Central America, as elsewhere, this transition has been
fueled by globalization and urbanization. Major diet-
ary changes include an increased use of animal prod-
ucts and processed foods that include large amounts of
sugar, refined flour, and hydrogenatedfats. At the
same time, a decline in the intake of whole grains,
fruit, and vegetables has been documented. While the
increased variety has improved micronutrient status
for many low-income groups, the inclusion of more
animal fat and refined foods has contributed to a rapid
increase in obesity and chronic disease throughout the
region.
These changes are more evident among immigrants
to the United States, where adoption of U.S. products
has been shown to have both positive and negative
impacts on nutritional status. Studies that compared
diets of Mexican residents to newly arrived Mexican-
American immigrants and to second-generation Mex-
ican Americans have documented both nutritionally
positive and negative changes with acculturation. On
the positive side, acculturated Mexican Americans
consume less lard and somewhat more fruit, vegeta-
bles, and milk than either newly arrived immigrants or
Mexican residents. On the negative side, they also
consume less tortilla, beans, soups, stews, gruels, and
fruit-based drinks, with greater use of meat, sweetened
ready-to-eat breakfast cereals, soft drinks, candy,
cakes, ice cream, snack chips, and salad dressings.
Resources
PERIODICALS
Guendelman, Sylvia, and Abrams, Barbara (1995). ‘‘Dietary
Intake among Mexican-American Women: Genera-
tional Differences and a Comparison with White Non-
Hispanic Women.’’American Journal of Public Health
85(1):20–25.
Romero-Gwynn, Eunice; Gwynn, Douglas; Grivetti, Louis;
McDonald, Roger; Stanford, Gwendolyn; Turner,
Barbara; West, Estella; and Williamson, Eunice (1993).
‘‘Dietary Acculturation among Latinos of Mexican
Descent.’’Nutrition Today28(4):6–12.
Romieu, Isabelle; Hernandez-Avila, Mauricio; Rivera, Juan
A.; Ruel, Marie T.; and Parra, Socorro (1997). ‘‘Dietary
Studies in Countries Experiencing a Health Transition:
Mexico and Central America.’’American Journal of
Clinical Nutrition65(4, Suppl):1159S–1165S.
Sanjur, Diva (1995).Hispanic Foodways, Nutrition, and
Health. Boston: Allyn and Bacon.
Tucker, Katherine L., and Buranapin, Supawan (2001).
‘‘Nutrition and Aging in Developing Countries.’’Jour-
nal of Nutrition131:2417S–2423S.
Katherine L. TuckerCentral European and
Russian dietDescription
A health gap separates Central and Eastern Europe
from the United States, Canada, Japan, and the West-
ern part of Europe. This East-West gap in health
started during the 1960s. Almost half of this gap was
due to cardiovascular disease (CVD) mortality differ-
entials. There has been a marked increase of CVD in
Central and Eastern Europe, which is only partially
explainable by the high prevalence of the three tradi-
tional CVD risk factors (hypercholesterolemia,hyper-
tension, and smoking) in these countries. There is an
extreme nonhomogeneity of the former Soviet bloc,
and the data from each country must be analyzed indi-
vidually. The aim here is to present the latest available
data, which show the health status of various regions of
postcommunist Europe. All data used are taken from
the World Health Organization (WHO) Health for All
Database (as updated in June 2003). The last available
data from most countries are from the year 2002.
As premature mortality was considered the most
important information, the standardized death rate
(SDR) for the age interval 0–64 years was used (SDR
is the age-standardized death rate calculated using the
direct method; it represents what the crude death rate
would have been been if the population had the same
age distribution as the standard European population).Central Europe (Poland, Hungary, Czech
Republic, Slovakia)
Total, CVD andcancermortality in Central Europe
was relatively low at the beginning of the 1960s, but then
an increase occurred. While the differences in 1970
between the nations of the European Union (EU) and
the Central European communist countries were not
great, from the mid-1970son, the relative trends in
CVD mortality in EU countries and Central Europe
showed a marked change: mortality in Central Europe
increased, whereas in EU countries it decreased steadily.
Between 1985 and 1990, the male CVD mortality in
Central Europe was more than two times higher than
in EU countries. A substantial proportion of this diver-
gence was attributable to ischemic heart disease. After
the collapse of Communism, however, a decrease in
CVD mortality in Central Europe was observed.The Former Soviet Union (Russian Federation)
The most significant changes in CVD mortality
have been observed in the region of the former SovietCentral European and Russian diet