If, typically, Latinos are less educated and are poorer, why do they live longer?
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Transcript: The Hispanic Paradox: Why do Latinos Live Longer?
Hispanics living in the United States tend to have less education, a higher poverty rate, and worse access to health care. They represent, like, the ultimate paradigm of health care disparities. The highest rate of uninsured, the lowest rates of health screening and counseling, and the poorest levels of blood pressure and blood sugar control, and other measures of deficient quality of care. So, wow, Hispanics living in the U.S. must just have dismal public health statistics, right?
According to the latest national data, the life expectancy of white men and women was 76 and 81. The lives of black men and women, cut short by years. How do Hispanics do? Amazingly, they beat out everyone. Hispanics live the longest.
This has been called the Hispanic Paradox. Hispanics have a 24% lower risk of premature death, and lower risks of 9 out of the leading 15 causes of death—notably less cancer and heart disease. This was first noticed 30 years ago, but understandably met with great criticism.
Maybe the data were unreliable? No, that did not seem to be it. Maybe only the healthiest people migrate? Turns out the opposite may be true. Then there’s always the salmon bias theory—proposing that maybe Latinos return to their home country to die, and so, aren’t counted in our death statistics. But that theory didn’t pan out, either.
Systematic reviews confirm the existence of this Hispanic paradox. And so, given the strong evidence, it might be time to accept it and move on to figuring out well, wait a second, why do they live so long? Figure out the cause.
The very existence of the Hispanic Paradox could represent a major opportunity to identify a protective factor for cardiovascular disease applicable to the rest of the population. After all, whatever is going on is strong enough to overcome the disadvantaging effects of poverty, language barriers, low levels of education, health literacy, quality of health care, and insurance coverage.
Before we get our hopes up too much, though, maybe it’s just genetic? No, because as foreign-born Hispanics acculturate to the United States, as they embrace the American way of life, their mortality rates go up. So, what positive health behaviors may account for Hispanic longevity?
Maybe they exercise more? No; Hispanics appear to be even more sedentary. Hispanics do smoke less; however, the paradox persists even after taking that into account. Maybe it’s their diet. As they acculturate, they start eating more processed foods and animal foods, and fewer plant foods—and perhaps one plant food in particular: beans.
Maybe a reason Hispanics live longer is because they eat more beans. Although Hispanics only represent about 10% of the population, they eat a third of the beans in the United States, individually eating four to five times more beans per capita; a few pounds a month as opposed to a few pounds a year.
And that may help explain the Hispanic Paradox, because legumes—beans, split peas, chickpeas, lentils—cool down systemic inflammation. This is the mechanism they propose in terms of lung health. While cigarette smoking and air pollution cause lung inflammation, which increases the risk for emphysema and lung cancer, when we eat beans, the good bacteria in our gut take the fiber and resistant starch, and form small-chain fatty acids that are absorbed into our system and decrease systemic inflammation—which not only inhibits lung cancer development, but also other cancers throughout the body.
Here’s the lung data, with Hispanics in red, having the lowest rates of COPD and lung cancer, and also tending to have lower rates of bladder cancer, throat cancer, and colorectal cancer, for both men and women.
This whole systemic inflammation concept is also supported by the fact that when Hispanics do get lung cancer, or colon cancer, or breast cancer, they have improved survival rates, and maybe the same with heart attack and stroke survival. Decreasing whole body inflammation may be important for both prevention and survival.
Now, Asian Americans, here in green, appear to have some protection, too, which may be because they eat more beans, too, in the form of tofu and other soy foods, as soy intake is associated with both lung cancer prevention, and lung cancer survival.
Now, Hispanics also eat more corn, tomatoes, and chili peppers. A quarter of the diet in Mexico is made up of corn tortillas, and Mexican-Americans born in Mexico, and Mexican-Americans born in the U.S., continue to eat more than the general population. Looking at cancer rates around the world, not only was bean consumption associated with less colon, breast, and prostate cancer, but also rice and corn consumption appeared protectively correlated, as well.
Of course, since NAFTA, the Mexican diet has changed to incorporate more soda, processed, and animal foods, and their obesity rates are fast catching up to ours.
In the U.S., Hispanics eat more fruits and vegetables than other groups; about six or seven servings a day—but still don’t even make the recommended minimum of nine servings, though. So, their diet could stand some improvement. So yes, Hispanics may only have half the odds of dying from heart disease, but it’s still the #1 cause of death among Hispanics.
Therefore, the current results should not be misinterpreted to mean that cardiovascular disease is rare among Hispanics. So, ideally, they’d be eating even more whole plant foods. But one thing everyone can learn from the Hispanic experience is that along with a shift towards a more plant-based diet in general, beans may be potent tools in the prevention and treatment of chronic disease.
To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.