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The South Asian Risk Factor

By Amitha Kalaichandran

Master of Health Science, MD Candidate 2012

South Asian children are at a higher risk of developing a number of chronic diseases, such as heart disease and diabetes, compared to other ethnicities.¹ ²

Reasons include family history, genetics, and the tendency to consume traditional foods that have a high glycemic index and contain “bad cholesterol” (LDL). For instance, fried foods made with large amounts of butter may contain a high amount of bad cholesterol and saturated fats.

White rice, a staple in South Asian cuisine, has a higher glycemic index, meaning it causes the body to secrete a large amount of insulin upon consumption. Insulin is the hormone required to deposit fat in the body, particularly in the abdominal areas.

Because of this higher risk in South Asian children, a large emphasis should be placed on encouraging a healthy lifestyle during childhood.


10 healthy habits that can help prevent chronic disease:


One should aim to include heart healthy foods, such as fish high in Omega-3 fatty acids, like salmon for instance, 1-2 times a week. Foods high in fiber, such as chickpeas and lentils (provided they are not cooked with a lot of butter and oil) help decrease the amount of bad cholesterol and help aid in digestion. A good tip to follow is only consuming food low in saturated and trans fats, limiting salt (marked as sodium on food labels), and limiting refined sugars. You should save junk food as a “treat” for special occasions.

Often, as much as we try, we cannot obtain every vitamin required for optimum nutrition through the foods we eat. A daily multivitamin can therefore serve as a great addition to a nutritious lifestyle. One key part is involving your children in creating a weekly grocery shopping list and taking them along to help identify vegetables and fruits, and teaching them how to read labels.


Exercise helps increase good cholesterol. We all know that exercise is good, but the type of exercise, and how much of it is key. Most experts currently recommend vigorous exercise for at least 3 times a week for at least one hour. What is considered vigorous? Think running/sprinting or team sports that allow your child’s heart rate to go up significantly, and cause a mild to heavy sweat. Team sports (which usually practice a few times a week) are a great way to build a routine of vigorous exercise and allow them to meet new friends and build teamwork skills.

Start slowly – children are natural interval trainers (e.g. they often take short sprints, then rest) and may become discouraged if they are pushed to go much further than their limit. Other ways include a family plan to exercise at least 3 times a week after dinner (to burn off calories) or 2 hours before bed (it will help them sleep better and earlier). A family walk (provided it is “brisk”) also provides some time to talk about your child’s day.


TV, computers and video game consoles have become a huge distraction for both children and adults. If your child currently spends more than 1 hour a day watching TV, on the computer, or playing video games, this will be a hard habit to break. So I suggest starting slowly. Try and make a compromise with your child to limit gaming and TV to 1 hour per day. Once an exercise routine is also built in, your child’s routine will in fact allow little time for gaming and TV.


Vaccines have been responsible for decreasing the prevalence of infectious diseases worldwide. In addition to routine vaccines, there are now vaccines for meningitis, rotavirus, pneumococcal disease, cervical cancer, and influenza. Your own country’s health plan will include a description of childhood vaccines that are part of the national strategy. You are encouraged to speak with your primary care provider about the side effects of some vaccines (the large majority which simply include some slight redness or pain at the injection site) and whether your child may be allergic to any vaccine components.


There are some key ways to decrease the chance of your child acquiring an infectious disease such as the cold and flu. In many countries the flu shot is available, and is very effective. However, a key way to prevent infectious disease transmission is emphasizing the importance of hand washing! If they attend school, mention they should wash their hands every time they go inside after playing, before eating, and after using the washroom.

Explain to them that they should have a lot of soap lather in their hands, and rub their hands together, including under nails and up to their wrists, for at least 30 seconds (tell them they can sing a rhyme while washing).


Like the rest of your body, the brain needs a lot of exercise to keep the mind healthy and sharp. You can implement such activities into your family dynamic with a weekly games night with games like Cranium™ or Scrabble™. Doing mind-strengthening activities now can help improve your kids’ concentration and prevent cognitive decline later.


Build a healthy relationship with your child’s teacher – often teachers are the first to notice developmental delay in kids (e.g. early signs of autism or global developmental delay) or vision impairment. They can also provide an indication of your child’s mental, emotional, and social development.


Even at a young age, children are prone to mental and emotional stress. Set a goal for a weekly family outing to de-stress and discuss challenges. You can also encourage your child to have a creative outlet for stress, such as through music (listening or playing), art, theatre, or dance. Try to create an open line of communication whereby your child feels free to discuss coping mechanisms for stress.


Having a restful sleep is key to your child’s good health. Each child may require a different amount of sleep, and can vary anywhere from 9 hours to 12 hours per night, depending on their age. A good indicator of the amount of sleep your child needs may be the amount of sleep they require after a day of normal activities, where they awaken naturally, i.e. without an alarm clock. There are five stages of sleep, and for the most part, one enters each stage sequentially. Enough time is required in order for sleep to be fully “restorative,” so that the body is given adequate opportunity to replenish itself.


It is important to choose a health provider that is knowledgeable, and whom you trust. It may be necessary to accept some uncertainty about your kids’ health – the field of medicine is not an absolute science. However, ensure that you receive all information necessary to make informed choices. Once your child reaches an age where they have a better understanding about their health, try and involve them in making healthcare decisions.

All of these tips are aimed at children, however it is important to be a role model for your kids with your own health choices. It is also key to remember that they are still kids, and drastic changes to their diet and activity level may not be received well. So, start slowly, and aim to make specific changes over time. Also include some built-in flexibility with respect to diet and activity – militaristic routines will be received with resistance and sometimes resentment. No matter what tips you try to promote, try to bring the family together around a common goal, and don’t forget that laughter and compassion can help ease any new transition towards a healthier lifestyle!



1Pollestad Kolsgaard ML, Andersen LF, Tonstad S, Brunborg C, Wangensteen T, Joner G. Ethnic differences in metabolic syndrome among overweight and obese children and adolescents: the Oslo Adiposity Intervention Study. Acta Paediatrica 2008; 97: 1557-1563.

2Whincup PH, Gilg JA, Papacosta O, Seymour C, Miller GJ, Alberti KG, Cook DG. Early evidence if ethnic differences in cardiovascular risk: cross-sectional comparison of British South Asian and white children. BMJ 2002; 324: 635.

The writer would like to acknowledge the contribution of Dr. Stacey Bernstein, Pediatrician at the Hospital for Sick Children, who reviewed this article.

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One Response to The South Asian Risk Factor

  1. Jennifer Perera January 12, 2011 at 4:33 pm #

    Nice informative article

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