People from India, Pakistan and Bangladesh are roughly 50 per cent more likely to die from coronary heart disease and up to six times more likely to have type 2 diabetes than white Europeans. A Grosseteste Dialogue in Nottingham heard John Kalk, Musaraf Hussain and Chris Packham investigate the physical causes, religious defences and healthcare responses.
Asians have more body fat
Obesity in Asian populations is underestimated, explains John Kalk
Recent research provides some insights into the high prevalence of both diabetes and coronary heart disease in the south Asian communities of the UK, which can also be applied in a practical way.
Asian populations tend to have more body fat than apparently similar European and north American people. Much of this extra fat is inside the body, especially in the belly, where it can predispose to diabetes and adverse changes in the cholesterol profile. Because ‘western’ standards for overweight are in current use, the frequency of overweight and obesity has been underestimated in Asians, and new, smaller, definitions should be used to define normal weight and overweight in this population. If this is done, more individuals will be identified as being at risk from the complications of overweight and obesity.
Overweight commonly starts in childhood, especially in south Asian children, who also tend to be physically under-active in the UK. Moreover, there is new evidence that the adverse metabolic changes which predispose to heart disease and diabetes frequently start in children as young as 10 years, especially if they do little exercise.
How can this new information be used to improve the health of UK south Asians?
Parents should encourage more physical activity for their children. If children are lean and active, their healthy ‘metabolic profile’ continues into young adulthood.
Routine screening for diabetes and heart disease risk factors (high blood pressure, cholesterol profile, smoking) should start in young adulthood, rather than in middle age as is usual practice. If abnormalities are found they should be vigorously managed to meet the targets set by professional associations.
In my view developing healthier children will be the key to long term health improvements.
Dr John Kalk is Lead Clinician in Diabetes at the Derbyshire Royal Infirmary.