Dietary practices among Arabic-speaking immigrants and refugees in Western societies: A scoping review

Sub-standard nutrition is a leading risk factor for many non-communicable diseases and causes 11 million diet-related deaths annually worldwide. Arabic-speaking immigrants and refugees (ASIR) are at high risk for poor nutrition due to socio-cultural and economic-ecological factors. We reviewed the literature to explore the impact of acculturation on ASIR's dietary practices and to investigate barriers vs. facilitators to healthy eating among them. Five electronic databases (PsycINFO, Medline, Anthropology Plus, Embase and Sociology Database) were systematically searched. Only English articles from North America (the US and Canada), Europe, Australia and New Zealand were included. Twenty-four studies were included for evidence synthesis. North America is substantially ahead of Europe in ASIR-nutrition research, whereas Australia and New Zealand are lacking in this type of research. Acculturation into a Western lifestyle was associated with positive and negative changes to ASIR's diet, with increased fruit/vegetable intake, but also a significant increase in consumption of low nutrient, energy-dense foods. Personal barriers to healthful eating related to lack of nutrition awareness and language issues, whereas improved nutrition education was a strong facilitator. Children's preferences and religious dietary proscriptions were key sociocultural barriers to nutritious eating, whereas availability/accessibility of ethnic grocery stores was a powerful facilitator. Within North America, but not Europe, unaffordability of healthy foods and lack of genetically modified food labelling were leading barriers to eating nutritiously. Community-engaged and mixed methods research on diet, nutrition and food (in)security among ASIR is required to inform the design of effective, culturally acceptable dietary interventions. Western societies need to introduce major changes in food policy and financial support for progressive programs to ensure equitable access to nutritious, culturally appropriate food for ASIR and other similar minority groups.