US-born hispanic people may be more vulnerable to chronic diseases than foreign-born counterparts

by Lourdes Medrano

AHA news: US-born hispanic people may be more vulnerable to chronic diseases than foreign-born counterparts

Hispanic people born in the United States may be at higher risk for multiple chronic diseases than their peers born in other countries, new research suggests.

Compared to first-generation Hispanic people born elsewhere, those born in the U.S. showed an unfavorable blood cardiometabolic profile associated with obesity, diabetes, chronic kidney disease and asthma, according to findings presented Thursday at the American Heart Association's Epidemiology, Prevention, Lifestyle and Cardiometabolic Health conference in Boston. The findings are considered preliminary until the full results are published in a peer-reviewed journal.

The longer foreign-born Latinos live in the U.S., the more prone they are to developing diseases that may be related to diet, lifestyle and environmental factors, said study co-author Yang Li, a researcher at the Albert Einstein College of Medicine in New York City.

"The difference of metabolic status between U.S.-born Latinos and non-U.S.-born Latinos is mainly driven by Westernized food," Li said. "In terms of individual risk factor, changing food patterns should be paid the first attention."

Li and his research colleagues analyzed metabolites—the byproducts after the body breaks down substances such as amino acids and some sugars—from 7,119 participants in the Hispanic Community Health Study/Study of Latinos, the largest and most representative study of a fast-growing population with cultural roots across Latin America and the Caribbean. Slightly more than 62 million Hispanic people make up 18.7% of the total U.S. population, according to 2020 census data.

A metabolomic profile considers several measurable factors, such as biomarker identification in blood and other body fluids, that reflect how healthy someone is, as well as the likelihood that chronic conditions may appear. The study included a six-year follow-up between the time the blood of participants was collected and when disease developed.

The study found that Hispanic people born in the U.S. had higher levels of metabolites related to a 22% higher risk of diabetes; 16% higher risk of severe obesity; 15% higher risk of chronic kidney disease; and 42% higher risk of asthma. Meanwhile, the metabolites higher in foreign-born Hispanic people were associated with lower risks of these diseases.

Diabetes and obesity are contributing factors to heart disease, the leading cause of death in the U.S. More than 40% of Hispanic adults experience obesity, according to the AHA's statistical update published in January. Nearly 12% of Hispanic adults had been diagnosed with diabetes as of 2019, Centers for Disease Control and Prevention data show.

"What's interesting about this area of work is that it helps us to understand how the human body is sort of manifesting changes to the social environment and changes to nutrition, changes to stress, differences in social experiences between people who are staying in their home countries versus those who are in the U.S., and across generations," said Dr. Monik Jiménez, an epidemiologist at Brigham and Women's Hospital in Boston and an assistant professor at Harvard Medical School who was not involved in the study.

Li said his study reinforces the importance of incorporating healthy plant-based foods in Hispanic diets for optimum health. Previous research has shown that a diet rich in whole plant foods, such as vegetables, fruits and whole grains, offers many benefits.

"What people eat is very important, and that's one of the things we know can change quite dramatically based on time in the United States and increased consumption of Westernized diet, like processed foods," Jiménez said.

Other research suggests the Latino diet deteriorates with migration to the U.S., leading to poor health. However, there is no conclusive evidence as to the reasons.

"This type of work gets us closer to understanding how those changes are embodied and lead to differences in disease outcomes," Jiménez said.

Both Li and Jiménez agree that more research is needed to fully understand the reasons behind diet acculturation among Hispanic people. "I think it's important to have a little bit more nuance around how U.S. nativity is associated," Jiménez said.

"One could imagine that maybe if you've been here a really long time, that if you came as an adult, you would have a different impact on the same length of time than coming as a child," she said.

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