Ethnic‐specific Pathways to Obesity‐related Disease: The Hispanic vs. African‐American Paradox

Obesity is a well-known risk factor for multiple chronic diseases, including diabetes, heart disease, fatty liver disease, and some forms of cancer. !e mechanisms of these relationships are unclear and may be speci"c for each disease. !e most likely explanations of why increased body fat causes multiple health problems include the mediating roles of hyperinsulinemia and insulin resistance, body fat distribution, including ectopic fat deposition in peripheral tissues, and in#amma tory mediators. Prior work in this area suggests that there are distinct ethnic di$erences in these obesity-related phenotypes that are evident early in life, and may help explain ethnic di$er ences in the incidence and prevalence of obesity-related disease outcomes. !e purpose of this article is to sum marize these di$erences speci"cally in Hispanics and African Americans. !e focus on these two ethnic groups is based on (i) they are the two largest ethnic minority groups in the United States and (ii) they share a similar propensity for obesity and insulin resistance, but markedly di$erent pro"les for obesity-related disease outcome, creating an informative comparative contrast. !ese comparisons yield two di$erent pro"les that could represent di$erent pathways to obesity-related diseases.