**5.1 Hyperinsulinemia**

There is an early leaning towards adult South-Asian phenotype in children, probably starting in neonatal period. Hyperinsulinemia and its attendant metabolic perturbations are more common in Asian neonates than in Caucasian ones [56]. Kuriyan and colleagues studied the waist circumference of Indian urban middle-class children between the ages of 6–16 years and found that their waist circumference was more than that of age- and sex-matched British children [57]. About one-third of the urban-Asian children have insulin resistance. The odds for hyperinsulinemia in one study were OR 4.7 (95% CI 2.4–9.4) in overweight children, OR 6.4 (95% CI 3.2–12.9) with high percentage body fat, OR 3.7 (95% CI 1.9–7.3) with high waist circumference, OR 6.8 (95% CI 3.3–13.9) with high waist hip ratio and OR 4.5 (95% CI 1.8–11.3) for sum of four skin-fold thicknesses (Sigma 4SF). Multiple logistic regression analysis showed that percentage body fat and Sigma 4SF were independent predictors of hyperinsulinemia with ORs being 3.2 and 4.5, respectively [58]. This being so, the risk of chubby children becoming obese adults is real.
