Among the general population 22.7 per cent of men and 23.2 per cent of women are obese (a BMI over 30 kg/m2). This compares with 25.2 per cent of black Caribbean men, 32.1 per cent of black Caribbean women and 38.5 per cent of black African women. The exception is black African men who have a lower obesity rate (17.1 per cent).
If we turn our attention to diabetes we find that the rate of doctor-diagnosed diabetes among the general population stands at 4.3 per cent for men and 3.4 per cent for women. But among the black population the rates are more than double ( black Caribbean men 10 per cent and black Caribbean women 8.4 per cent).
As we reported last week on Britain, diabetes can lead to loss of sight and people of African heritage are four times more likely than white people to develop glaucoma – and to develop it at a younger age.
But it does not stop there; black Caribbeans have the highest levels of hypertension (high blood pressure). Among the general population the rates are 31.7 per cent of men and 29.5 per cent of women. But among black Caribbeans the rates are 38.4 per cent for men and 31.7 per cent for women.
Another alarming revelation is the prevalence of asthma in young black boys. Black Caribbean boys (30 per cent) were more likely than boys in the general population (23 per cent) to have had asthma diagnosed by a doctor. However, doctor-diagnosed asthma was less prevalent among Black African boys (17 per cent) and only 9 per cent of black African girls were diagnosed with asthma, compared with 18 per cent among girls in the general population.
So we already have the evidence in the UK of higher levels of inflammatory diseases among the black population. For the record, the problem is just as pronnounced in the Caribbean. The issue of health was discussed at a recent CARICOM meeting in St Kitts, which looked at a report called The Caribbean Commission on Health and Development , headed by Sir George Alleyene, Chancellor of the University of the West Indies. The study showed that deaths resulting from diabetes, hypertension and heart disease were ten times higher than the number resulting from AIDS and HIV and it looked at the high cost to the region of treating these illnesses.
In the USA 3.2 million African Americans aged 20 (13.3 per cent of the population) have diabetes, a third of whom are undiagnosed and on average, African Americans are 1.8 times more likely than hispanics or whites to suffer from diabetes. (Source: National Diabetes Education Program).
On the African continent more than 20 million people are affected by hypertension and its prevalence ranges from 25 per cent to 35 per cent in adults aged between 25 and 64. Each year there are 300,000 deaths as a result of rheumatic heart disease with 20 million people requiring ongoing hospitalisation. So we are beginning to see that inflammatory diseases are a big problem not just for black people in the UK, but also in the USA, the Caribbean and on the African continent. (Source: WHO Africa Report June 2005).
How inflammatory diseases develop and why people of African descent are more susceptible:
Ian Stoakes is a research professor, author and ex-Director of the Dietary Research Foundation. He previously worked in the area of behavioural science looking at the role of inflammation as a means of creating behaviour. But he was keen to understand the cause of the inflammation, a very new area of science.Survey links higher asthma rates, ethnicityLow Prepregnancy BMI for Black Women Tied to Vaginal Inflammation, PrematurityBlack Teen-Agers with Severe Athma are Three Times Likely Than White Teens to Have Steroid-Resistant AsthmaUnderweight Black Women Risk Preterm DeliveryDermatology of Pigmented SkinRacial Average Differences In Inflammation Responses FoundBlacks Need More Asthma Meds
Doctors in this area of research were saying that they thought it was caused by ‘non-self’ getting into the bloodstream and producing this immune response. ‘Non-self’ put simply is anything that does not originate from the body (nail varnish, for example) and ‘self’ is everything that does come from the body (nails for example).
Doctors looking at this area of research were not able to demonstrate this and were not necessarily interested in looking at this particular aspect of inflammation. But Stoakes approached a manufacturer about what equipment was available to test blood for certain chemicals. Such equipment is not cheap.
Stoakes told Black Britain that when he first became involved in this area of research in the late 1980s a haematology analyser cost around £120,000.He managed to talk a manufacturer into loaning him a machine that he could experiment with. This was how he discovered what causes inflammation.
He told Black Britain: “Inflammation is a response that your body has that is generated by your immune system in response to something which shouldn’t be there.”
A new study published in the Journal of the American Heart Association called Ethnic Differences in Arterial Responses and Inflammatory Markers in Afro Caribbean and Caucasian Subjects found that African Caribbean people had “Higher insulin levels and increased inflammatory markers compared with matched Caucasians.”
But what does this mean? Stoakes explained: “If you have more inflammatory receptors than your Caucasian counterparts, you are going to suffer quicker, longer and more intensely.”
So this research points to why black Caribbeans are more prone to develop inflammation, which can lead to inflammatory disease, but the crucial connection is how the process of inflammation takes place, as this is the key to how inflammation can be prevented.
Stoakes confirmed: “The biggest source of non-self that gets into the body three or four times a day is food.” Digestion is the normal process by which the body converts ‘non-self’ food sources into ‘self.’ But if that system breaks down or food is not digested properly, food particles can find their way into the bloodstream and that is where the fireworks begin!
The body’s immune system is then activated and white blood cells begin to attack the ‘non-self’ detected in the bloodstream. One of the major white cells that spring into action is called the neutrophil .
In 1999 Professor Casatella from Verona University in Italy revealed that the neutrophil produces around 50 pro-inflammatory chemicals and that 80 million neutrophil cells are produced each day and they are hugely significant in relation to the development of inflammatory diseases.
Stoakes explained: “An inflammatory illness is the result of inflammation being continued either because the pathogen (non-self) cannot be overcome or because it is continually replaced. This process, in some form or other is the root of all inflammatory illness.”