Diabetes mellitus has reached epidemic proportions worldwide. South Asians are known to have an increased predisposition for diabetes which has become an important health concern in the region. We discuss the prevalence of pre-diabetes and diabetes in South Asia and explore the differential risk factors reported.

A randomised crossover study of eight overweight or obese men (aged 24–49 years, BMI 25.5–31.3 kg/m²), who followed two diets for 4 weeks each, was performed to determine whether substitution of saturated fat with monounsaturated fat affects body weight and composition. Subjects were provided with all food and beverages as modules (selectedad libitum) of constant macronutrient composition, but differing energy content. The % total energy from saturated fat, monounsaturated fat and polyunsaturated fat was 24, 13 and 3% respectively on the saturated fatty acid (SFA)-rich diet and 11, 22 and 7% respectively on the monounsaturated fatty acid (MUFA)-rich diet. MUFA accounted for about 80% of the unsaturated fats consumed on both diets. Body composition, blood pressure, energy expenditure (resting and postprandial metabolic rates, substrate oxidation rate, physical activity), serum lipids, the fatty acid profile of serum cholesteryl esters and plasma glucose and insulin concentrations were measured before and after each diet period. Significant (P≤0·05) differences in total cholesterol and the fatty acid composition of serum cholesteryl esters provided evidence of dietary adherence. The men had a lower weight (-2·1 (se0·4) kg,P=0·0015) and fat mass (-2·6 (se0·6) kg,P= 0·0034) at the end of the MUFA-rich diet as compared with values at the end of the SFA-rich diet. No significant differences were detected in energy or fat intake, energy expenditure, substrate oxidation rates or self-reported physical activity. Substituting dietary saturated with unsaturated fat, predominantly MUFA, can induce a small but significant loss of body weight and fat mass without a significant change in total energy or fat intake.

Dietary diversity is recognized as a key element of a high quality diet. However, diets that offer a greater variety of energy-dense foods could increase food intake and body weight. The aim of this study was to explore association of diet diversity with obesity in Sri Lankan adults.

To determine whether the age-related reduction in basal metabolic rate (BMR) is explained by a quantitative and/or qualitative change in the components of lean tissue, we conducted a cross-sectional study in groups of young ( n = 38, 18–35 yr) and older ( n = 24, 50–77 yr) healthy individuals. BMR was measured by indirect calorimetry. Body composition was obtained by using dual-energy X-ray absorptiometry (DEXA), which permitted four compartments to be quantified [bone mineral mass, fat mass (FM), appendicular lean tissue mass (A_LTM), and nonappendicular lean tissue mass (NA_LTM)]. Absolute BMR and A_LTMwere lower, whereas FM was significantly higher in the older, compared with young, subjects. BMR, adjusted for differences in FM, A_LTM, and NA_LTM,was significantly lower in the older subjects by 644 kJ/day. In separate regression analyses of BMR on body compartments, older subjects had significantly lower regression coefficients for A_LTMand NA_LTM, compared with young subjects. Hence, the age-related decline in BMR is partly explained by a reduction in the quantity, as well as the metabolic activity, of DEXA-derived lean tissue components.