Diet quality among Indigenous and non-Indigenous language speakers in Mexico.

Background The Indigenous population in Mexico has a high prevalence of malnutrition, poverty, and low educational level. Whether these disadvantages translate into poorer diet quality has not been thoroughly evaluated. Objective Compare the diet quality and its sociodemographic determinants between Mexican adult Indigenous and non-Indigenous-language speakers who participated in two national health and nutrition surveys (ENSANUT 2018 and ENSANUT 100k). Methods Diet quality was measured with the Global Diet Quality Score (GDQS). We also compared the consumption of nutrients and food groups. Differences in diet quality (GDQS, nutrients, and food groups) between Indigenous-language speakers and non-Indigenous-language speakers, were estimated using linear regressions adjusted for age, sex, and energy intake. We tested whether the association of sociodemographic factors (age, sex, education level, socioeconomic status, urban/rural area, and region) with GDQS score differed between both groups using linear regression models with interaction terms. Results Diet quality scores were low for both Indigenous-language speakers and non-Indigenous-language speakers (less than 21 out of a total of 49 possible points). However, Indigenous-language speakers had a slightly higher GDQS score than non-Indigenous-language speakers [0.35 (95% CI 0.05, 0.66)]. This higher quality was driven by a lower consumption of unhealthy foods, while healthy food consumption scores were lower among Indigenous-language speakers. Nutrient results were mixed: Indigenous-language speakers had higher intakes of fiber, carbohydrates and folate, but lower intakes of protein, fat, calcium, zinc, vitamin B12, vitamin A and vitamin D. Conclusions Despite social disadvantage, the Indigenous-language speakers have a slightly higher dietary quality score in comparison to non-Indigenous-language speakers. However, this minimal difference signals a rapid nutritional transition. Efforts must be made to improve their access to healthy foods while preventing the nutrition transition towards unhealthy foods.