Global epidemiology of obesity, vegetarian dietary patterns, and noncommunicable disease in Asian Indians.
An increase in noncommunicable disease (NCD) in India has been attributed to an epidemiologic transition whereby, due to urbanization, there is an increase in traditional cardiovascular disease risk factors such as obesity. Accumulated biomarker data on the "Asian Indian phenotype" identify central obesity, which occurs at a lower body mass index (BMI), as a particularly potent risk factor in Asian Indians. A revised WHO case definition for obesity in India [BMI (in kg/m(2)) >25] has identified an obesity epidemic that exceeds 30% in some cities and rivals that in Western nations. This review summarizes 2 key lines of evidence: 1) the emergence of an obesity epidemic in urban and rural India and its contribution to the NCD burden and 2) the role of a "nutrition transition" in decreasing the whole plant food content of diets in India and increasing risk of obesity and NCDs. We then present new epidemiologic evidence from Asian Indians enrolled in the Adventist Health Study 2 that raises the possibility of how specific whole plant foods (eg, nuts) in a vegetarian dietary pattern could potentially prevent obesity and NCDs in a target population of >1 billion persons.
From the Center for Health Research, School of Public Health (PNS, KNA, and WJ) and the Preventive Medicine Residency Program, Loma Linda University, Loma Linda, CA (MJO); the Department of Community Medicine, Pondicherry Institute of Medical Sciences, Pondicherry, India (AP); and the Center for Nutrition, Healthy Lifestyles, and Disease Prevention, Loma Linda, CA (PNS, WJ, JSJ, SR, and JS).
Pramil N
PN
Singh
From the Center for Health Research, School of Public Health (PNS, KNA, and WJ) and the Preventive Medicine Residency Program, Loma Linda University, Loma Linda, CA (MJO); the Department of Community Medicine, Pondicherry Institute of Medical Sciences, Pondicherry, India (AP); and the Center for Nutrition, Healthy Lifestyles, and Disease Prevention, Loma Linda, CA (PNS, WJ, JSJ, SR, and JS).
Kristen N
KN
Arthur
From the Center for Health Research, School of Public Health (PNS, KNA, and WJ) and the Preventive Medicine Residency Program, Loma Linda University, Loma Linda, CA (MJO); the Department of Community Medicine, Pondicherry Institute of Medical Sciences, Pondicherry, India (AP); and the Center for Nutrition, Healthy Lifestyles, and Disease Prevention, Loma Linda, CA (PNS, WJ, JSJ, SR, and JS).
Michael J
MJ
Orlich
From the Center for Health Research, School of Public Health (PNS, KNA, and WJ) and the Preventive Medicine Residency Program, Loma Linda University, Loma Linda, CA (MJO); the Department of Community Medicine, Pondicherry Institute of Medical Sciences, Pondicherry, India (AP); and the Center for Nutrition, Healthy Lifestyles, and Disease Prevention, Loma Linda, CA (PNS, WJ, JSJ, SR, and JS).
Wesley
W
James
From the Center for Health Research, School of Public Health (PNS, KNA, and WJ) and the Preventive Medicine Residency Program, Loma Linda University, Loma Linda, CA (MJO); the Department of Community Medicine, Pondicherry Institute of Medical Sciences, Pondicherry, India (AP); and the Center for Nutrition, Healthy Lifestyles, and Disease Prevention, Loma Linda, CA (PNS, WJ, JSJ, SR, and JS).
Anil
A
Purty
From the Center for Health Research, School of Public Health (PNS, KNA, and WJ) and the Preventive Medicine Residency Program, Loma Linda University, Loma Linda, CA (MJO); the Department of Community Medicine, Pondicherry Institute of Medical Sciences, Pondicherry, India (AP); and the Center for Nutrition, Healthy Lifestyles, and Disease Prevention, Loma Linda, CA (PNS, WJ, JSJ, SR, and JS).
Jayakaran S
JS
Job
From the Center for Health Research, School of Public Health (PNS, KNA, and WJ) and the Preventive Medicine Residency Program, Loma Linda University, Loma Linda, CA (MJO); the Department of Community Medicine, Pondicherry Institute of Medical Sciences, Pondicherry, India (AP); and the Center for Nutrition, Healthy Lifestyles, and Disease Prevention, Loma Linda, CA (PNS, WJ, JSJ, SR, and JS).
Sujatha
S
Rajaram
From the Center for Health Research, School of Public Health (PNS, KNA, and WJ) and the Preventive Medicine Residency Program, Loma Linda University, Loma Linda, CA (MJO); the Department of Community Medicine, Pondicherry Institute of Medical Sciences, Pondicherry, India (AP); and the Center for Nutrition, Healthy Lifestyles, and Disease Prevention, Loma Linda, CA (PNS, WJ, JSJ, SR, and JS).
Joan
J
Sabaté
D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000209:etiology*; D014676:Diet, Vegetarian; D066273:Diet, Western / Q000009:adverse effects*; D005247:Feeding Behavior; D006801:Humans; D007194:India; D009765:Obesity / Q000453:epidemiology / Q000209:etiology*