title: Cardio-metabolic health risks in indigenous populations of Southeast Asia and the influence of urbanization.
abstract: BACKGROUND
  South East Asia (SEA) is home to over 30 tribes of indigenous population groups who are currently facing rapid socio-economic change. Epidemiological transition and increased prevalence of non-communicable diseases (NCD) has occured. In Peninsular Malaysia, the Orang Asli (OA) indigenous people comprise 0 · 6% (150,000) of the population and live in various settlements. OA comprise three distinct large tribes with smaller sub-tribes. The three large tribes include Proto-Malay (sub-tribes: Orang Seletar and Jakun), Senoi (sub-tribes: Mahmeri and Semai), and Negrito (sub-tribes: Jehai, Mendriq and Batek).
  
  
  METHODS
  We studied the health of 636 OA from seven sub-tribes in the Peninsular. Parameters that were assessed included height, weight, BMI and waist circumference whilst blood pressure, cholesterols, fasting blood glucose and HbA1c levels were recorded. We then analysed cardio-metabolic risk factor prevalences and performed multiple pair-wise comparisons among different sub-tribes and socio-economic clusters.
  
  
  RESULTS
  Cardio-metabolic risk factors were recorded in the seven sub-tribes.. Prevalence for general and abdominal obesity were highest in the urbanized Orang Seletar (31 · 6 ± 5 · 7%; 66 · 1 ± 5 · 9%). Notably, hunter gatherer Jehai and Batek tribes displayed the highest prevalence for hypertension (43 · 8 ± 9 · 29% and 51 · 2 ± 15 · 3%) despite being the leanest and most remote, while the Mendriq sub-tribe, living in the same jungle area with access to similar resources as the Batek were less hypertensive (16.3 ± 11.0%), but displayed higher prevalence of abdominal obesity (27.30 ± 13.16%).
  
  
  CONCLUSIONS
  We describe the cardio-metabolic risk factors of seven indigenous communities in Malaysia. We report variable prevalence of obesity, cholesterol, hypertension and diabetes in the OA in contrast to the larger ethnic majorities such as Malays, Chinese and Indians in Malaysia These differences are likely to be due to socio-economic effects and lifestyle changes. In some sub-tribes, other factors including genetic predisposition may also play a role. It is expected that the cardio-metabolic risk factors may worsen with further urbanization, increase the health burden of these communities and strain the government's resources.
authors: Jeffrey Cheah School of Medicine, Monash University Sunway, Sunway, Malaysia. Maude.Phipps@monash.edu.|Jeffrey Cheah School of Medicine and Health Sciences, Monash University (Sunway Campus), Jalan Lagoon Selatan, Sunway, 46150, Selangor, Malaysia. Maude.Phipps@monash.edu.
authors: Maude E
authors: ME
authors: Phipps
authors: Jeffrey Cheah School of Medicine, Monash University Sunway, Sunway, Malaysia. kevin.kckl@gmail.com.
authors: Kevin K L
authors: KK
authors: Chan
authors: Jeffrey Cheah School of Medicine, Monash University Sunway, Sunway, Malaysia. Rakesh.Naidu@monash.edu.
authors: Rakesh
authors: R
authors: Naidu
authors: Institute for Medical Research, Ministry of Health, Sunway, Malaysia. nazaimoor@imr.gov.my.
authors: Nazaimoon W
authors: NW
authors: Mohamad
authors: Institute of Medical Molecular Biotechnology, University Teknologi Mara, Mara, Malaysia. hoh.boonpeng@gmail.com.
authors: Boon-Peng
authors: BP
authors: Hoh
authors: Jeffrey Cheah School of Medicine, Monash University Sunway, Sunway, Malaysia. Quek.Kia.Fatt@monash.edu.
authors: Kia-Fatt
authors: KF
authors: Quek
authors: Jeffrey Cheah School of Medicine, Monash University Sunway, Sunway, Malaysia. Badariah.Ahmad@monash.edu.
authors: Badariah
authors: B
authors: Ahmad
authors: Jeffrey Cheah School of Medicine, Monash University Sunway, Sunway, Malaysia. Siti.Harnida@monash.edu.
authors: Siti M I
authors: SM
authors: Harnida
authors: Jeffrey Cheah School of Medicine, Monash University Sunway, Sunway, Malaysia. Anuar.Zaini@monash.edu.
authors: Anuar Z M
authors: AZ
authors: Zain
authors: Jeffrey Cheah School of Medicine, Monash University Sunway, Sunway, Malaysia. Khalid.Kadir@monash.edu.
authors: Khalid A
authors: KA
authors: Kadir
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000706:statistics & numerical data*; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology*; D006973:Hypertension / Q000453:epidemiology*; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D014507:Urbanization; D055815:Young Adult
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