Racism and racial discriminations against Afro-Brazilians remain a major social and political problem in Brazil. Brazil was not only the last country to abolish slavery, but the one which received the most enslaved Africans compulsory in its territory (it is estimated a population of 4.8 million Africans between 1550 and 1862)1. The historical legacy of slavery is still seen in a broad range of persistent inequities. Governmental statistics show that brown and black Brazilians (which amount to 46.8% and 9.4% of the population, respectively) usually have lower income, schooling degree, formal employment, internet access and political representation, and higher rates of incarceration, deaths due to homicide, law enforcement and early mortality 2.
As a social and political determinant of health, racial discrimination is a multidimensional and complex phenomenon. It is often characterized as a “racialized social system” based on practices, mechanisms, values, beliefs, and behaviors that reproduce racial domination on a social group and give privilege and power to a dominant group through racial designations 3, 4. This unfair and oppressive treatment of members of a particular social group based on ethnic or racial designations can occur at different levels, from an internalized one to the interpersonal, structural and/or systemic levels 5, 6.
Self-reported racial discrimination has been widely adopted as an instrument to measure and assess the impact of racial discrimination on health outcomes 7. As a daily and prolonged phenomenon, interpersonal racial discrimination harms people’s health as a social stressor, triggering physiological, psychological, and behavioral responses to it 8. When these experiences are accumulated during one’s lifetime, they can harm one’s mental and physical health, leading to non-communicable chronic diseases, such as obesity 9, 10.
In this sense, previous longitudinal studies have investigated the association between perceived racial discrimination and anthropometric outcomes, demonstrating an association with weight increase, but not with waist circumference increase 10, 11. This association seems to be partially explained by the modification of eating behaviors due to stress. A systematic review demonstrated that individuals who endure day-to-day racial discrimination exhibit poor eating behaviors, such as emotional eating, binge eating, and loss of control when eating, and consume unhealthy diets, such as excessive consumption of sweets and fats and lower consumption of fruits and vegetables, due to this kind of stress 9. Another systematic review on the impact of psychological factors (stress, anxiety, depression, and discrimination) on emotional eating and weight among American Black women suggested that negatively perceived stress may be predictive of emotional eating, and negative emotions influence overeating among women with overweight and obesity 12.
In Brazil, a cross-sectional analysis demonstrated that Brazilian black women are more likely to have obesity than white women 13, and a longitudinal analysis found a positive association for obesity 14. Studies that measure the association of this particular outcome with perceived racial discrimination, and not only with race, skin color and/or ethnicity, are very scarce in Brazil, though 15.
The association between racial markers and food consumption has received even less attention. A review that included data from the largest Brazilian population surveys identified the association between socioeconomic status and food consumption have highlighted that only 5 of the 24 studies included color/race in the analyses. These studies found that the consumption of fruits and vegetables was higher among whites. On the other hand, cardiovascular risk markers foods were associated with brown and black race/color. No study evaluating the association of racial discrimination with food consumption or eating behaviors was found. 16
Despite the growing evidence of the association between perceived racial discrimination with eating behaviors and obesity, the causal pathways of this relationship remain relatively underexplored and the mediating role of food consumption is not frequently investigated. In addition, as far as we know, only one study evaluated the association of experiences of racial discrimination with obesity and none with food consumption in Brazil. How racial discrimination affects eating behavior and obesity within different ethnic, cultural, social, and economic contexts is paramount for tackling social and political determinants of health beyond the Global North.
Thus, this study aimed to analyze the direct and indirect associations between self-reported experiences of racial discrimination with dietary patterns and obesity and abdominal obesity in a sample from southern Brazil. The study hypotheses (H) were: (H1) Experience of racial discrimination has a positive direct effect on obesity and abdominal obesity; (H2) Experience of racial discrimination had a positive direct effect on unhealthy dietary patterns (Carbs and Sugar DP and Fast-food DP); (H3) Experience of racial discrimination had an inversely direct effect on healthy dietary patterns (Healthy DP and Brazilian Traditional DP); (H4) Experience of racial discrimination had a positive indirect effect on obesity, and on abdominal obesity that was mediated by higher intake of unhealthy dietary patterns; (H5) Experience of racial discrimination has a positive indirect effect on obesity and abdominal obesity that can be attenuated by higher intake of healthy dietary patterns.