PAMF Health Blog

Be Well, Be Well Informed

South Asian Health Check-List

Posted on Oct 25, 2011 | 6 comments

Did you know that South Asians are more susceptible to heart attack, stroke and diabetes? Compared to other ethnicities, South Asians are at a heightened risk to develop these chronic illnesses up to a decade earlier. Consider these facts:

  • The World Health Organization (WHO) projects that most of the world’s heart patients will be South Asians in the next few years.
  • One-third of diabetics worldwide are Indian.
  • 50 percent of heart attacks in South Asians occur before the age of 55.
  • Nearly one half of Indians have Metabolic Syndrome, a precursor to diabetes and heart disease.

South Asians are people who can trace their background to India, Pakistan, Bangladesh, Sri Lanka, Bhutan, Maldives or Nepal. They are at heightened risk because of a combination of genetic, cultural and lifestyle factors. These include:

  • Many South Asians carry extra body weight around their stomach.  This is known as abdominal obesity and has been associated with a higher risk of diabetes and heart disease.  You can find out your South Asian adjusted body mass index and waist to hip circumference on the PAMF South Asian Health website.
  • South Asian foods tend to be high in calories and starch, especially traditional party foods that once were eaten only on special occasions but now are sometimes consumed daily.
  • Many South Asians lifestyles are sedentary. This is particularly true for those who work with computers.
  • South Asians may face unique stressors, including stress from immigration, cultural differences, family and overworking.

If your heritage is South Asian, make sure to visit your doctor for regular blood tests and physical exams. Know your vital numbers for cholesterol, blood pressure, blood sugar and body size, and recognize that a healthy number for a South Asian person may be different than that for someone from another ethnicity. The target numbers you want to shoot for are:

  • LDL less than 100 for most South Asians (discuss your LDL goal with your doctor)
  • Triglycerides less than 150
  • HDL greater than 40 (men), HDL greater than 50 (women)
  • Total cholesterol-to-HDL ratio of less than 4.0 (total cholesterol divided by your HDL level). This is a much better indicator of risk than your total cholesterol level.
  • Blood pressure should be systolic (top number) less than 130 and diastolic (bottom number) less than 80.
  • A body mass index (BMI) that is no greater than 23.
  • Waist-to-hip ratio (WHR) of less than 0.90 for men and less than 0.85 for women.
  • A fasting blood sugar test result of less than 100 mg/dL.

This blog post contributed by Rani Pallegadda, B.S., M.D., candidate and PAMF Research Institute intern. You can learn more about South Asian wellness at the Palo Alto Medical Foundation’s South Asian Health website.

Please note that we are unable to respond to personal medical questions through the comments feature below. For information about personalized health care, or if you need help in choosing a PAMF physician, please visit Becoming a PAMF Patient ( or call 1-888-398-5677. If you are a PAMF patient, you can email your doctor securely via our My Health Online program. Thank you


  1. NO, the ideal targets should be:

    Total cholesterol less than 150 and LDL less than 80.
    (please check a site

    No.2, to prevent diabetes, a diet rich is magnesium and chromium is advisable.

    Broccoli, Romaine lettuce and raw onions are a good source of chromium for vegetarians.

    • Hi Karen,

      Total cholesterol and LDL targets are controversial with many different recommendations from expert groups. In general, it is true that with LDL the lower the number the lower the risk. The guidelines we provide are general recommendations based on established studies and our experience with South Asians. We cannot recommend the more aggressive targets without evaluating patients first. We are aware of the positive effects of nutrition on diabetes and heart disease risk, but the direct evidence for micronutrients such as magnesium and chromium is not proven by large, well established studies. Bottom line is that a diet rich in a variety of different fruits and vegetables is beneficial in preventing diabetes, heart disease, cancer and a number of other chronic conditions.

      Thank you for taking the time to read our blog and for your comment.

      Dr. Ronesh (Ron) Sinha
      PAMF Internal Medicine and co-leader of the South Asian Wellness Task Force

      • i did not appreciate this article. I feel this article could in itself be a stressor for any south Asian person. I feel that a person”s medical doctor can pass on information one as one as needed rather than singling out and generating fear toward one particular ethnic group such as the South Asians.

        • Hi Cheryl,

          I appreciate your frank feedback. We are a large multispecialty group which serves a great number of South Asians. On a daily basis we see South Asians who come to us with advanced cardiovascular disease or multiple risk factors and much of this is due to a lack of awareness in our community and among the vast majority of doctors. Delivering culturally customized health care is not a part of standard medical training. Many of our heart attack patients were seeing other doctors and were told that they were “fine” when in fact they were high risk based on South Asian specific criteria. I also am not a fan of using fear to motivate patients or an entire community, but our community does have a tendency to be less motivated about health issues, and exercise and healthy eating are not usually a high priority. This is one of the reasons why India has become the diabetes and heart disease capital of the world. Hopefully the day will come when all doctors are trained in delivering culturally competent care and awareness has spread among our high risk ethnic groups. Until then, we are committed to providing this information to our patients and to our diverse communities.

          Thank you,
          Dr. Ron Sinha, PAMF Internal Medicine and co-director of PAMF South Asian Health program.

          Thank you.

  2. Thank you very much for this article. It is really important that we Indians are aware of our higher risk and not go by the general risk criteria. Do you plan to have any information seminars/ flyers related to this information available to patients?

    • Hi Shubhra,

      We’re glad you enjoyed the article – and yes, there are several printouts, recipes, tip sheets, videos and other information related to South Asian health on our website at Thank you for your comment and we hope you enjoy visiting our South Asian Health website.

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