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 Oct;57(10):962-971. doi: 10.1016/j.jneb.2025.06.006. Epub 2025 Jul 5.

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.

Keywords: Cambodian; diet; intervention; trauma.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Asian* / psychology
  • Cambodia / ethnology
  • Diet, Healthy* / psychology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Refugees* / psychology
  • Refugees* / statistics & numerical data
  • Retrospective Studies
  • Southeast Asian People
  • Stress Disorders, Post-Traumatic