Copyright © 2014 Albuquerque Journal
A new nationwide survey has found that obesity among Latinos is widespread, and severe obesity is a particular problem among young adult members of the country’s largest and fastest-growing minority group.
The obesity epidemic “is unprecedented and getting worse,” said Robert Kaplan, lead author of the study, published in this month’s Journal of the American Heart Association, and professor of epidemiology and population health at Albert Einstein College of Medicine in the Bronx, N.Y. “Because young adults with obesity are likely to be sicker as they age and have higher health care costs, we should be investing heavily in obesity research and prevention, as if our nation’s future depended upon it,” he said.
The research looked at 16,344 people of various Latino origins in four urban areas: the Bronx, Chicago, Miami and San Diego. The men and women in the study were an average age of 40 and 41, respectively.
The largest ethnic group consisted of people with roots in Mexico, 37 percent, followed by people of Cuban heritage, 20 percent, and Puerto Rican, 16 percent.
The study is the first large-scale data collection on body mass index, or BMI, and cardiovascular disease risk factors in the U.S. Latino community.
Although New Mexico was not included in the study, it has the highest percentage of Latinos in the nation. But Dr. Susan Baum, medical director of the Chronic Disease Prevention and Control Bureau in the New Mexico Department of Health, advises caution before jumping to any conclusions.
Others have arrived more recently, and cultural and environmental influences cannot be discounted.
The study suggests severe obesity may be associated with a considerably heightened risk for cardiovascular diseases. BMI is a calculation based on height and weight. Severe obesity is characterized by a BMI of 40 or higher.
The study found that overall, 18 percent of women and 12 percent of men had levels of obesity that signal special concern about health risks, as defined by having a BMI above 35. The most severe class of obesity, those with a BMI greater than 40, (5-foot-5 and weighing more than 240 pounds) was most common among young adults between 25 and 34 years old. This included 5 percent of men and 10 percent of women.
Moreover, more than half of the severely obese had unhealthy levels of HDL cholesterol – the “good” cholesterol – and of inflammation. Another 40 percent of the severely obese Latinos had high blood pressure, and slightly more than a quarter had diabetes.
“This is a heavy burden being carried by young people who should be in the prime of life,” Kaplan said. “Young people, and especially men – who had the highest degree of future cardiovascular disease risk factors in our study – are the very individuals who tend to neglect the need to get regular checkups, adopt healthy lifestyle behaviors, and seek the help of health care providers.”
High blood pressure and diabetes – two major risk factors for heart disease and stroke – appear to be more tightly linked with severe obesity among men than they are among women.
The findings for young Latino adults in their child-bearing and child-rearing years suggest health care providers should take a holistic, family approach to weight management, Kaplan said. Biological and societal factors affecting parents’ weight also could affect their children, he said.
In New Mexico, Baum pointed out that obesity affects all races and ethnic groups, particularly Latinos, Native Americans and African Americans, all of whom have statistically significant higher rates of obesity than whites.
She noted that while the study associated obesity with increased risk of cardiovascular disease, that link has not been proven. She said the medical community is confronted with a cardiovascular paradox when it tries to make sense of changing statistics regarding mortality: Since the mid-1980s, while obesity rates have been going up, the death rate from heart attacks and strokes has been going down.
The fear is that growing rates of obesity might presage an increase in heart attacks, particularly among the severely obese.
The causes and effects of obesity, Baum said, can be “extremely complex” and can be influenced by any number of factors, including diet, physical activity, genetics, governmental policy and smoking. The state is working on addressing risk factors for heart disease and stroke, and is working with partners statewide in the Million Hearts Initiative, which seeks to prevent a million deaths over a five-year period that began in 2012.
“Tobacco control is absolutely key,” Baum said.
According to the American Heart Association, Latino youths smoke more than non-Latino whites: 28 percent of Latino eighth-graders compared to 23.7 percent of white children.
Smoking, however, is but one of several risk factors, Baum said. Others include high blood pressure, high cholesterol and obesity. And just because someone is overweight does not mean all is lost, she said. However, “the more risk factors you have, the worse off you are.”
The AHA published a statement this week outlining the burden of heart disease and stroke and emphasizing the importance of culturally sensitive health care for Latinos.
The statement notes that Latinos will make up nearly a third of the nation’s population by mid-century, yet there is no comprehensive document about the cultural values and behavioral aspects that influence cardiovascular health promotion, prevention and acceptance of treatment recommendations.
“This segment of the population has been somewhat ignored,” said Dr. Carlos Rodriguez, lead author of the AHA statement and an associate professor of medicine and epidemiology at Wake Forest Baptist Medical Center in North Carolina. “Given the large Hispanic population in the U.S., it would be very hard to improve the health of the nation if this population is left behind.”
Heart disease is the No. 1 cause of death for all Americans, but research has shown Latinos are not as aware of the danger and their own personal risk factors.