Culturally Tailored Nutrition Education for Promoting Healthy Dietary Behavior and Reducing Body Weight and Waist Circumference Among Bhutanese Adults in Massachusetts

Abstract Objectives Refugees bear a high burden of diet-related chronic diseases due to unhealthy eating habits. Culture strongly influences their dietary behavior; however, culturally tailored nutrition education intervention targeted at refugees is limited. We assessed the effect of culturally-tailored nutrition intervention to promote healthy dietary behavior and reduce body weight and waist circumference among Bhutanese adults in Massachusetts. Methods A community-based nutrition education intervention (once a week of 60 mins for 3-week) was implemented among 44 Bhutanese adults resettled in Massachusetts with a pre-post test evaluation. The intervention focused on the health benefits of nutrients, healthier food choices, healthy cooking techniques, healthy eating plate, and hands-on activities to make a weekly diet plan. We measured body weight and waist circumference, and dietary behavior (green leafy vegetables, colored vegetables, fruits, salad, meat, egg, rice, curry, milk, and sugary drinks, etc.) using a food frequency questionnaire before and after the intervention. We used paired t-tests for continuous and McNemar tests for categorical variables to analyze the pre-and post-test differences. Results All participants completed intervention sessions, along with pre-and post-intervention assessments. The mean (SD) age of the participants was 30.6 (11.5) years, and duration in the US was 5.6 (2.9) years. The proportion of participants eating a healthy food at least one time per day increased significantly from pre- to post-intervention: fruits (29.5% vs. 72.7%), green leafy vegetables (29.5% vs. 75%), colored vegetables (25% vs. 61.4%), salad (18.1% vs. 52.3%), milk (27.2% vs. 47.7%), and egg (18.2% vs. 40.9%) (p < 0.001). Intake decreased significantly for rice (72.7% vs. 20.4%), meat (25% vs. 2.3%) and sugary drinks (27.3% vs. 4.5%) (p < 0.01). The mean body weight decreased significantly by 1.4 kg (67.0 kg vs. 65.6 kg) and waist circumference by 3.3 cms (90.2 cms vs. 86.9 cms) (p < 0.01). Conclusions Culturally tailored nutrition education intervention improved healthy food consumption and reduced body weight and waist circumference among Bhutanese adults. This program should be evaluated with larger populations at community levels. Funding Sources University of Massachusetts Amherst.