People Of South Asian Descent Research Articles

Insecurities of Expulsion

Abstract This article examines citizenship formations and political practices in relation to racialized and gendered postcolonial insecurities for the “Asian community” in contemporary Uganda. After disaggregating the notion of Asian community, it examines (1) how formalistic, liberal, and legal-juridical conceptions of citizenship and political practice are ineffective analytics in the context of Africanization efforts and racialized expulsion in Uganda; and (2) the tendency to erase people of South Asian descent from the study of normative state-society relations and political engagement via civil society in mainstream scholarship. It argues for a productive synthesis of Indian and African postcolonial theories of democratic agency and political practice by analyzing the possibilities and limitations of Partha Chatterjee's notion of “political society” relative to local community governance and the cultural politics of informal citizenship practices in contemporary Uganda. Contemporary citizenship formations are richly textured practices that can be both democratic and antidemocratic in nature, often characterized by disavowal of liberal, legal-juridical forms of citizenship. Finally, by closely examining domains of gender-based activism and coalition building within and across racialized communities, this essay explores the possibilities for popular politics and democratic, inclusionary multiracial and gendered citizenship in the post-Asian-expulsion context of Uganda.

Non-invasive markers of liver fibrosis in fatty liver disease are unreliable in people of South Asian descent

ObjectiveLiver biopsy is the most accurate method for determining stage and grade of injury in non-alcoholic fatty liver disease (NAFLD). Given risks and limitations of biopsy, non-invasive tests such as...

Fish consumption and omega-3-fatty acids in prevention of diet-related noncommunicable diseases

AbstractDiet-related noncommunicable diseases (DR-NCDs) which include obesity, hypertension, lipid disorders, type 2 diabetes mellitus, and cardiovascular (CV) disease are more common among people of South Asian descent because of genetic and other poorly understood factors. Indians are also one of the lowest consumers of fish and shellfish in the world despite being blessed with an extensive coastline. Consumption of fatty fish and fish oils supplementation has been demonstrated to improve blood pressure, lipid profiles, and CV outcomes. Data are still unclear if there is any impact on glucose intolerance with increased consumption of fatty fish or use of fish oils and omega-3-fatty acid (O3FA) supplements. The review focuses on the mechanisms of improvements with O3FAs on various aspects of DR-NCDs and reviews of current clinical data.

“If a Muslim says ‘homo’, nothing gets done”: Racist discourse and in-group identity construction in an LGBT youth group

ABSTRACTThis article presents ethnographic data emerging from research with a group of LGBT young people, detailing the construction of a shared identity. Using discourse analysis, it shows how the group members position people of South Asian descent as a homogenous out-group, one framed as ‘other’ to their own in-group identity of ‘non-Asian’ due to the assumption that Asian people are homophobic. It is argued that this very local form of identity construction is facilitated by broader discourses of Islamophobia, as well as homonormative ideologies positioning gay people as white. The article therefore provides evidence to support Bucholtz & Hall's (2005) claim that identity positioning relates not only to the interactional moment and the norms of a given ethnographic context, but that it also encompasses macro-level discourses and ideologies. It also, however, reveals the pervasiveness of Islamophobic discourses in Britain today, and the marginalisation of LGBT people of colour. (LGBT identity, racist discourse, homonormativity, Islamophobia)*

Contribution of Environmental Risk Factors Including Lifestyle to Inequalities Noncommunicable (Chronic) Diseases such as Diabetes

Health inequalities: differences in health status or in the distribution of health determinants between different population groups. Some health inequalities are attributable to biological variations or free choice and others are attributable to the external environment and conditions mainly outside the control of the individuals concerned. 347 million people worldwide have diabetes. In 2012 an estimated 1.5 million deaths were directly caused by diabetes. More than 80% of diabetes deaths occur in low- and middle-income countries. WHO projects that diabetes will be the 7th leading cause of death in 2030. Healthy diet, regular physical activity and maintaining a normal body weight can prevent or delay the onset of type 2 diabetes. Risk factors: 1. Age- the prevalence of diabetes rises steeply with age: *one in twenty people over the age of 65 have diabetes, *and this rises to one in five people over the age of 85 years. The diagnosis of diabetes may be delayed in older people, with symptoms of diabetes being wrongly attributed to ageing. 2. Ethnic: type 2 diabetes is up to six times more common in people of South Asian descent and up to three times more common in those of African and African-Caribbean descent then in the white population. It is also more common in people of Chinese descent and other non-Caucasian groups. 3. Gender: the frequency of diabetes usually is higher in men than in women. This may be because gender compounds other aspects of inequality- women often bear the brunt of poverty, and socio-economic differences in the prevalence of diabetes are more marked for women, probably because of differences in smoking rates, food choices and the prevalence of obesity. 4. Overweight/Obesity: every 1 kg/m2 more causes increase risk: cardiovascular diseases 2%, coronary artery disease- 3% , myocardial infarction- 5% , heart failure- 5% , peripheral vascular disease- 5%. Health inqualities important in diabetes -- modifiable: social-economics (wellbeing, nutrition, education, physical activity, environmental…), health service (access to services for prevention and treatment diabetes) . Keyword: Inequalities, diabetes, risk factors

Effect of a lifestyle intervention on weight change in south Asian individuals in the UK at high risk of type 2 diabetes: a family-cluster randomised controlled trial

The susceptibility to type 2 diabetes of people of south Asian descent is established, but there is little trial-based evidence for interventions to tackle this problem. We assessed a weight control and physical activity intervention in south Asian individuals in the UK. We did this non-blinded trial in two National Health Service (NHS) regions in Scotland (UK). Between July 1, 2007, and Oct 31, 2009, we recruited men and women of Indian and Pakistani origin, aged 35 years or older, with waist circumference 90 cm or greater in men or 80 cm or greater in women, and with impaired glucose tolerance or impaired fasting glucose determined by oral glucose tolerance test. Families were randomised (using a random number generator program, with permuted blocks of random size, stratified by location [Edinburgh or Glasgow], ethnic group [Indian or Pakistani], and number of participants in the family [one vs more than one]) to intervention or control. Participants in the same family were not randomised separately. The intervention group received 15 visits from a dietitian over 3 years and the control group received four visits in the same period. The primary outcome was weight change at 3 years. Analysis was by modified intention to treat, excluding participants who died or were lost to follow-up. We used linear regression models to provide mean differences in baseline-adjusted weight at 3 years. This trial is registered, number ISRCTN25729565. Of 1319 people who were screened with an oral glucose tolerance test, 196 (15%) had impaired glucose tolerance or impaired fasting glucose and 171 entered the trial. Participants were in 156 family clusters that were randomised (78 families with 85 participants were allocated to intervention; 78 families with 86 participants were allocated to control). 167 (98%) participants in 152 families completed the trial. Mean weight loss in the intervention group was 1.13 kg (SD 4.12), compared with a mean weight gain of 0.51 kg (3.65) in the control group, an adjusted mean difference of -1.64 kg (95% CI -2.83 to -0.44). Modest, medium-term changes in weight are achievable as a component of lifestyle-change strategies, which might control or prevent adiposity-related diseases. National Prevention Research Initiative, NHS Research and Development; NHS National Services Scotland; NHS Health Scotland.

MYBPC3's alternate ending: consequences and therapeutic implications of a highly prevalent 25 bp deletion mutation.

Hypertrophic cardiomyopathy (HCM) is the most common form of inherited cardiac disease and the leading cause of sudden cardiac death in young people. HCM is caused by mutations in genes encoding contractile proteins. Cardiac myosin binding protein-C (cMyBP-C) is a thick filament contractile protein that regulates sarcomere organization and cardiac contractility. About 200 different mutations in the cMyBP-C gene (MYBPC3) have thus far been reported as causing HCM. Among them, a 25 base pair deletion in the branch point of intron 32 of MYBPC3 is widespread, particularly affecting people of South Asian descent, with 4% of this population carrying the mutation. This polymorphic mutation results in skipping of exon 33 and a reading frame shift, which, in turn, replaces the last 65 amino acids of the C-terminal C10 domain of cMyBP-C with a novel sequence of 58 residues (cMyBP-C(C10mut)). Carriers of the 25 base pair deletion mutation are at increased risk of developing cardiomyopathy and heart failure. Because of the high prevalence of this mutation in certain populations, genetic screening of at-risk groups might be beneficial. Scientifically, the functional consequences of C-terminal mutations and the precise mechanisms leading to HCM should be defined using induced pluripotent stem cells and engineered heart tissue in vitro or mouse models in vivo. Most importantly, therapeutic strategies that include pharmacology, gene repair, and gene therapy should be developed to prevent the adverse clinical effects of cMyBP-C(C10mut). This review article aims to examine the effects of cMyBP-C(C10mut) on cardiac function, emphasizing the need for the development of genetic testing and expanded therapeutic strategies.

Microcirculatory Rarefaction in South Asians — A Potential Mechanism for Increased Cardiovascular Risk and Diabetes

People of South Asian descent have an increased risk of cardiovascular disease (CVD) and diabetes, but little is known about the microcirculation in South Asian people despite evidence that this plays an important role in the aetiology of CVD. We compared the retinal microcirculation in a population-based sample of 287 middle-aged adults (144 European 143 South Asian) matched for age and sex. Retinal photographs were taken and analysed using a validated semi-automated program and microvascular measures were compared. Blood pressure, anthropometry and fasting bloods were also measured. South Asians had significantly fewer arteriolar and venular vessels and bifurcations. Arterioles and venules were longer and venules were also more tortuous in South Asians. These differences were not explained by adjustment for traditional risk factors including blood pressure, body mass index, diabetes or measures of insulin resistance. People of South Asian descent have rarefaction of the retinal microcirculation compared to age-sex matched individuals of European descent. Reduced microvascular density could contribute to the elevated risk of CVD and impaired glucose tolerance in South Asian people.

PS5 - 28. An 8-day very low calorie diet improves insulin sensitivity in middleaged obese male Hindostani but not in Caucasians

People of South Asian descent, such as the Hindostani population in The Netherlands, develop type 2 diabetes (DM2) at a younger age and lower BMI compared to Caucasians.

PS2 - 7. A 5-day high fat high calorie diet impairs insulin sensitivity in healthy, young, lean male Hindostani but not in Caucasians

People of South-Asian descent, such as the Surinamese Indo-Asian (Hindostani) population in The Netherlands, develop type 2 diabetes and cardiovascular disease at a much younger age and BMI as compared to the Caucasian population. Moreover, the incidence and seriousness of these diseases is much higher in Hindostani as compared to Caucasians. The cause of these differences is unknown but might be (among others) causally related to body fat distribution and/or fatty acid handling. This study investigates whether there are differences in insulin sensitivity between healthy, young, lean male Hindostani and Caucasians at baseline, and whether the response in insulin sensitivity to a 5-day high fat high calorie (HFHC) diet differs between both ethnicities.

Obesity, Hypertension, and Migration: A Meta-Analysis of Populations of the South Asian Diaspora

The effects of migration on human health have been a topic of interest for demographers and human biologists. Even if migrants to a new region achieve a higher standard of living in their new place of residence, their improved living conditions may not be associated with better health. Part of the difficulty of understanding the health consequences of migration is the complications in trying to control for variables that may affect health, such as gender, age, and urban or rural environment of migrants and nonmigrants. In this paper we report results of a meta-analysis of the body mass index (BMI) and blood pressure (BP) of people of South Asian descent, by comparing nonmigrants who inhabit the subcontinent, with migrants who moved to various places around the globe. Our results indicate that BMI almost always increases to a significant level upon migration and that an increase in BMI is most pronounced in female migrants. Our results also show that BP does not always increase in migrant communities and that it is actually lower in some migrant samples than it is in comparable nonmigrant groups. Therefore, our results show that BP and the BMI do not behave in the same manner following a migration event. We propose that the BMI changes experienced by migrants are likely to reflect different activity levels and diet in the new homeland. However, the BP changes experienced by migrants are likely to reflect stress broadly defined. Such stress may be increased or decreased, depending on the specific migration experience. We propose that the BMI and BP measure two different dimensions of the migration experience.

Obesity, Hypertension, and Migration: A Meta-Analysis of Populations of the South Asian Diaspora

The effects of migration on human health have been a topic of interest for demographers and human biologists. Even if migrants to a new region achieve a higher standard of living in their new place of residence, their improved living conditions may not be associated with better health. Part of the difficulty of understanding the health consequences of migration is the complications in trying to control for variables that may affect health, such as gender, age, and urban or rural environment of migrants and nonmigrants. In this paper we report results of a meta-analysis of the body mass index (BMI) and blood pressure (BP) of people of South Asian descent, by comparing nonmigrants who inhabit the subcontinent, with migrants who moved to various places around the globe. Our results indicate that BMI almost always increases to a significant level upon migration and that an increase in BMI is most pronounced in female migrants. Our results also show that BP does not always increase in migrant communities and that it is actually lower in some migrant samples than it is in comparable nonmigrant groups. Therefore, our results show that BP and the BMI do not behave in the same manner following a migration event. We propose that the BMI changes experienced by migrants are likely to reflect different activity levels and diet in the new homeland. However, the BP changes experienced by migrants are likely to reflect stress broadly defined. Such stress may be increased or decreased, depending on the specific migration experience. We propose that the BMI and BP measure two different dimensions of the migration experience.

The Asian enigma: predisposition for low adult BMI among people of South Asian descent

To investigate the Asian enigma, the phenomenon of relatively high levels of undernutrition among children and adult women in South Asia, despite more favourable records with respect to infant mortality, women's education, food availability or other aspects of living conditions in comparison with, for example, sub-Saharan Africa. Literature has been explored to identify countries outside South Asia that are home to sizeable population segments from different ethnic backgrounds, including people of South Asian and African descent, and to compare prevalence rates of undernutrition in combination with indicators of standard of living between these various population segments. Data on adult undernutrition prevalence rates among population groups of different ethnic descent living in the same country (South Africa, Fiji and the USA) generally reveal the highest prevalence rates of low BMI among adults, males and females, from South Asian background. The relatively high rates of low BMI among adults from South Asian background cannot be explained by less favourable socio-economic characteristics, such as lower income or less access to food. It is hypothesized that there exists among adults of South Asian descent an ethnic predisposition for a low BMI. Other factors that may contribute to high levels of undernutrition in South Asia are discrimination of women and a poor dietary quality of poor households' food composition pattern. The question needs to be addressed whether the commonly used cut-off point for adult underweight (BMI < 18.5 kg/m2) is universally applicable or whether ethnic differences should be taken into account.

Global South Asians: introducing the modern diaspora

By the end of the twentieth century some nine million people of South Asian descent had left India, Bangladesh or Pakistan and settled in different parts of the world, forming a diverse and significant modern diaspora. In the early nineteenth century, many left reluctantly to seek economic opportunities which were lacking at home. This is the story of their often painful experiences in the diaspora, how they constructed new social communities overseas and how they maintained connections with the countries and the families they had left behind. It is a story compellingly told by one of the premier historians of modern South Asia, Judith Brown, whose particular knowledge of the diaspora in Britain and South Africa gives her insight as a commentator. This is a book which will have a broad appeal to general readers as well as to students of South Asian and colonial history, migration studies and sociology.

Does Hypoadiponectinemia Explain the Increased Risk of Diabetes and Cardiovascular Disease in South Asians?

A substantial body of evidence has documented the high prevalence of type 2 diabetes and cardiovascular disease (CVD) among people of South-Asian descent, defined on the basis of ancestral origin from the Indian subcontinent comprised of India, Pakistan, Bangladesh, and Sri Lanka (1–7). These observations relate to both native South Asians in urban settings and those living overseas in different countries (including the U.K., Canada, the U.S., South Africa, Singapore, Fiji, and Trinidad), leading to the suggestion that members of this ethnic group may share an underlying predisposition to metabolic and vascular disease (3,4,6–10). It has been postulated that a gene-environment interaction between underlying genetic susceptibility and urbanization-induced lifestyle changes (such as increased caloric intake and decreased energy expenditure) may promote the clinical expression of a high-risk phenotype (7). Clinically, this phenomenon translates to a 1.5- to 10-fold–higher incidence of coronary artery disease (CAD) in immigrant South Asians compared with the general populations of the host countries (2–4,10,11). Furthermore, South Asians exhibit clinical features suggestive of a distinctly aggressive cardiovascular pathophysiology compared with other ethnic groups. These features include significantly higher cardiovascular mortality (4,12) and earlier onset of CAD in young adults (7,13). Thus, identification of the determinants of vascular disease in South Asians may be relevant to both 1 ) our understanding of the pathophysiology of CVD and 2 ) preventive health care for the approximately one-fifth of the world’s population that comes from the Indian subcontinent. A similarly worrisome problem is the rising prevalence of type 2 diabetes in South Asians. India currently has the highest number of cases of diabetes in the world (14). In addition, it has been projected that between 2000 and 2030, the number of patients with diabetes …

Predicting Coronary Risk in UK South Asians: An Adjustment Method for Framingham-Based Tools

Background Although people of South Asian descent appear to be at increased risk of cardiovascular disease (CVD) compared to the general population there is no validated tool for predicting risk in this group. Design This study was based on an analysis of data from the Health Survey for England (HSE) 1998 and 1999 to identify a simple method for adjusting the Framingham equation to estimate coronary risk in South Asians which could be then applied to existing simple paper-based tools. Methods The different adjustments investigated were fixed increments to the age, total cholesterol (TC), and TC: high density lipoprotein (HDL) cholesterol ratio and multipliers for the TC: HDL cholesterol ratio. Framingham risk modified according to a factor derived from an earlier overview of prospective studies was used as a standard to estimate sensitivity and specificity of adjustment methods. The receiver-operating characteristic (ROC) plot was used to compare the different adjustments in the primary role of identifying individuals above or below a given risk threshold. Results All adjustment methods produced a graded monotonic increase of coronary risk in 4497 eligible subjects from the HSE 1998 dataset. Multiplying TC: HDL cholesterol ratio gave the largest area under the ROC curve. However adding 10 years to the age of South Asian people was the simplest way of calculating coronary heart disease risk using paper-based methods and still provided acceptable accuracy. Conclusion Our result should be used to achieve the systematic evaluation of each individual for primary prevention of CHD in South Asians in primary care. Eur J Cardiovasc Prev Rehabil 12:46-51 © 2005 The European Society of Cardiology

Predicting coronary risk in UK South Asians: an adjustment method for Framingham-based tools

Although people of South Asian descent appear to be at increased risk of cardiovascular disease (CVD) compared to the general population there is no validated tool for predicting risk in this group. This study was based on an analysis of data from the Health Survey for England (HSE) 1998 and 1999 to identify a simple method for adjusting the Framingham equation to estimate coronary risk in South Asians which could be then applied to existing simple paper-based tools. The different adjustments investigated were fixed increments to the age, total cholesterol (TC), and TC:high density lipoprotein (HDL) cholesterol ratio and multipliers for the TC:HDL cholesterol ratio. Framingham risk modified according to a factor derived from an earlier overview of prospective studies was used as a standard to estimate sensitivity and specificity of adjustment methods. The receiver-operating characteristic (ROC) plot was used to compare the different adjustments in the primary role of identifying individuals above or below a given risk threshold. All adjustment methods produced a graded monotonic increase of coronary risk in 4497 eligible subjects from the HSE 1998 dataset. Multiplying TC:HDL cholesterol ratio gave the largest area under the ROC curve. However adding 10 years to the age of South Asian people was the simplest way of calculating coronary heart disease risk using paper-based methods and still provided acceptable accuracy. Our result should be used to achieve the systematic evaluation of each individual for primary prevention of CHD in South Asians in primary care.

Essential fatty acid metabolism in patients with essential hypertension, diabetes mellitus and coronary heart disease

Mortality and morbidity from coronary heart disease (CHD), diabetes mellitus (DM) and essential hypertension (HTN) are higher in people of South Asian descent than in other groups. There is evidence to believe that essential fatty acids (EFAs) and their metabolites may have a role in the pathobiology of CHD, DM and HTN. Fatty acid analysis of the plasma phospholipid fraction revealed that in CHD the levels of gamma-linolenic acid (GLA), arachidonic acid (AA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are low, in patients with HTN linoleic acid (LA) and AA are low, and in patients with non-insulin dependent diabetes mellitus (NIDDM) and diabetic nephropathy the levels of dihomo-gamma-linolenic acid (DGLA), AA, alapha-linolenic acid (ALA) and DHA are low, all compared to normal controls. These results are interesting since DGLA, AA and EPA form precursors to prostaglandin E 1, (PGE 1), prostacyclin (PGI 2), and PGI 3, which are potent platelet anti-aggregators and vasodilators and can prevent thrombosis and atherosclerosis. Further, the levels of lipid peroxides were found to be high in patients with CHD, HTN, NIDDM and diabetic nephropathy. These results suggest that increased formation of lipid peroxides and an alteration in the metabolism of EFAs are closely associated with CHD, HTN and NIDDM in Indians. Since insulin resistance and hyperinsulinemia and features of obesity, NIDDM, HTN and CHD, diseases that are common in Indians, and as decreased insulin sensitivity is associated with decreased concentrations of polyunsaturated fatty acids (PUFAs) in skeletal muscle phospholipids and, possibly, in the plasma, the possibility is raised that changes in the metabolism of EFAs may have a fundamental role in the pathobiology of these conditions. If this is true, this suggests that supplementation of GLA, DGLA, AA, EPA and/or DHA may be indicated to prevent CHD, HTN and NIDDM in Indians.

Gender, leisure and sport: a case study of young people of South Asian descent — A response

(1989). Gender, leisure and sport: a case study of young people of South Asian descent — A response. Leisure Studies: Vol. 8, No. 3, pp. 237-240.

Gender, leisure and sport: a case-study of young people of South Asian descent

Although there is a growing body of research in the United Kingdom into gender differences in leisure opportunities and behaviour, little is known about the extent to which such differences are modified by ethnicity. In this paper we present the findings of an exploratory investigation into factors influencing the lifestyles of young people of South Asian descent and appraise various strategies to obviate gender inequalities in their leisure.