Indians Have To Work Almost 10x Harder Than White People To Be Healthy

Growing up, I always felt like I had to work harder to maintain my body weight. I envied my friends in middle and high school who had thin waists without even trying! In fact, they were doing the opposite of trying – they ate junk food and still had beautiful waistlines. Meanwhile, I was waking up early to exercise before school just to stay fit.

Despite all my efforts, I seemed to have stubborn fat in my abdomen that just wouldn’t go away unless I got ultra lean. However, getting too lean came with its own issues, like low thyroid and hormone levels, fatigue, and irregular periods.

Then, I learned about the “South Asian phenotype,” and it all made sense.

South Asian Phenotype

The “South Asian phenotype” refers to the genetic and physiological characteristics of people from South Asian countries (ie. India, Bangladesh, Sri Lanka, Pakistan, Nepal, Bhutan). It says that South Asians are more susceptible to “metabolic syndrome” than any other ethnicity.

What is metabolic syndrome?

Metabolic syndrome is a cluster of conditions that increase the risk of heart disease, stroke, and type 2 diabetes. These conditions include high blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels.

What is metabolic syndrome?

Because Indians and other South Asians are more susceptible to metabolic syndrome, we literally have to work 5-9x harder than a white person to stay healthy.

In this post, I’ll dive deep into the research on the South Asian phenotype. We’ll explore the contributing factors of this unfortunate phenomenon and consider ways to counteract this reality so we can stay healthy and fit.

Let’s get right into it.

What The Studies Say About The South Asian Phenotype

I’m going to save you a ton of time and condense dozens of research papers into just a few paragraphs. Trust me, you’ll want to keep reading.

1) South Asians have a disproportionately higher risk of metabolic syndrome compared to every other ethnic group

South Asians have a disproportionately higher risk of metabolic syndrome compared to every other ethnic group. For instance, 33% of South Asian men and 11% of South Asian women with a NORMAL bodyweight have both dysglycemia (blood sugar issues) and dyslipidemia (cholesterol issues). Now, compare this to 8% and 2% in white men and women, respectively. This means South Asians are 5-9x more likely to have metabolic syndrome at a NORMAL body weight compared to any other ethnic group. In other words, even those who don’t appear “fat” are metabolically quite unhealthy. Yikes!

"The South Asian (“Asian Indian”) phenotype" is why Indians have to work almost 10x harder than white people to be healthy
Source

2) South Asians have the highest rates of premature heart disease in the world

Because we are predisposed to metabolic issues, we South Asians face at least double the risk of heart disease compared to white people. What’s even more concerning is that we have the highest rates of premature heart disease and diabetes in the world, both occurring a whole 10 years earlier than in other ethnicities. One theory is that it is because South Asians tend to have low HDL and small, dense, dysfunctional HDL particles, which makes us more prone to heart disease.

CHD mortality rates are almost twofold higher amongst south Asian, than white European males
Coronary Heart Disease in South Asians vs. White Caucasians

3) South Asians store more body fat

South Asians have higher body fat percentages at lower BMI levels. In fact, South Asians have 3-5% higher body fat than whites, at any given BMI. What’s worse is that we tend to store more abdominal fat than any other ethnicity. Ever seen an Indian uncle with a giant belly? Well, this is why.

Generally, South Indians store more fat in their tissues and organs, like the liver, skeletal muscle, and heart. For instance, this is why 25% of Indians living in urban areas have Non-Alcoholic Fatty Liver Disease.

This type of visceral fat around the abdomen and organs is considered the most deadly fat in the human body. It leads to plaque buildup in the arteries, diabetes, and high blood pressure.

4) South Asians have a lower tolerance for high-carb diets

South Asians tend to have a lower tolerance for high-carb diets. Research consistently shows that when comparing a South Asian to a white person with the same BMI, the South Asian will almost always have higher glucose levels. Furthermore, a South Asian consuming a high-fat and high-carb diet becomes insulin resistant much quicker than any other ethnic group.

South Asian phenotype. South Asians have a much higher risk of diabetes than other ethnicies.
Source

5) BMI is not a good measure of health for South Asians

Since South Asians tend to store more body fat and become insulin resistant more quickly, they often develop metabolic syndrome at lower BMI levels compared to white individuals. That’s why BMI is no longer considered an accurate measure of health for South Asians, as many of them have a normal BMI but the metabolic health of an obese person.

Given the inaccuracy of using BMI to measure health for South Asians, a much better indicator of their metabolic health is waist circumference. Have you ever noticed those Indian aunties and uncles with totally normal limbs but fat around the belly? That’s how obesity tends to show up in Indians – right in the belly.

6) Metabolic syndrome is higher in urban areas than rural ones

Historically, India has struggled with malnutrition and an underweight population. However, with the rise of urbanization, the narrative is changing. In urban areas of India, there are now more overweight adults than underweight ones.

So, what’s causing this shift?

Well, when you mix the typical Indian diet, which is high in carbs and low in protein, with the low physical activity common in urban areas, it significantly increases the risk of metabolic syndrome.

In rural India, farming forces people engage in heavy physical labor, allowing them to manage a high-carb diet. But those living in urban areas have yet to adjust their diet to match their more sedentary lifestyle.

Urban city lifestyle in India is not helpful to the South Asian Phenotype
Urban city lifestyle in India

7) Poor nutrition in early life is likely the leading cause

So why do South Asians have all these metabolic predispositions? One hypothesis suggests that many people in India experience poor nutrition during pregnancy and early childhood, leading to low birth weight and poor early life growth. This, in turn, predisposes them to Type 2 diabetes later in life.

This theory is backed by studies showing that children born underweight but who gain weight quickly during infancy and childhood have higher levels of body fat and insulin resistance as adults. Furthermore, rapid BMI gain in childhood and adolescence, but lower BMI in infancy, was also associated with glucose intolerance.

Another study revealed that Indian newborns have poor muscle and visceral mass but higher fat for a given weight compared to white babies. Indian babies were lighter, thinner, shorter, and had relatively lower lean tissue mass than white babies, but their body fat was on par with white babies. The theory here is that this poor body composition at infancy carries on later in life.

That’s why nutrition during pregnancy is SO important. Many Indian women don’t get enough protein and nutrients during pregnancy, and they have higher insulin resistance during pregnancy, which leads to higher body fat levels in newborns. These children then end up developing serious health issues later in life. I’ve written extensively about the importance of nutrition during pregnancy and early childhood in previous posts:

In conclusion, due to the modern urban lifestyle and specific genetic factors, South Asians tend to have higher body fat and lower lean muscle mass. This puts them at a significantly increased risk for diabetes and heart diseases.

What This Means For Us South Asians

I’ve heard about the South Asian phenotype, but delving deeper into it has truly put things into perspective. It now makes sense why:

  • Nearly everyone in my family gets diabetes and heart diseases after turning 50
  • Indian men and women appear to have a beer belly despite not consuming beer
  • Seemingly normal-weight relatives have diabetes and high triglycerides

Everything clicks now.

Although it’s unpleasant to face this reality, we have no choice but to accept it and learn how to overcome it.

The modern urban lifestyle in India is simply unsustainable. The streets are overcrowded and the air is highly polluted, leaving little incentive to walk. Moreover, the streets aren’t designed for walking, so most people rely on transportation or stay indoors all day.

Crowded and polluted streets of India are not conducive to the South Asian phenotype
Crowded and polluted streets of India

Additionally, Indians hold their traditional food in high regard and refuse to believe that the typical Indian diet could be anything but excellent. When others point out that their diet is too high in carbs and too low in protein, they become upset and defensive.

If the diet were truly that great, then why are so many Indians suffering from poor metabolic health? It’s time to stop living in denial and take ownership of our well-being. Otherwise, the future may not be as bright as we hope.

How Can We Fix The South Asian Phenotype?

People want magic pills and potions to fix their health, but fundamentally, health comes down to just two things: Diet and Lifestyle.

Diet

First and foremost, Indians do not eat enough protein. This is an example of a typical meal. High in carbs, and barely any protein.

Dosa, Idli  and Chutney: Example of high carb foods South Asians eat regularly

Educating them on the importance of protein is crucial. Many are simply unaware of their diet and the ratio of carbs vs. protein vs. fat they consume. One solution is to make food tracking super simple and easy. HealthifyMe is an example of an app in India attempting to do this, but still very early.

Secondly, we need more role models discussing the epidemic of metabolic syndrome in India and the importance of high protein diets. Indians often follow the advice of authoritative figures like politicians and Bollywood actors. The more these individuals spread the message, the better.

Lifestyle

Besides diet, lifestyle contributes significantly to India’s health crisis. Whenever I visit India, I notice I’m indoors a lot. This is because the streets are dirty, and it’s generally unsafe for women to walk alone. Yet, walking is one of the most beneficial things we can do for our health.

Cultivating a gym culture could make a huge difference, especially for the younger generation. Gym culture is growing in India, and I hope it continues to do so. Cult.fit is a great example of a company pushing this effort forward.

For many Indians, going to a gym is a hassle and impractical, so we need to bring the gym to their homes. This is where online fitness will play a significant role. The caveat is that the current experience with online fitness isn’t great because it happens on Zoom, which isn’t the best user experience.

I’m actually prototyping a product to solve this issue. It’s still early, but I hope to have a demo to show in a couple of months 🙂

Besides exercise, stress management and sleep are other priorities that need more attention. Companies like Ultrahuman and Fittr are doing good work here by bringing smart rings to the Indian market.

Parting Thoughts

Although the South Asian phenotype makes it more challenging for Indians to maintain good health, it’s not an insurmountable obstacle. By accepting our genetic predispositions and proactively improving our diet and lifestyle, we can counteract these risks. Let’s not be disheartened by the statistics; instead, let’s use this knowledge as motivation to make better choices for our health and well-being.

If you’ve read this far, I encourage you to take control of your health by prioritizing a balanced diet rich in protein and engaging in some form of physical activity every day. Remember, every small change counts. Together, we can inspire and support each other on this journey towards better health for all South Asians.

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One Comment

  1. Nice article. I can relate to it so much. I work out 5 days a week for 1.25hrs and still I have an okay-ish body with a lot of fat around the abdomen.

  2. This might be one of the greatest and most important articles for Indians on the internet.

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