Culturally Specific Trauma History is Associated with Dietary Intake Outcomes of a Healthy Eating Intervention Among Cambodian American Refugees: A Retrospective Cohort Study

J Nutr Educ Behav. 2025 Jul 5:S1499-4046(25)00347-1. doi: 10.1016/j.jneb.2025.06.006. Online ahead of print.

ABSTRACT

OBJECTIVE: In a retrospective cohort study, we examined associations between trauma indicators and changes to dietary intake among Cambodian Americans who received the culturally-derived Eat, Walk, Sleep intervention.

METHODS: Participants had depression and a high risk of developing type 2 diabetes (n = 135). Trauma indicators included experiences under the Pol Pot regime and current symptoms of posttraumatic stress and baksbat, a culture-bound syndrome of distress. Measurement of dietary intake at baseline, 12 months, and 15 months included self-reported brown rice, white rice, sweetened drinks, sodium, and fat.

RESULTS: Longer exposure to Pol Pot was associated with a greater increase (improvement) in brown rice; longer exposure to Pol Pot and higher baksbat were associated with greater effort to reduce fat.

CONCLUSIONS AND IMPLICATIONS: Eat, Walk, Sleep was most beneficial for those with certain trauma characteristics. Future work includes investigation of potential mechanisms of action of Eat, Walk, Sleep, such as self-efficacy and peer support.

PMID:40616574 | DOI:10.1016/j.jneb.2025.06.006