Add to that, doing the right thing

when it comes to preventing

and treating a chronic disease,

fighting a virus, or losing weight,

and suddenly our nutrition choices

can seem almost overwhelming.

Well, I’m here to help.

Welcome to the Nutrition Facts Podcast.

I’m your host, Dr. Michael Greger.

Does it ever seem to you

that some of us are kept from living longer, healthier lives

because of our skin color?

In our first story, we look at health equity

and why black Americans are sicker and die younger

than their white counterparts on average.

During the COVID-19 pandemic, the death rate for African Americans

was as much as six times higher than white America.

The higher Black pandemic deaths placed a harsh spotlight on their

longstanding higher mortality and diminished longevity in general.

Unfortunately, diminished African American life expectancy

predates the COVID-19 pandemic by decades.

The Black-white death gap for women is about 3 years,

and for men closer to 5 years.

The COVID-19 death disparities may have to do with limited access

to healthy food in predominantly Black communities,

the housing density, the need to work or else,

the inability to practice social distancing,

but also the underlying burden of ill health.

Increased COVID-19 mortality and complications occur more often

in individuals with pre-existing conditions like hypertension,

obesity, diabetes, and cardiovascular disease,

comorbidities that are more prevalent in African Americans.

More high blood pressure, more diabetes, more strokes,

and more likely to die at early ages from all causes put together.

The question is why? Why do Black Americans

live sicker and die younger than their white counterparts?

Well, one big factor is socioeconomic status.

In the United States, race is closely tied to class,

with African Americans about twice as likely to be living in poverty.

On average, education levels are lower as well; however, even

among African Americans whose socioeconomic status is comparable

to that of whites, despite the higher education and more

socioeconomic resources, health outcomes are still poorer.

Part of that has to do with lifestyle behaviors.

For example, fewer than 5% of African American adults

met physical activity guidelines.

Smoking rates are actually comparable,

though African Americans tend to be exposed

to more second-hand smoke and have lower quit rates.

This may be because they're more likely to use menthol cigarettes,

which enhance the addictive potential of nicotine.

Why menthol? Because tobacco companies target the marketing

of mentholated products to African Americans.

Black lives... Black lung.

Similarly, if you look at food messages on African American television shows,

not only does Black prime time contain a greater number of food commercials,

African American audiences may be receiving nearly 3 times as many

advertisements for low-nutrient junk such as candy and soda.

That may be one reason why African Americans tend to consume

fewer fresh fruits and vegetables and are more likely to eat junkier foods.

Of course, where are you going to get those fresh fruits and vegetables?

There are fewer supermarkets located in Black neighborhoods

compared with white neighborhoods, as in four times fewer supermarkets.

What Black neighborhoods do excel in though is fast food.

Predominantly Black neighborhoods have 60% more fast food restaurants

per square mile compared to predominantly white neighborhoods.

Now, of course, dietary behaviors alone do not fully explain

the significant differences in diet-related disease patterns

between racial groups.

There are differences in employment and poverty and home ownership

and healthcare access, all of which can affect outcomes.

But while there are certainly many social and economic factors such as

racism and income inequality that contribute to health disparities,

there is good evidence that simply eating a more plant-based diet

could help eliminate disparities in cardiovascular disease and diabetes.

Here's the diabetes data.

Even after controlling for education, income, physical activity,

and even BMI, non-Blacks eating strictly plant-based diets

had 57% lower odds of diabetes,

and among Black vegans, it was even more striking, 70% lower odds.

And that was after taking BMI into account.

So even at the same weight, Black vegans had 70% lower odds

of diabetes than Black omnivores.

And the racial disparity is only about half that, 36%.

So the increased risk of diabetes among Black participants

was on the order of one-third, while the protection afforded

by vegan diets in this subgroup was about 70%.

Even just a vegetarian diet that includes still eating dairy and eggs

may more than counteract the racial disparity in diabetes risk.

And they're not the same weight. African Americans have higher

obesity rates, cutting their life spans by six years.

But Black vegetarians and vegans have less than half

the risk of obesity, compared to those who eat meat,

and this is after adjusting for differences in physical activity.

So even at the same exercise levels, those eating more plant based

had but a fraction of the obesity risk.

High blood pressure.

In African Americans, hypertension is the most significant contributor

to their increased cardiovascular disease burden and mortality.

But Black vegetarians and vegans combined had 44% lower odds

of hypertension, an important finding for Black individuals

where hypertension is so prevalent, with no benefit found for those

who cut out all other meat, but continued to eat fish.

And the same thing found for total cholesterol and LDL cholesterol:

cutting odds in half among Black vegetarians and vegans.

As with non-Blacks, the researchers conclude,

"these results suggest that there are sizeable advantages

to a vegetarian diet in Black individuals."

What about vegetarians versus vegans?

The title gives it all away: "Cardiovascular Disease

Risk Factors are Even Lower in African American Vegans..."

This is something we've known about when

Caucasian vegans have been compared to vegetarians.

However, it was not known whether African American vegans

exhibited a more favorable cholesterol profile until now.

Significantly lower LDL cholesterol in vegans.

Now, of course, the vegans were also significantly slimmer:

on average normal weight as opposed to the over-weight vegetarians.

But even after taking that into account,

those eating more plant based had significantly lower cholesterol.

So there's tremendous potential for plant-based diets

to promote health among Blacks living in the United States.

In fact, they may have an even greater benefit.

For example, African Americans have an excess burden

of chronic kidney disease, not only because they have more

high blood pressure and diabetes, but there are genetic factors:

8% to 12% of African Americans are carriers of the sickle cell trait,

which places them at significantly higher risk of kidney disease.

So while Blacks represent a relatively small fraction of the US population,

they account for more than a third of all patients on dialysis

due to chronic kidney disease.

And that's where plant-based diets can come in: shown to protect

against both chronic kidney disease development as well as progression.

Three-quarters of Blacks are lactose intolerant, too,

so would again stand to benefit even more from eating plant based.

It is unacceptable that for decades, the American healthcare system

has failed African Americans and other minority communities

in terms of helping to prevent some of our leading killers.

But that just makes it all the more important for them

to take the reins of their own health destiny.

In our next story, we look at what role diet and baby powder may play

in the development of fibroids and ovarian cancer.

If you randomly select a group of women and ultrasound their uterus,

the majority of them have fibroid tumors by age 50,

and by most, I mean, more than 80% of black women,

and about nearly 70% of white women.

Half of white women already have fibroids by their early 40s,

and the same could be said

for African-American women in their mid 30s.

After getting over the shock of how widespread fibroids are,

the next question becomes, why the racial disparity.

Is it diet, stress, environmental exposures?

Maybe whatever it is could offer a clue

as to what causes fibroids.

For example, African-Americans tend to have

a lower intake of fruits and vegetables,

and fruits and vegetables appear protective

against fibroids, particularly citrus,

though not apparently just citrus juice.

It’s interesting, if you measure the levels of beta-carotene

in fresh surgical tissue samples of uterine fibroids

and adjacent normal uterus tissue

obtained during hysterectomies,

you find significantly lower concentrations in the fibroids.

In fact, beta-carotene was not even detectable

in half the fibroid specimens.

The same thing is actually found in cancer.

Most cancerous tissues tested had undetectable levels of beta carotene,

compared to the normal tissue right next to the tumor.

So, maybe decreased levels of beta-carotene

somehow plays a role in causing these conditions?

Sounds like a bit of a stretch, but you don’t know...