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Lancet Reg Health Southeast Asia
Lancet Reg Health Southeast Asia
The Lancet Regional Health - Southeast Asia
2772-3682
Elsevier

S2772-3682(24)00132-X
10.1016/j.lansea.2024.100482
100482
Correspondence
The South Asian phenotype: greater clarity would help to improve cardiometabolic health
Hills Andrew Peter andrew.hills@utas.edu.au

School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, 7250, Australia
11 9 2024
10 2024
11 9 2024
29 10048227 8 2024
2 9 2024
© 2024 The Author
2024
https://creativecommons.org/licenses/by-nc/4.0/ This is an open access article under the CC BY-NC license (http://creativecommons.org/licenses/by-nc/4.0/).
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pmcIn a recent paper,1 renowned endocrinologist and proponent of the thin-fat Indian phenotype, Dr Chittaranjan Yajnik, provided an erudite overview of the phenotypic characteristics of South Asian Indians in the context of the double burden of malnutrition.

Despite numerous publications detailing differences between Indians of South Asian origin and white Europeans, there are major gaps in our knowledge of ethnic differences in size, shape, and body composition across the lifespan with implications for health and disease.

Many years ago, Yajnik2 referenced the drawback of simple anthropometric indices and only very recently has the ‘quality’ of growth of infants been quantified using objective body composition assessment.3 Other work in adults by Sattar and Gill4 reported significantly higher type 2 diabetes prevalence in South Asians at an earlier age and lower body mass index (BMI) than white Europeans. In a recent overfeeding intervention, Sattar and Gill's group compared the effect of induced weight gain in South Asian and white European men without overweight or obesity and reported a higher susceptibility of the former group to adverse metabolic consequences with weight gain.5 We know even less about responses to weight loss interventions in South Asians.

Much of the research to date has been cross-sectional and dominated by anthropometry. It's time to consider longitudinal studies of South Asians to profile phenotypic changes, ideally across BMI and body fat levels. A better understanding of phenotypic changes using objective measures would help to inform novel approaches to prevent and manage cardiometabolic conditions in South Asia.

Contributors

Conceptialisation: APH.

Writing-original draft: APH.

Declaration of interests

None to declare.
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References

1 Yajnik C.S. Early life origins of the double burden of malnutrition: life can only be understood backwards Lancet Reg Health Southeast Asia 28 2024 100453
2 Yajnik C.S. Yudkin J.S. The Y-Y paradox Lancet 363 2004 163 14726172
3 Murphy-Alford A.J. Johnson W. Nyati L.H. Body composition reference charts for infants from birth to 24 months; multi-center infant body composition reference study (MIBCRS) Am J Clin Nutr 117 6 2023 1262 1269 37270290
4 Sattar N. Gill J.M.R. Type 2 diabetes in migrant south Asians: mechanisms, mitigation, and management Lancet Diabetes Endocrinol 3 2015 1004 1016 26489808
5 McLaren J. Gao X. Ghouri N. Weight gain leads to greater adverse metabolic responses in South Asian compared with white European men: the GlasVEGAS study Nat Metab 16 2024 Aug 10.1038/s42255-024-01101-z [Online ahead of print]
