Obesity and Dyslipidemia in South Asians

Abstract

Obesity and dyslipidemia are emerging as major public health challenges in South Asian countries. The prevalence of obesity is more in urban areas than rural, and women are more affected than men. Further, obesity in childhood and adolescents is rising rapidly. Obesity in South Asians has characteristic features: high prevalence of abdominal obesity, with more intra-abdominal and truncal subcutaneous adiposity than white Caucasians. In addition, there is greater accumulation of fat at “ectopic” sites, namely the liver and skeletal muscles. All these features lead to higher magnitude of insulin resistance, and its concomitant metabolic disorders (the metabolic syndrome) including atherogenic dyslipidemia. Because of the occurrence of type 2 diabetes, dyslipidemia and other cardiovascular morbidities at a lower range of body mass index (BMI) and waist circumference (WC), it is proposed that cut-offs for both measures of obesity should be lower (BMI 23–24.9 kg/m2 for overweight and ≥25 kg/m2 for obesity, WC ≥80 cm for women and ≥90 cm for men for abdominal obesity) for South Asians, and a consensus guideline for these revised measures has been developed for Asian Indians. Increasing obesity and dyslipidemia in South Asians is primarily driven by nutrition, lifestyle and demographic transitions, increasingly faulty diets and physical inactivity, in the background of genetic predisposition. Dietary guidelines for prevention of obesity and diabetes, and physical activity guidelines for Asian Indians are now available. Intervention programs with emphasis on improving knowledge, attitude and practices regarding healthy nutrition, physical activity and stress management need to be implemented. Evidence for successful intervention program for prevention of childhood obesity and for prevention of diabetes is available for Asian Indians, and could be applied to all South Asian countries with similar cultural and lifestyle profiles. Finally, more research on pathophysiology, guidelines for cut-offs, and culturally-specific lifestyle management of obesity, dyslipidemia and the metabolic syndrome are needed for South Asians.

Lifestyle and the Most Important Risk Factors of Cardiovascular Disease in Physicians, Nurses, and Faculty Members

“…The authors called for the implementation of intervention programs with emphasis on improving knowledge, attitude, and practices regarding healthy nutrition, physical activity, and stress management (36). Previous studies have demonstrated very high prevalence rates of hypercholesterolemia among American men (54.9%) and Puerto Rican women (41.0%) (16).…”

“…It seems that quantitative and qualitative research is needed to analyze the roles and responsibilities of health care professionals and determine the reasons for their unwillingness to control CVD risk factors (47). Specifically in the context of South Asia, further research on pathophysiology, guidelines for cut-offs, and culturally-specific lifestyle management of obesity, dyslipidemia, and the metabolic syndrome is required (36).…”

Metabolic Syndrome; Are Our Women at Risk to Develop. A Study at Abbasi Shaheed Hospital

“…16 Several studies have shown that South Asians are at a greater risk of CVD because of their increased body fat and increased abdominal fat distribution at similar BMIs than Caucasians. 8,15,23 The prevalence of obesity and metabolic syndrome is on the rise, leading to increased morbidity.…”

Dyslipidemia Among the Elderly in Slums of West Delhi

“…Its prevalence has increased over a period of 20 years among the urban population in India [4]. Rapid urbanization, rural-tourban migration, poor dietary habits, physical inactivity, sociocultural factors, and genetic predisposition all contribute to dyslipidemia [5]. The WHO Study on Global Aging and Adult Health carried out among 39,436 adults during 2007-2010 revealed that rural-urban migrants had a similar risk factor profile for non-communicable disease to the urban group, suggesting that exposure to urban environments may promote assimilation of health behavior regardless of previous life experiences [6].…”