Nutrients · 3 authors, 3 centres
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This study of 213 Chinese immigrants in Portugal found that 71.4% had a high level of Western dietary acculturation, associated with higher energy and fat intake. Breakfast was the most Westernized meal, while lunch and dinner remained largely traditional. The findings highlight a negative nutritional transition with insufficient intake of fiber, vitamins, and minerals, and excessive consumption of fat and sodium, increasing risk for chronic diseases.
**Background:** Chinese immigrants in Western countries have a higher prevalence of chronic diseases such as type 2 diabetes and cardiovascular disease, with dietary acculturation proposed as a contributing factor. Dietary acculturation is the process by which minority groups adopt the eating patterns of the host country. Significant differences exist between Chinese and Portuguese food cultures regarding meal composition, timing, and serving styles. This study aimed to characterize changes in eating habits among Chinese immigrants in Portugal and identify shifts toward Westernized acculturation.
**Methods:** A quantitative ethnographic study was conducted in Lisbon, Portugal. A total of 213 Chinese immigrants (18–64 years, residing in Portugal for ≥1 year) were recruited through Chinese commercial establishments and community institutions. Data were collected between 10 April 2022 and 1 June 2022 via semi-structured interviews and 24-hour dietary recalls. Dietary acculturation was assessed using a 22-item questionnaire adapted from Satia-Abouta et al., covering Eastern and Western acculturation domains. Nutrient intake was calculated using the Food Composition Table of INSA (Portugal, version 5.0 2021) and the Food Composition Table of China (2019). Statistical analyses included t-tests, ANOVA, and Kolmogorov-Smirnov tests, with significance set at p<0.05.
**Key Results:** The sample comprised 117 (54.9%) women, mean age 36±11 years, mean residence time 15±7 years. Most participants were from ZheJiang province (75.6%), were married (61.0%), and worked as merchants (67.6%). The mean Western acculturation score was 70.1±8.9 (range 43–96). No participants had low or very high acculturation; 28.6% had moderate and 71.4% had high Western acculturation. Higher acculturation was significantly associated with higher energy intake (moderate: 1389.6±379.4 kcal vs. high: 1535.3±357.9 kcal, p=0.009) and higher fat intake (moderate: 62.3±20.2 g vs. high: 68.1±17.3 g, p=0.035). Both genders had intakes below DRIs for energy, carbohydrates, fiber, vitamin A, vitamin C, vitamin D, thiamine, riboflavin, folate, potassium, calcium, magnesium, iron, and zinc. Intakes exceeded recommendations for protein, simple sugars, vitamin E, vitamin B12, sodium, and phosphorus. Sodium intake corresponded to 7.2 g salt/day in males and 7.6 g salt/day in females. Breakfast was markedly Westernized (milk, yogurt, coffee, cereal, toast), while lunch and dinner remained predominantly Chinese. Longer residence in Portugal was associated with greater likelihood of mixing Chinese and Portuguese meals (p<0.05).
**Clinical Implications:** Chinese immigrants in Portugal are at risk of nutritional imbalance, with a shift from carbohydrate-rich traditional diets to higher-fat, higher-sodium Western patterns. The decline in nutritional quality may increase susceptibility to obesity, cardiovascular disease, and diabetes. Culturally sensitive dietary guidelines and targeted nutritional interventions are needed to promote positive dietary transitions, encourage retention of healthy traditional habits, and facilitate adoption of healthy Western foods (e.g., olive oil, salads). Healthcare professionals should be aware of these acculturation patterns to provide culturally appropriate care.