Background Despite Sub-Saharan African (SSA) immigrants being a highly diverse and rapidly growing U.S. immigrant group, research on their post-immigration dietary behaviors that determine future health is unclear. Dietary acculturation, the adaptations and adoptions of food habits in the U.S., warrants scholarly attention. Objective A scoping review was conducted to synthesize current literature that examines post-immigration diets and the effects of dietary acculturation among SSA immigrants. Study Design, Settings, Participants In September 2022, three databases were searched to retrieve studies published between 2000 and 2022. From 3,388 initially retrieved articles on adult and adolescent immigrants (including refugees), 31 were included after screening. Measurable Outcome/Analysis Twenty-four articles reported dietary factors, including dietary quality, healthy diet, alcohol use, and food security; three only examined the relationship between food security and diet; and four reported on alcohol use only. Results SSA immigrants continue to eat a variety of foods and maintain low alcohol intake. Culturally important foods include traditional starches (eg, sorghum), traditional spices, goat meat, and fried fish. Buying fresh produce, eating at home, eating family meals, and skipping meals when not hungry remain essential to SSA immigrants. Dietary acculturation is reflected in changes in food purchasing, food preparation, and eating practices such as shopping in both ethnic stores and U.S. supermarkets, reading nutrition labels, preparing traditional dishes with healthier cooking methods, and increased snacking. Dietary acculturation is also expedited by child feeding and intensified by participating in food assistance programs. Meanwhile, some groups expressed pride in mastering adaptive skills in preparing U.S. foods that symbolize culture bridging. The various dimensions of dietary acculturation make it difficult to determine its impact on overall diet quality and consumption quantities using current research methods and available evidence. Conclusions Migration from SSA to the U.S. presents the dilemma between adapting and maintaining foodways. Studies that examine detailed intake data are urgently needed. Understanding the complex dietary acculturation is fundamental to supporting immigrant health. Funding None

(1) Examine changes in healthy food availability among Hispanic Caribbean restaurants (HCR) in response to COVID-19. (2) Assess the association between changes and restaurant type. A random sample of HCRs (n = 89) offering Cuban, Dominican, Puerto Rican cuisine, were examined in Summer 2019 (T1) using the NEMS-HCR, an adapted version of the Nutrition Environment Measures Survey for Restaurants (NEMS-R) and reassessed after the onset of COVID-19 in January 2021 (T2, n = 76) using online menus. We examined menu changes between T1 and T2 data sets in the NEMS-HCR overall healthy food availability (HFA) score, and specific variables: the number of healthy main dish salads (HMDS) and the menu proportion of nonfried foods (NFF) on the menu. We then examined changes by restaurant type (sit-down vs. counter-style) using repeated measures ANOVA. Between T1 and T2, 7 HRCs permanently closed, 1 closed for the season, and 5 were excluded due to lack of online menus. Mean proportion of NFF significantly decreased from 71.7% ± 17.5 (T1) to 66.1% ± 17.8 (T2) (P = 0.002). Changes in HFA scores (4.5 ± 2.0 to 4.1 ± 2.2) and HMDS (1.7 ± 2.8 to 1.8 ± 3.0) were not statistically significant (P = 0.06 and P = 0.65, respectively). Repeated measures ANOVA indicated no correlation between the decrease in availability of NFF between T1 and T2 and restaurant type (P = 0.29). Restaurants can play a significant role in the mitigation of diet-related diseases such as cardiovascular disease and diabetes by providing customers with healthy menu offerings. Our study showed a decrease in healthier menu options, particularly non-fried entrees, contributing to our understanding of how restaurants may need to adapt for their own survival in times of crisis such as a pandemic or disaster. Because unfavorable menu options can contribute to the rising incidence of diet-related chronic diseases within the community, more research is needed to understand how restaurants respond to crises in order to better support the preservation of HFA within their menu selections, and the effects of these changes in customers' diets. CUNY PSC Award and NIH National Heart, Lung, and Blood Institute

Restaurants are understudied yet increasingly important food environment institutions for tackling diet-related diseases. This scoping review analyzes research and gray literature (n = 171 records) to assess which healthy eating promotion strategies have been implemented in restaurants and the associated motivations, barriers, and outcomes, compared by restaurant type (corporate/chain vs. independently owned restaurants) and initiator (restaurant-initiated vs. investigator-initiated). We found that the most commonly reported strategy was the increase of generally healthy offerings and the promotion of such offerings. Changes in food availability were more common among corporate restaurants and initiated by restaurants, while environmental facilitators were more commonly initiated by investigators and associated with independently owned restaurants. Aside from those associated with revenue, motivations and barriers for healthy eating promoting strategies varied by restaurant type. While corporate restaurants were also motivated by public health criticism, independently owned restaurants were motivated by interests to improve community health. Revenue concerns were followed by food sourcing issues in corporate restaurants and lack of interest among independently owned restaurants. Among reporting sources, most outcomes were revenue positive. This study shows the need for practice-based evidence and accounting for restaurant business models to tailor interventions and policies for sustained positive changes in these establishments.