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A review of the Hispanic paradox: time to spill the beans?

Robert P. Young, Raewyn J. Hopkins
European Respiratory Review 2014 23: 439-449; DOI: 10.1183/09059180.00000814
Robert P. Young
1Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand. 2School of Biological Sciences, University of Auckland, Auckland, New Zealand
1Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand. 2School of Biological Sciences, University of Auckland, Auckland, New Zealand
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  • For correspondence: roberty@adhb.govt.nz
Raewyn J. Hopkins
1Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand. 2School of Biological Sciences, University of Auckland, Auckland, New Zealand
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  • Figure 1.
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    Figure 1.

    Inter-ethnic differences in mortality and/or incidence for chronic obstructive pulmonary disease (COPD) and lung cancer per 100 000, the basis of the “Hispanic paradox” [37, 38].

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    Figure 2.

    Age-adjusted incidence rates (per 100 000) for several cancers for 1999–2003 according to sex and ethnicity in the USA for a) males and b) females [39].

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    Figure 3.

    Lung cancer incidence per 100 000 [38], adjusted lung cancer risk [41], chronic obstructive pulmonary disease (COPD) mortality per 100 000 [37], COPD prevalence in adults [34] and percentage consuming bean [43] in the USA according to ethnicity. #: odds ratio×100; ¶: %×10.

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    Figure 4.

    Schematic of the relationship between smoking and legume consumption (smoking–diet relationship) in relation to pulmonary inflammation, systemic inflammation, chronic obstructive pulmonary disease (COPD) and cancer (both lung and extrapulmonary). MΦ: macrophage; PMN: polymorphonuclear neutrophil; IL: interleukin; TNF: tumour necrosis factor; CRP: C-reactive protein.

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  • Table 1. Basis of the Hispanic paradox based on incidence, prevalence and mortality figures for chronic obstructive pulmonary disease (COPD) and lung cancer in USA and South American populations comparing Mexican/Hispanic with other ethnicities
    DiseaseClinical phenotypeComparisonOutcome %Risk reduction %First author [ref.]
    COPDCOPD prevalence (%) over 2007–2009 among adults aged ≥18 yearsMexican versus non-Hispanic white2.6 versus 5.754Akinbami [34]
    Mexican versus Puerto Rican2.6 versus 6.962
    COPD prevalence unadjusted (GOLD)
    Prevalence of rapid FEV1 decline
    Mexican versus non-Hispanic white14.9 versus 29.550Bruse [35]
    Mexican versus non-Hispanic white21.6 versus 31.632
    COPD prevalence in two Latin American cities (adjusted for smoking and ethnicity)Mexico City versus Montevideo12.7 versus 20.337Menzes [36]
    COPD mortality rates (2006) (age-adjusted per 100 000 per year)Hispanic versus Caucasian (males)21.2 versus 50.558American Lung Association [37]
    Hispanic versus American Indian (males)21.2 versus 32.234
    Hispanic versus Caucasian (females)13.1 versus 39.166
    Hispanic versus American Indian (females)13.1 versus 28.654
    Lung
    cancer
    Lung cancer incidence rates 2002–2006 (age-adjusted per 100 000 per year)Hispanic versus Caucasian (males)43.2 versus 77.644American Lung Association [38]
    Hispanic versus American Indian (males)43.2 versus 51.616
    Hispanic versus Caucasian (females)24.7 versus 54.855
    Hispanic versus American Indian (females)24.7 versus 39.838
    Lung cancer incidence rates 1999–2003 (age-adjusted per 100 000 per year)Hispanic versus Caucasian (males)52.7 versus 88.841Howe [39]
    Hispanic versus Caucasian (females)26.7 versus 56.252
    Lung cancer mortality rates 2002–2006 (age-adjusted per 100 000 per year)Hispanic versus Caucasian (males)33.9 versus 69.952American Lung Association [38]
    Hispanic versus American Indian (males)33.9 versus 41.218
    Hispanic versus Caucasian (females)14.4 versus 40.965
    Hispanic versus American Indian (females)14.4 versus 28.349
    Lung cancer mortality rates 1999–2003 (age-adjusted per 100 000 per year)Hispanic versus Caucasian (males)37.2 versus 73.850Howe [39]
    Hispanic versus Caucasian (females)14.7 versus 42.065
    • GOLD: Global Initiative for Chronic Obstructive Lung Disease; FEV1: forced expiratory volume in 1 s.

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A review of the Hispanic paradox: time to spill the beans?
Robert P. Young, Raewyn J. Hopkins
European Respiratory Review Dec 2014, 23 (134) 439-449; DOI: 10.1183/09059180.00000814

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A review of the Hispanic paradox: time to spill the beans?
Robert P. Young, Raewyn J. Hopkins
European Respiratory Review Dec 2014, 23 (134) 439-449; DOI: 10.1183/09059180.00000814
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  • Article
    • Abstract
    • Introduction
    • The COPD–lung cancer link
    • Systemic inflammation in the COPD–lung cancer link
    • The Hispanic paradox
    • Legumes/beans and systemic inflammation
    • Other ethnic groups and the consumption of legumes
    • Conclusion
    • Footnotes
    • References
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