The rise of prosperity in South Asian countries such as India has created a health paradox: despite improved economic conditions, increasing numbers of children are either overweight or undernourished. Changing lifestyles have a dramatic impact on the prevalence of obesity and metabolic syndrome in the Indian population. Dr. Anoop Misra provides a comprehensive overview of his findings on the prevalence, risk factors, body composition and other medical characteristics of obesity and metabolic syndrome in Asian Indians and compares these to Caucasian populations. He takes a look at cellular and biochemical parameters, such as lipid content in muscle and liver, and adipocyte size, explaining how these are affected by adverse perinatal influences and rapid catch-up growth in infancy. Misra applies these findings to the latest consensus statement and guidelines for defining obesity and metabolic syndrome in Asian Indians. What can we do to stem this epidemic? Misra concludes by outlining specific lifestyle and dietary changes, thereby providing a universal roadmap for avoiding diabetes- and cardiovascular-related deaths around the world.