Boston, MA - Hispanic kids and adolescents who are overweight already exhibit signs of endothelial dysfunction and subclinical inflammation that predispose them to type 2 diabetes and cardiovascular disease, a new study suggests [1]. The research—among the first to study early markers of these chronic illnesses in Latino kids—is another sign that the so-called "Hispanic paradox" that seemed to protect Hispanics against chronic diseases, including heart disease, may no longer apply.

Dr A Enrique Caballero (Joslin Diabetes Center, Boston, MA) and colleagues, writing in the March 2008 Diabetes Care, report that blood pressure, triglycerides, markers of inflammation—including high-sensitivity C-reactive protein (hs-CRP)—and markers of endothelial dysfunction were all higher among 21 overweight kids and teens than among a control group of 17 lean Latino kids and teenagers (mean age 13 in both groups).

"Our youngsters are now developing higher rates of obesity and type 2 diabetes, something that we didn't see very often before, and we wondered whether the overweight kids, even before they had any problems with their blood sugar, their blood pressure, and their cholesterol, already had problems in their circulation," Caballero explained to heartwire. "Our findings are really the first comprehensive evaluation of these endothelial dysfunction markers in Latino kids who are overweight."

While other studies have looked at children from other ethnic groups, this is the first to compare lean and overweight Hispanic kids, he explained, adding that there have been no comparative studies of kids from different ethnic groups.

"But for a long time people believed that Hispanics were protected from the development of heart disease, because population studies seemed to show that the risk of heart attack was lower in the Hispanic population, even though the Hispanic group tends to have more diabetes and obesity. This was called the Hispanic paradox," Caballero noted. "But with our findings, I think the opposite is probably true: if you are Hispanic and you're overweight, you already have a lot of abnormalities in your circulation that may predispose you to the development of heart disease early on in life. If the Hispanic paradox were true, we'd probably expect these kids to have normal circulation and normal markers, but in fact that's not the case. They are as high-risk from their obesity as any other population would be."

Caballero believes the focus should shift to preventing or reversing childhood obesity, rather than attempting to treat diabetes, high cholesterol, high blood pressure, etc, after the fact. Part of this shift needs to happen within the Latino community, he said. "We tend to think that having an overweight kid means he is strong and healthy and eating well, which is part of our Hispanic culture, and that's wrong. That's not the right approach."