A BMI of 24 sounds healthy by the standard chart. For a person of Indian origin, it may not be. Diabetes guidance in the UK and the US, and the World Health Organization's own advice for Asian populations, all recognise that South Asians develop type 2 diabetes, high triglycerides and heart disease at a lower body weight than people of European origin. If you live in the USA, UK, Canada, Australia or the Gulf, the "normal" chart on the clinic wall may be giving you false comfort.
What the guidelines say
| Source | What it says for people of South Asian / Asian origin |
|---|---|
| WHO expert consultation (Lancet, 2004) | Asian populations carry high diabetes and heart risk at BMIs below 25; public-health action points at a BMI of 23 and 27.5 |
| NICE, UK (NG246) | For people of South Asian heritage, overweight from a BMI of 23 and obesity from 27.5; keep waist under half your height |
| American Diabetes Association | Screen Asian Americans for diabetes from a BMI of 23, not 25 |
| International Diabetes Federation | Central obesity for South Asians starts at a waist of 90 cm in men and 80 cm in women |
Why it happens
1. More fat around the organs at the same weight
At the same BMI, people of South Asian origin tend to carry more body fat and more of it around the abdomen and liver — sometimes called the "thin-fat" pattern. That fat is the metabolically active kind that drives insulin resistance.
2. Insulin resistance starts earlier
Insulin resistance often begins years before blood sugar crosses the diabetes line. Early signs include rising triglycerides, low HDL, a growing waist, fatty liver on an ultrasound, dark skin patches on the neck, and — in women — PCOS.
3. A carbohydrate-heavy plate with little protein
A traditional plate is generous with rice and roti and light on protein and vegetables, especially when portions grow after a move. The answer is not to drop Indian food but to rebalance the plate.
4. Less movement in the new routine
Desk jobs, cars and long winters or hot summers indoors remove the everyday walking that helps muscles use glucose. Muscle is where most of the sugar from a meal goes — less movement means more of it stays in the blood.
Signs your sugar may already be rising
Pre-diabetes rarely announces itself. These are the signs Dt. Himani most often sees in reports and conversations before a diagnosis:
- An HbA1c creeping up year after year, even if it is still "normal"
- Triglycerides above 150 mg/dL with HDL on the low side
- A waist that keeps growing while your weight looks stable
- Fatty liver noted on an ultrasound done for something else
- Afternoon sleepiness after a rice-heavy lunch, and cravings for sweets by evening
- Dark, velvety skin on the back of the neck or underarms
- Irregular periods and PCOS in women
- A parent or sibling with type 2 diabetes
If you are vegetarian
Many Indian vegetarians eat too little protein, which leaves the plate even more carbohydrate-heavy. Good vegetarian proteins that fit any Indian kitchen include dal and sprouts, chana, rajma, paneer, curd and Greek yoghurt, tofu, soya chunks, besan, peanuts and seeds. The aim is a palm-sized portion of protein at every main meal. Vegetarians — and anyone on metformin — should also have vitamin B12 checked regularly.
Movement that actually helps
You do not need a gym. A 10–15 minute walk after lunch and dinner lowers the sugar spike from that meal, and two or three short sessions of strength work a week — squats, wall push-ups, resistance bands — build the muscle that soaks up glucose. For winters indoors or Gulf summers, a walk in the mall, a staircase or a yoga session at home all count. Dt. Himani is also a Certified Yogaacharya and runs live online yoga that pairs with the diet plan.
Tests worth asking your doctor about
- HbA1c and fasting glucose — even if your BMI is "normal" by the standard chart.
- Lipid profile — high triglycerides and low HDL are early warning signs.
- Liver function and an ultrasound if advised — fatty liver often comes before diabetes.
- Thyroid, vitamin D and vitamin B12 — especially for vegetarians and people on metformin.
- Waist measurement — under 90 cm for men and 80 cm for women, and under half your height.
Dt. Himani does not prescribe medicines or supplements; she builds the diet from your results and works alongside your doctor.
The Indian plate that lowers the risk
| Instead of | Try | Why |
|---|---|---|
| Half the plate white rice | One katori rice or 2 rotis; half the plate sabzi and salad | Fewer fast carbs per meal |
| Maida bread, naan, biscuits | Whole-wheat, jowar, bajra or ragi rotis | More fibre, slower sugar rise |
| Dal as a thin side | A full katori of dal, chana, rajma or paneer/eggs/fish | Protein at every meal steadies sugar |
| Fruit juice | Whole fruit with a few nuts | Fibre slows absorption |
| Sweet chai several times a day | Two cups with little or no sugar | Removes hidden sugar |
| Heavy dinner at 10 PM | Light dinner 2–3 hours before sleep | Better fasting sugar in the morning |
Talk to Dt. Himani about your health
What works for one person can be wrong for another — your reports, your routine and the food your family cooks all matter. Book a one-on-one consultation with Dt. Himani Sharma to discuss your health and goals.
Consult NowHow Dt. Himani helps
Diabetes, pre-diabetes and insulin resistance are among the conditions Dt. Himani Sharma works with most in her 14+ years of practice. She consults online by video call and WhatsApp, Monday to Saturday from 9 AM to 9 PM India time, and reads your HbA1c, fasting sugar, lipids and liver reports to guide what you eat — with follow-ups as your numbers change.
From her Google reviews
“Her ability to explain complex nutritional concepts in an easy-to-understand way has empowered me to make better food choices.” — Swati Agarwal
“Each call allowed us to review progress and make necessary adjustments … The sustainable changes she suggested focused on balanced nutrition and healthy habits, making it easy to stick to the plan.” — Manish Tiwari
“Dt. Himani personalised the plan based on her preferences and is a constant support throughout the process.” — Bhuvi Agrawal, on her mother’s plan
Living outside India? See guides for the USA, the UK, Canada, Australia, Singapore and the Gulf.
Consult Dt. Himani About Your Diabetes Risk
Book a one-on-one online consultation with Dt. Himani Sharma to talk through your HbA1c, fasting sugar and lipid reports, wherever you live.
Consult Now on WhatsAppWork with Dt. Himani: Online Indian dietitian — across India & worldwide · Dietitian in Gurgaon (Sector 93)
Frequently Asked Questions
Why do Indians get diabetes at a lower BMI?
At the same weight, people of South Asian origin tend to carry more fat around the abdomen and liver, which drives insulin resistance. Diabetes and heart risk therefore rise at a lower BMI than in people of European origin.
What BMI is overweight for people of Indian origin?
UK guidance from NICE uses a BMI of 23 for overweight and 27.5 for obesity for people of South Asian heritage, in line with the WHO's action points for Asian populations. US guidance screens Asian Americans for diabetes from a BMI of 23.
What waist size is a risk for Indians?
The International Diabetes Federation uses 90 cm for South Asian men and 80 cm for women as the threshold for central obesity. NICE also advises keeping your waist under half your height.
Can I still eat rice and roti if I have pre-diabetes?
Yes, in measured portions. A plate with half vegetables, a full serving of dal or another protein, and one katori of rice or two rotis keeps Indian food while steadying blood sugar.
Can an Indian dietitian help me online if I live outside India?
Yes. Dt. Himani Sharma consults by video call and WhatsApp, Monday to Saturday from 9 AM to 9 PM India time, and works from your own reports.