South Asians and their increased cardiovascular risk: A review of risk factors and diet and lifestyle modification

Abstract

South Asians (SAs) have a significantly higher incidence and severity of type 2 diabetes and cardiovascular disease (CVD)<br />than Caucasians and can present with atypical ischaemic symptoms. This can present a challenge for health professionals<br />who may not be aware of the lowered thresholds recommended for SA body mass index, waist circumference and age.<br />Although SAs are likely to have all the hallmarks of metabolic syndrome: central obesity, insulin resistance, impaired glucose<br />tolerance, reduced high density lipoprotein, high triglycerides and hypertension, conventional risk factors alone do not fully<br />predict the increased CVD risk among this community. Furthermore, SAs themselves may not be aware of their increased<br />predisposition to disease nor of the dietary and lifestyle modifications which could reduce the risk and severity of their<br />condition. Even where some modification has been attempted, there may be cultural pressure to conform to a traditional<br />diet and the requirements for fasting and feasting. Principally, SAs should avoid large late meals, reduce sugary sweets and<br />drinks, alcohol and foods fried in plant oils which create damaging transfats, while increasing protein and non-fried vegetables<br />to help glycaemic control. Chewing paan, with or without added tobacco, is a particular risk factor for both CVD and cancer,<br />on a par with the dangers of smoking. Although not in the culture, exercise would also be of great benefit.