Worse Cardiometabolic Health in African Immigrant Men than African American Men: Reconsideration of the Healthy Immigrant Effect

Abstract

Background: The healthy immigrant effect is a phrase that has been used for decades to describe better cardiometabolic health in African immigrants than African Americans. The recent global increase in cardiometabolic diseases raises the possibility that immigrant health may be changing. Therefore, a new assessment of cardiometabolic health in African immigrants is warranted. Methods: Glucose tolerance status, blood pressure, and visceral adipose tissue (VAT) volume were compared in 214 self-identified healthy men comprised of 138 African immigrants, 76 African Americans, mean age 36 -9 years [mean -standard deviation (SD); range 20-64 years]. Insulin resistance was defined by the lowest quartile of the insulin sensitivity index (S I £ 2.28 mU/L

A1C Combined With Glycated Albumin Improves Detection of Prediabetes in Africans: The Africans in America Study

“…The Africans in America cohort was established to determine the cardiometabolic health status of African immigrants (13,20–22). At the initial telephone interview, all participants had to self-identify as healthy and specifically deny a history of diabetes.…”

“…The participants’ regions of origin in Africa were West (55%), Central (21%), and East (24%). As described previously, recruitment was achieved by newspaper advertisements, flyers, and the National Institutes of Health (NIH) Web site (13,20,22). The study was approved by the National Institute of Diabetes and Digestive and Kidney Diseases Institutional Review Board.…”

“…Waist circumference (WC) was measured at the level of the anterior iliac crest, and the mean of three WC determinations was reported. Visceral adipose tissue (VAT) was measured at the level of L2-3 by abdominal computed tomography (CT) scans (20). …”

Cardiometabolic Health in African Immigrants to the United States: A Call to Re-examine Research on African-descent Populations

“…[43][44][45] In 1995, Osei et al 42 evaluated insulin resistance, beta-cell function and glucose effectiveness in 30 African immigrants (Ghanaians) and 68 African Americans. No differences in the metabolic pathways that lead to diabetes and cardiovascular disease were identified.…”

“…45 Again, they determined that the African immigrants were more likely to be hypertensive and have diabetes or pre-diabetes than the African Americans. Interestingly, the African immigrant men were less obese, less likely to smoke and more likely to be both married and college graduates than the African American men.…”