Hispanics have intrigued medical researchers for decades by living longer than non-Hispanic whites, despite the barriers many of them face to securing health care.

But Hispanics should not let the so-called “Hispanic paradox” lull them into a sense of complacency.

Research suggests Hispanics’ unusually low infant and adult mortality rates and longer lifespans will be offset in coming generations by two scourges of the Western diet: obesity and diabetes. Indeed, Hispanics are expected to lose their lead in life expectancy over non-Hispanic whites by 2035, according to projections from the U.S. Census Bureau.

About 8 in 10 adult Hispanics were overweight or obese by 2018, according to the most recent federal data.

Strategies for better health

While genes determine much of your vulnerability to disease, you can still do a lot to lower your risk of chronic diseases.

“You can reduce your risk for all of these diseases, and particularly for heart disease and cancer, by following four simple strategies,” said Dr. Jeffrey Hutchings, a family physician with Novant Health Crown Point Family Physicians in Charlotte. “Don’t smoke tobacco, maintain a healthy body weight, be physically active and eat a healthy diet.”

Given rising levels of obesity nationwide, Hutchings monitors patients closely for signs of:

• Increasing levels of blood fats.
• Elevated blood pressure.
• Elevated blood sugar levels.
• Reductions in ”high-density lipoprotein cholesterol,” or HDL C), the so-called “good cholesterol” that helps remove excess cholesterol.

The presence of three or more of these conditions signals higher risk of heart disease, stroke and Type 2 diabetes.

Those without regular access to such tests can keep an eye on their waste size. Having a pot belly is a telltale sign of what health care providers call “central obesity,” which is a precursor to the five chronic illnesses most fatal to U.S. Hispanics.

Based on an analysis of death certificates by the Centers for Disease Control and Prevention (CDC, here are the top 5 deadliest illnesses for Latinos as of 2017.

No. 1: Heart disease

Heart disease accounts for about 1 in 5 Hispanic deaths in the United States. In North Carolina, it was the second biggest killer of Hispanics after cancer, according to a state study.

North Carolina reports the greatest risk factors for heart disease among the state’s Hispanic population were being overweight or obese.

To lower their risk, Hutchings urges his patients to keep their blood pressure under control, limit alcohol consumption, manage their stress, manage their diabetes and make sure they get enough sleep.

No. 2: Cancer

Cancer accounts for roughly 1 in 5 Hispanic deaths with cancer rates among foreign-born Hispanics being substantially lower than their U.S.-born counterparts.

Lack of health care and regular screenings have been cited as major cancer risks for Hispanics who are less likely to be screened for colorectal cancer, breast cancer and cervical cancer than non-Hispanic whites.

To reduce risk of cancer, Hutchings recommends protecting your skin from the sun, practicing safe sex, avoiding risky behaviors, getting vaccinated for HPV and hepatitis, knowing your medical history, and getting regular screenings.

No. 3: Stroke

Excluding auto accidents, poisonings and other unintentional injuries, stroke was the third biggest killer of U.S. Hispanics, though far behind heart disease and cancer. That year, the CDC estimates cerebrovascular disease accounted for about 1 in 20 Hispanic deaths.

High blood pressure is the single most important risk factor for stroke and the rate of uncontrolled high blood pressure (readings of at least 140/90) is higher among adult Hispanic males than the general adult male population.

The best way to reduce your risk of stroke, said Hutchings, is to not smoke or become obese.

No. 4: Diabetes

While Hispanics have a lower death rate overall than non-Hispanic whites, they are significantly more likely to die from diabetes. This is likely due, in part, to limited English, lower incomes and a lack of health insurance, which make it more difficult to obtain the health care, medicine, food, recreational amenities and other resources that are staples of a healthy lifestyle.

Preventing obesity is particularly critical to preventing and managing diabetes, which increases the risk of heart disease, blindness and amputations.

No. 5: Alzheimer’s disease

The mortality rate of this disease has risen sharply among U.S. Hispanics in recent years, due, in large part, to aging of the population. In 2017, Alzheimer’s accounted for nearly 1 in 20 Hispanic deaths, up sharply from 2011.

While Alzheimer’s disease is believed to be driven largely by genetics, there is a growing consensus in the medical community that obesity and type 2 diabetes are significant risk factors. Inadequate sleep, poor diet and nutrition, stress, and lack of exercise can increase the risk of the disease.

In other words, the threat of Alzheimer’s disease gives you one more reason to make healthy choices.