Culturally Informed Dietary Approaches for Cardiometabolic Risk Reduction in South Asians: An Evidence-Based Review

Background/Objectives: South Asians (SAs), including individuals from India, Pakistan, Bangladesh, and Sri Lanka, experience a disproportionately high burden of cardiometabolic disease at lower body mass index (BMI) thresholds than other populations. Rates of cardiovascular disease and diabetes are elevated even below the standard overweight BMI range defined by the World Health Organization. Because dietary practices are strongly influenced by cultural and religious traditions, culturally tailored interventions are essential for effective cardiometabolic risk reduction. This article serves as an initial approach to dietary guidance in the SA community. Methods: A literature review was conducted using the Ovid MEDLINE(R) ALL database to identify English-language studies evaluating dietary interventions in SA populations. Studies were selected through title and abstract screening, with additional articles identified through reference review. Results: Several dietary strategies were associated with improved cardiometabolic outcomes in SA. Diets emphasizing whole, minimally processed plant-based foods and reduced refined carbohydrate intake were associated with improvements in weight, BMI, lipid profiles, and glycemic control. Recommended dietary patterns included non-starchy vegetables, plant-based proteins such as lentils, and whole grains. Intermittent fasting approaches, including time-restricted eating and the 5:2 diet, demonstrated benefits for insulin sensitivity and aligned with traditional fasting practices common in SA cultures. Discussion: Future studies are needed to better characterize the dietary diversity within the SA community. Public health initiatives should focus on education and early intervention. Conclusions: Dietary interventions aligned with cultural South Asian food practices may improve adherence and reduce cardiometabolic risk.