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Among established risk factors studied here or reported in an earlier paper the only one to which South Asians had less exposure was smoking. In either men or women (or both) there was a relative excess of the other known risk factors. There was evidence in support of three newer hypotheses for the high incidence of coronary heart disease (CHD), namely, insulin resistance, stress, and socioeconomic deprivation. The high CHD rates in South Asians are likely to result from a complex interaction of risk factors.

To relate health to length of residence in the United Kingdom in an age-controlled sample of British South Asians, a cross-sectional survey was undertaken with interviews and physical measures in a two-stage stratified random cluster sample in the City of Glasgow. The sample consisted of 159 South Asians aged 30-40, with a mean age of 35 years (73.6 per cent of those invited). The main measures considered were body structure, lung function, pulse and blood pressure, history of physical and mental health, results of standardized questionnaires on mental health, angina and respiratory health, recent and past symptoms, history of accidents and sickness behaviour. It was found that over a quarter of the health measures showed differences by length of residence, and long-established residents had almost consistently worse results. More were overweight, reported heart trouble and respiratory conditions, had had accidents, experienced symptoms, especially respiratory and psychosomatic, needed glasses and took time ill in bed. Comparisons with North Indian data make it unlikely that these results are explained by positive selection of recent migrants. Also, the results do not endorse the assumption that the UK environment has promoted higher levels of health in migrants longer exposed to it, nor that the stress of the move promotes higher levels of illness in recent migrants. Further investigation is required of ways in which the UK environment, or the particular situation of South Asians within it, may be damaging to health.

AIMS:To compare anthropometric measurements and to define their behavioural associations in migrant and British-born South Asians (who have increased cardiovascular risk) or Italians (who have reduced cardiovascular risk), and in the general population of British women living in the west of Scotland. STUDY DESIGN: Cross-sectional survey of women aged 20 -42 y, selected mainly from birth registration data, which included 63 migrant South Asians, 56 British-born South Asians, 39 migrant Italians, 51 British-born Italians, and 50 subjects representative of the general population of women, all resident in the west of Scotland. MEASUREMENTS: Height, weight, body mass index (BMI), and waist and hip circumferences. RESULTS: With age adjustment, migrant South Asians (0.88) had greater waist-to-hip ratio than British-born South Asians (0.84; P < 0.05), while there was no difference between migrant (0.81) and British-born (0.79) Italian groups. Both migrant (P < 0.001) and British-born South Asian (P < 0.05) groups had higher waist-to-hip ratio and were about 3 cm shorter than Italian groups and the general population. Neither weight nor BMI were different between ethnic groups. Waist and hip circumferences were not different between migrant and British-born ethnic minority groups. Migrant South Asians (86.8 cm) had significantly (P < 0.05) larger waist circumference than the general population (78.6 cm). British-born Italian women (103.0 cm) had larger hip circumference than the general population of women (96.4 cm), while other groups had similar hip circumferences. Additional adjustments for physical activity, smoking, alcohol consumption and parity reduced the differences in anthropometric measurements: only waist-to-hip ratio of migrant South Asians remained significantly (P < 0.01) higher than that of the general population women. CONCLUSIONS: The adverse anthropometric indicators of cardiovascular risk in migrant South Asian women are substantially explained by their lifestyle factors and parity. British-born South Asian women are more similar to the general population women. Anthropometric differences between migrant or British-born Italians and the general population women are small.