandwiches 382 1.93 3.24 1.31
Pasta 387 1.35 2.55 1.20
Bread 382 3.11 3.91 0.80
Tortillas 377 1.16 1.88 0.72
Vegetables
Broccoli 387 2.27 3.53 1.26
French fries 388 1.83 2.98 1.15
Lettuce 387 2.52 3.50 0.98
Asparagus 386 2.06 2.57 0.51
Corn 399 2.77 3.09 0.32
Onion 395 2.97 3.24 0.27
Squash 386 2.34 2.61 0.27
Carrots 394 3.25 3.51 0.26
Potatoes 392 3.11 3.37 0.26
Tomatoes 391 3.61 3.82 0.21
Snow beans (Snow peas) 389 2.73 2.91 0.18
Mushrooms 390 3.35 3.52 0.17
Bell pepper (Green pepper) 396 3.28 3.41 0.13
Fruits
Grapes 391 3.05 3.67 0.62
Strawberries 392 2.31 2.89 0.58
Cantaloupe 393 2.35 2.91 0.56
Cherries 385 1.92 2.46 0.54
Bananas 396 3.42 3.89 0.47
Apples 394 3.56 4.01 0.45
Grapefruit 395 2.12 2.54 0.42
Oranges 395 3.48 3.74 0.26
Peaches 397 2.73 2.96 0.23
Mangoes 393 2.21 2.38 0.17
Watermelon 397 2.93 3.08 0.15
Pears 397 3.00 3.09 0.09
Meat/meat alternatives
Hamburger 394 1.64 2.87 1.23
Hot dog 394 1.50 2.60 1.10
Turkey meat 389 1.38 2.26 0.88
Ham 391 2.17 2.69 0.52
Beef 396 2.81 3.28 0.47
Shrimp 395 3.00 3.40 0.40
Chicken meat 389 3.60 3.90 0.30
Bacon 396 1.82 2.04 0.22
Crab 398 2.23 2.35 0.12
Dairy products
Low-fat milk 380 1.90 3.41 1.51
Cheese 389 1.44 2.74 1.30
Yogurt 392 2.23 3.05 0.82
Ice cream 395 2.70 3.11 0.41
Fats/sweets
Doughnuts 395 1.59 2.58 0.99
Butter 392 1.65 2.47 0.82
Pies 394 1.52 2.30 0.78
Chocolate 394 2.56 2.97 0.41
Cookies 392 3.16 3.40 0.24
Cakes 394 2.68 2.88 0.20
Cooking oil (for cooking) 394 4.64 4.74 0.10
Beverages
Coffee 396 1.98 3.01 1.03
Regular 395 2.63 3.27 0.64
Sodas
a
Food items are listed in descending order based on consumption frequency increase (see mean difference column for the consumption frequency increase). An ␣ level ⱕ0.05 was
used for analyses.
b
5⫽Daily, 4⫽weekly, 3⫽monthly, 2⫽yearly, 1⫽never.
c
After⫺before.

774 May 2004 Volume 104 Number 5

 fats/sweets group; and coffee and regular sodas in the
Table 4. Food items with significantly decreased consumption fre- beverage group. Food items that showed large decrease
quency by Chinese Americans in Pennsylvania after immigration: (mean difference⬎.5) included steamed bun/bread in the
Paired t tests resultsa grain food group and milk powder in the dairy products
Before After group.
immigration immigration Mean Demographics, socioeconomic information, and accul-
Food group n meanb meanb differencec turation indicators had a significant influence on Chinese
Americans’ dietary pattern change. Table 5 shows the
Grains significant relationships among consumption frequency
Steamed bun/ increase of each food group and demographic and socio-
bread 383 3.58 2.85 ⫺0.73 economic factors. No significant relationships exist be-
Dumpling 394 3.10 2.94 ⫺0.16 tween the consumption frequency increase of dairy prod-
Noodles 384 3.67 3.55 ⫺0.12 ucts, fats/sweets, and beverages and the demographic
Rice 396 4.92 4.81 ⫺0.11 variables. Table 6 summarizes the significant relation-
Vegetables ships between consumption frequency increase of each
Bean sprouts 392 3.57 3.26 ⫺0.31 food group and acculturation indicators. The number of
Bamboo congenial American friends was not associated with the
shoots 386 2.90 2.65 ⫺0.25 consumption frequency increase in any food group. Con-
Eggplant 394 3.28 3.08 ⫺0.20 sumption frequency increase of dairy products was not
Napa cabbage 393 3.62 3.47 ⫺0.15 associated with any acculturation indicators.
Spinach 397 3.39 3.25 ⫺0.14
Fruits Dietary Variety
Lychee 395 2.22 1.89 ⫺0.33 The mean dietary variety scores were 26.14 and 32.06
Persimmon 397 2.23 1.93 ⫺0.30 before immigration and after immigration, respectively.
Meat/meat Dietary variety (t398⫽⫺11.298; P⬍.001) significantly in-
alternatives creased after participants immigrated into the United
Frog legs 397 1.80 1.41 ⫺0.39 States.
Soybeans 391 3.26 2.95 ⫺0.31
Rabbit meat 394 1.41 1.20 ⫺0.21
Tofu (bean DISCUSSION
curd) 398 4.08 3.90 ⫺0.18 Chinese Americans in this study reported changes in
Duck meat 394 2.68 2.50 ⫺0.18 some of their general food consumption habits. For exam-
Snake meat 395 1.25 1.07 ⫺0.18 ple, the frequency of grocery shopping significantly de-
Dog meat 397 1.22 1.04 ⫺0.18 creased from daily or several times per week to weekly
Shark fin 394 1.50 1.36 ⫺0.14 after immigration. Similarly, Neilson (30) found that the
Pork 395 4.30 4.20 ⫺0.10 Chinese persons shopped much less frequently after they
Fish 395 3.72 3.62 ⫺0.10 immigrated to Canada.
Dairy The consumption frequency of items from all seven food
products groups increased after Chinese Americans immigrated to
Milk powder 388 2.13 1.34 ⫺0.79 the United States. This observation could be attributed to
Beverages an overall improvement in economic status after immi-
Tea 394 3.82 3.66 ⫺0.16 gration. These results also appear to support Newman
a
and Linke’s (22) study, which found that Chinese Amer-
Food items are listed in descending order based on consumption frequency decrease
icans increased consumption frequency of items from all
(see mean difference column for the consumption frequency decrease). An ␣ level
ⱕ0.05 was used for analyses.
10 food groups (breads/cereals, vegetables, fruits, meats,
b
5⫽Daily, 4⫽weekly, 3⫽monthly, 2⫽yearly, 1⫽never. fish, egg, dairy products, beverages, nuts, and legumes)
c
After⫺before. after immigration, with the meat group showing the larg-
est increase. The authors suggested that foods are more
accessible and available year round in American super-
markets whereas in other countries some foods are avail-
sumption frequency of Western and some inexpensive able only on a seasonal basis (21). The results from this
and available common foods was increased. Tables 3 and survey also support the findings from Pan and colleagues
4 list food items whose consumption frequency was sig- (31), who reported a significant increase in fat and sweets
nificantly increased and decreased after immigration in intake among Asian students in the United States. How-
each food group. Food items that had a large increase ever, the results conflict with these authors’ finding of a
(mean difference⬎.5) included bagels, pizza, breakfast decrease in vegetable consumption after immigration
cereal, sandwiches, pasta, bread, and tortillas in the (31). Based on these results, Chinese Americans may
grain food group; broccoli, french fries, lettuce, and as- have higher risk of cardiovascular disease and some
paragus in the vegetable group; grapes, strawberries, kinds of cancer than Chinese in China because higher
cantaloupe, and cherries in the fruit group; hamburger, consumption frequency of red meat, dairy products, and
hot dogs, turkey meat, and ham in the meat/meat alter- fats/sweets may result in higher intake of fat (14,19,32).
natives group; low-fat milk, cheese, and yogurt in the Within all seven food groups, a consumption frequency
dairy products group; doughnuts, butter, and pies in the trend was observed. The consumption frequency of tradi-

Journal of THE AMERICAN DIETETIC ASSOCIATION 775

 Table 5. Relationship between demographic characteristics of Chinese Americans in Pennsylvania and mean consumption frequency change
of food groups
Demographic variable Spearman’s
Food group related to food group Results r /ANOVAa (F )

Grain Educationb Those with a higher education increase consumption frequency more r⫽0.208**
Incomec Those with a higher household income increase consumption frequency more r⫽0.153*
Place of origind Those from Mainland China increase consumption frequency more than those F⫽10.938***
from Taiwan, Hong Kong, and other places; those from Taiwan increase
consumption frequency more than those from other places
Vegetablee Agef Those who were older increase consumption frequency more r⫽0.118*
Educationb Those with a higher education increase consumption frequency more r⫽0.127*
Incomec Those with a higher household income increase consumption frequency more r⫽0.178**
Fruit Marital statusg Those who are married increase consumption frequency more than those F⫽6.096**
who are single
Educationb Those with a higher education increase consumption frequency more r⫽0.163**
Incomec Those with a higher household income increase consumption frequency more r⫽0.203**
Presence of childrenh Those who have children increase consumption frequency more F⫽8.872**
Place of origind Those from Mainland China increase consumption frequency more than those F⫽11.817***
from Taiwan and Hong Kong
Meat/meat Educationb Those with a higher education increase consumption frequency more r⫽0.137*
alternative Place of origind Those from Mainland China increase consumption frequency more than those F⫽14.927***
from Taiwan
a
ANOVA⫽analysis of variance.
b
1⫽Less than 12th grade (third grade in high school) (n⫽15); 2⫽graduated high school (n⫽28); 3⫽some college or vocational training (n⫽18); 4⫽graduated vocational/technical
college (n⫽33); 5⫽graduated college (4-year bachelor’s degree) (n⫽70); 6⫽graduate or professional school (masters, PhD, MPA, lawyer) (n⫽233).
c
1⫽Under $10,000 (n⫽21); 2⫽$10,000-$24,999 (n⫽52); 3⫽$25,000-$49,999 (n⫽53); 4⫽$50,000-$100,000 (n⫽153); 5⫽above $100,000 (n⫽112).
d
1⫽Mainland China (n⫽276); 2⫽Taiwan (n⫽90); 3⫽Hong Kong (n⫽17); 4⫽other (n⫽16).
e
French fries were excluded from the vegetable group.
f
1⫽18-24 years (n⫽19); 2⫽25-34 years (n⫽52); 3⫽35-44 years (n⫽223); 4⫽45-54 years (n⫽84); 5⫽55-64 years (n⫽14); 6⫽above 65 years (n⫽7).
g
1⫽Never married (n⫽38); 2⫽married, not separated (n⫽343); 3⫽divorced (n⫽9); 4⫽widowed (n⫽5); 5⫽separated (n⫽3).
h
1⫽Yes (n⫽342); 2⫽no (n⫽57).
*P⬍.05.
**P⬍.01.
***P⬍.001.

tional Chinese foods decreased whereas the consumption
frequency of certain Western foods increased. One possi-
ble explanation is limited availability and a perceived
lower quality of traditional Chinese foods in the United
States. This result coincides with the findings from other
studies conducted with Chinese immigrants (26-30).
Overall, despite the increase of American foods and the
decrease of traditional Chinese foods, Chinese Americans
still retain some core foods of grains, fruits, vegetables,
and meat/meat alternatives, and introduce some Ameri-
can grain products, animal products, dairy products, fats/
sweets, and beverages into their dietary pattern.
Participants in this study indicated that the two main
reasons for changing their eating habits were conve-
nience and availability. This finding corresponds with the
findings of some earlier studies (10,30). Cost was also
mentioned as an important factor affecting food consump-
tion changes in the previous studies. However, in the
current study only a small portion of participants men-
tioned cost. Cost may still be a variable that influences
changes in food consumption frequency but was not ob-
served probably because 66.4% of the participants had a
yearly household income above $50,000.
Demographic characteristics and acculturation influ-
enced Chinese Americans’ dietary pattern changes. Dairy
products were the only food group whose consumption
change was not influenced by the demographic character-
istics and acculturation indicators, despite its large con-
sumption increase. One explanation could be that Chi-
nese Americans began to increase their consumption
frequency of dairy products quickly after immigration
because dairy products are more readily accessible and
available and are comparatively less expensive in the
United States than in China.
A higher socioeconomic status (higher education and
higher income) was associated with larger increase in
grain, vegetable, and fruit consumption frequency, which
supports Newman’s results (21). Participants who were
more acculturated, as measured by longer residency in
the United States, had higher increase in consumption
frequencies of vegetables, fats/sweets, and beverages.
People with better English proficiency had a greater in-
crease in their consumption frequency of grains, fruits,
meat/meat alternatives, and fats/sweets. As suggested by
Satia and coworkers (15,16), the higher increase of vege-
table and fruit consumption frequency with increased
acculturation and higher socioeconomic status might be
explained by more access to nutrition education materials
in English. In addition, higher increase in the consump-
tion frequency of meat/meat alternative and fats/sweets

776 May 2004 Volume 104 Number 5

 Table 6. Relationship between acculturation indicators of Chinese Americans in Pennsylvania and mean consumption frequency change of food
groups
Acculturation indicator
Food group related to food group Results Spearman’s r

Grain English proficiencya Those with a higher English proficiency increase consumption frequency more 0.179**
Vegetableb Length of residencyc Those residing in the United States for a longer time increase consumption 0.164**
frequency more
Fruit English proficiencya Those with a higher English proficiency increase consumption frequency more 0.182**
Meat/meat English proficiencya Those with a higher English proficiency increase consumption frequency more 0.137*
alternative
Fats/sweets Length of residencyc Those residing in the United States for a longer time increase consumption 0.142**
frequency more
English proficiencya Those with a higher English proficiency increase consumption frequency more 0.128*
Beverage Length of residencyc Those residing in the United States for a longer time increase consumption 0.198**
frequency more
a
1⫽Poor (n⫽25); 2⫽fair (n⫽158); 3⫽good (n⫽162); 4⫽excellent (n⫽52).
b
French fries were excluded from the vegetable group.
c
1⫽0-5 years (n⫽79); 2⫽6-10 years (n⫽115); 3⫽11-15 years (n⫽109); 4⫽above 15 years (n⫽94).
*P⬍.05.
**P⬍.01.

by more acculturated Chinese Americans may be ex-
plained by their greater access to the mainstream cul-
ture. The presence of children in the household may have
an influence on Chinese Americans’ dietary pattern
change. Participants with children at home had a higher
increase in the consumption frequency of fruit. This cor-
responds with the literature, which indicates that immi-
grants with children tend to adopt Western dietary pat-
terns (33). However, caution should be utilized when
comparing Chinese Americans with children and those
with no children because our study only included a small
number of participants with no children.
Dietary variety was significantly increased after immi-
gration, probably because foods are more available year
round in American supermarkets than in China and Chi-
nese Americans still retained some Chinese core foods
after immigration.
A large portion of the Chinese Americans who partici-
pated in this study were middle aged and from Mainland
China and Taiwan. It is possible that the sample did not
include enough participants from Hong Kong to make
meaningful comparisons among places of origin. A large
number of participants had a high level of education and
high income. Those with a lower educational level and
lower income may not have similar dietary patterns. In
addition, subjects might not be able to accurately recall
details of their diet in China, especially for those who
have resided in the United States for a long time. Recall
of previous dietary habits has found to be less accurate
than the recall of current dietary habits (18).
CONCLUSIONS
This study indicated that very few Chinese Americans
participated in nutrition education programs. This lack of
participation may be due in part to the lack of culturally
appropriate educational programs. When designing nu-
trition education programs for first-generation Chinese
Americans, nutrition educators should consider their di-
etary changes—such as skipping breakfast and increased
consumption frequency of fats, sweets, and soft drinks—
as observed in this study. For example, acculturated first-
generation Chinese Americans should be encouraged to
decrease their fats, sweets, and soft-drink consumption.
Less-acculturated people may be encouraged to maintain
their healthful dietary pattern and increase consumption
of vegetables and fruits. Nutrition educators may suggest
alternative, less-expensive vegetable and fruit options to
persons of lower socioeconomic status. Because conve-
nience and availability are the two main reasons for
changing eating habits, recipes of convenient and nutri-
tious Chinese-like American foods could also be created to
help Chinese Americans include healthful and conve-
nient American foods into their diet. Nutrition education
materials in Chinese should be designed.
The authors thank the Pennsylvania Chinese organiza-
tions and Chinese schools for assistance in distributing
the questionnaires; J. Lynne Brown, PhD, RD; Catherine
N. Cutter, PhD; and Cathy Kassab, PhD for their sugges-
tions. This study was funded through the Department of
Food Science at the Pennsylvania State University and
Nutrition, Health and Food Management Division Stu-
dent Grant from the American Association of Family and
Consumer Sciences.
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