Being Your Own Advocate: Health Checks for South Asians

In many industrialized countries, there isn’t enough research focused on South Asians’ unique health needs. This gap means that doctors might not fully understand the specific challenges this community faces. Standard health screenings might not be adequate for South Asians.

That’s why it’s crucial for you to be informed about your health risks. By knowing what tests to ask for and what results to look out for, you can advocate for yourself effectively.

Here’s a guide to help you navigate your health checks and understand the optimal ranges for South Asians. These are the tests I recommend and the reference ranges I use for optimum health:

Key Measurements and Targets

•  Body Mass Index (BMI)
  South Asians are at higher risk for diabetes, heart disease, and other conditions, even at lower BMIs. The USA’s ‘Screen at 23’ initiative reflects this heightened risk.
  – BMI ≥ 23 is considered overweight for South Asians
  – BMI ≥ 27 is considered obese
  Screening for diabetes, kidney, and heart disease should begin once BMI reaches 23.
• Waist Measurements
  Waist circumference is a key indicator of metabolic health. Healthy ranges are:
  – Women: Less than 80 cm
  – Men: Less than 90 cm.
  Waist to Hip ratio(WHR) is a good assessment of metabolic health. Ideal WHR should be less than 0.8. Values higher than 1 are associated with a much higher risk of T2D and Cardiovascular Disease.
• Blood Pressure
  For optimal heart health, blood pressure should be below 130/70 mmHg.
• QRISK3 (UK)
  This cardiac risk calculator is specifically designed to factor in the higher risk faced by the South Asian population, unlike many other risk calculators.

Recommended Tests

Blood Tests:

• Full Blood Count (FBC)
  This test checks for anaemia, which is important as many South Asians follow vegetarian or vegan diets or eat less red meat.
• Iron Studies
  Iron is essential for making haemoglobin, which carries oxygen in your blood. Adequate iron helps prevent anaemia and supports overall energy levels.
• Vitamin B12
  B12, found in animal foods, is vital for nerve function and blood cell production. If you’re vegetarian or vegan, taking a B12 supplement is essential.
• Kidney Function Tests
  High blood pressure and Type 2 diabetes (both more common in South Asians) can affect kidney function. Regular tests can help monitor and manage these risks.
• Liver Function Tests
  These check for non-alcoholic fatty liver disease. An ALT level over 30 can indicate fat build-up in the liver.
• Fasting Glucose
  This test measures blood sugar levels to check for Type 2 diabetes.
• HbA1c
  This test shows average blood glucose levels over the past three months. In South Asians, a level over 5.6% may be a concern.
• 12-hour Fasting Insulin
  A key early indicator of metabolic issues. Fasting insulin levels:
  • Less than 6 is good
  • Less than 9 is acceptable
  • Over 12 is a concern
• Fasting Lipid Profile

  • A fasting lipid profile is essential for assessing heart health, particularly for South Asians who are at a higher risk of cardiovascular disease. Here are the key readings to focus on:

    – Triglycerides: Less than 1 mmol/L
    This level shows how well your body processes excess carbohydrates, which are converted into fat.

    – HDL (Good Cholesterol):
    – Over 1 mmol/L for men
    – Over 1.3 mmol/L for women

    Higher levels of HDL help protect against heart disease.

    – Triglyceride: HDL Ratio:
    A ratio of less than 1 is ideal and is one of the most accurate predictors of low cardiovascular risk.

• High-Sensitivity CRP
  Measures low-grade chronic inflammation, a root cause of many chronic diseases. Levels should be less than 1.
• Vitamin D
  South Asians often have low Vitamin D levels due to less sun exposure. This vitamin is crucial for bone health and many body processes.
• Lp(a) (specialised test)
  About 30-35% of South Asians have high Lp(a) levels, which may increase cardiovascular risk. There’s no treatment yet, so it’s vital to manage all other risk factors rigorously. Costs $20-30

Other Important Screenings

• CT Coronary Calcium Score (CAC)
  For men over 40 and women over 45, this test helps predict heart disease risk. It costs about $150 and isn’t covered by Medicare.
• Bone Mineral Density Scan
  Checks for conditions like osteopenia and osteoporosis, especially important if you have a family history, or if you’re vegetarian/vegan and may have low calcium or Vitamin D. This scan may not be covered by Medicare.

By keeping track of these measurements and tests, you can take control of your health and make sure you get the care and attention you need. Remember, being informed and proactive is key to staying healthy.