Objective-To examine the hypothesis, in a community not studied before, that insulin resistance associated with centralised adiposity is the mechanism underlying the predisposition of Asian immigrant communities to both ischaemic heart disease and diabetes mellitus.Design-Cross sectional study within one socioeconomic stratum.Setting-Two factories in the textile sector in Bradford, West Yorkshire.Subjects-Male manual workers of Asian (110) and non-Asian origin (156) aged 20-65 years.Results-Diabetes was almost three times more prevalent in the Asian group. Two hours after an oral glucose load Asian men had double the serum insulin concentrations of non-Asian men (p < 0 0001). Asian men also had significantly lower concentrations of plasma total cholesterol (p < 0 03), high density lipoprotein cholesterol (HDL) (HDL2, p < 0-0001; HDL3, p < 0-0001), and apolipoprotein AI (p < 0 0001). Fasting plasma triglyceride concentrations were slightly higher (p = 0 072) in the Asian men; thus the ratio of triglyceride cholesterol was higher (p = 0 006). The interrelation between serum insulin and plasma lipid concentrations indicated metabolic differences between the ethnic groups. Insulin concentrations were associated with cholesterol concentrations in the Asian men only and there was a lack of association between triglyceride, low density lipoprotein cholesterol, and HDL cholesterol in this group. The risk marker profile in the Asian men was therefore quite different to that of their non-Asian counterparts and was associated with a greater tendency to centralised adiposity.Conclusion-These data support the insulin resistance hypothesis and thus have important implications for

As part of a study of risk markers for ischaemic heart disease in Bradford, dietary intakes were assessed for 286 male manual workers of Asian and Caucasian origins using a 3‐day diet diary and a food‐frequency questionnaire. Caucasian men were found to eat more variable diets, the choice of foods being partly dependent on the canteen facilities in the workplace. Processed meat products and sweet baked goods featured almost daily, whereas intake of fresh fruit and salads did not. Most Asian meals followed the traditional pattern of curry (lamb/mutton, chicken, vegetable and occasionally white fish) with chapatis and, less frequently, rice. Salad and yoghurt were often eaten with the curry and fresh fruit was frequently consumed after the meal. Such meals were consumed one or more times per day. Although overall vegetable consumption was of a similar frequency in both ethnic groups, the Asian men ate a greater variety. The frequency of ‘fried food’ consumption was similar for both Asian and Caucasian diets although different types of foods were consumed. These different dietary patterns were reflected in higher estimated intakes of protein and sugar amongst Caucasians and lower intakes of fibre, compared with Asian men. Total fat intakes and P:S ratios were highest in the Hindu group although both Caucasian and Asian men were estimated to consume more total fat than is currently recommended. The results of this study highlight the need for ‘healthy eating’ advice to be designed specifically for the ethnic group in question, rather than for general healthy eating messages to be translated into the appropriate language. Although conducted within one population only, this study should be of interest to all dietitians working in multi‐cultural communities.

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