The overall aim of this pilot study was to describe type 2 diabetes risk among Asian Indian adults of Kerala ethnicity living in the US. The analysis of BMI revealed that most of the women in this study were overweight and the men were obese. Asian Indians generally exhibit lower Body Mass Index and waist circumference and tend to accumulate intra-abdominal visceral fat when compared to Caucasians [12
]. Studies report that BMI and waist circumference serve as parameters to estimate general or abdominal fat masses, respectively. The strength of association between waist circumference and type 2 diabetes risk depends on body mass index. Individuals of low or normal weight with a large waist circumference have the same risk of developing type 2 diabetes as preobese individuals with small waist circumference [29
]. The BMI and waist circumference were higher in most of the males and females screened in this study.
The sagittal abdominal diameter is a strong anthropometric marker of insulin resistance and hyperinsulinemia in obese men than the commonly used waist-to-hip ratio and other anthropometric measures. Sagittal abdominal diameter is a more independent measure compared with waist circumference to predict arterial stiffness in subjects with type 2 diabetes [34
]. Several common anthropometric measures correlate with body fat and abdominal fat. Obese individuals with excess visceral fat have an increased risk for the development of type 2 diabetes [8
]. The anthropometric measures and body fat percentage were higher in most of the subjects screened in this study, suggesting type 2 diabetes and cardiovascular disease risk in the Asian American Indians.
In a study that included Asian Indian immigrants living in the US, respondents had high physical inactivity but poor knowledge of cardiovascular disease risk factors [16
]. The physical activity pattern of the majority of the subjects in our study showed an activity level of <3000
MET/week, indicating behaviors consistent with sedentary behavior. This study revealed that decreased physical activity was associated with higher BMI and body fat percentage in Asian Indians. This study finding was consistent with other studies focusing on physical activity patterns among Asian Indians living in the US [14
Studies have shown that adopting US norms and culture may lead to obesity and type 2 diabetes among immigrants as well as poor control of type 2 diabetes [36
]. The association between length of residence and the higher risk for obesity may be in part due to the adoption of poor dietary patterns and a sedentary lifestyle that is more typical of the host country [7
]. This study found that a length of residence in the US over 10 years was associated with an increase in the BMI and body fat percentage.
Family history has been shown to be a risk factor for the majority of chronic diseases such as type 2 diabetes and cardiovascular disease. Family history of diabetes is not only a risk factor, but it is also positively associated with risk awareness and risk-reducing behaviors [17
]. This pilot study revealed that a family history of type 2 diabetes was associated with higher body fat percentage.
The Diabetes Risk Score developed by Lindström and Tuomilehto [19
] reported that consumption of fruits and vegetables less than 3-4
times/week predicts diabetes risk. The fruit and vegetable intake was more than 3-4
times/week for most of the subjects in the present study, indicating no predictable type 2 diabetes risk related to dietary pattern.