Abstract India is undergoing a rapid epidemiological transition in which young adults face an increasing burden of cardiometabolic risk. This integrative review synthesises epidemiological, mechanistic and policy evidence to clarify the prevalence of dyslipidemia, obesity, Vitamin D deficiency and metabolically unhealthy phenotypes among Indian youth, and to highlight priorities for early detection. National surveys indicate that nearly 77% of adolescents show at least one lipid abnormality, 20%–40% of adults are overweight or obese, and more than half exhibit central adiposity; Vitamin-D deficiency affects 70%–100% of the population. Even individuals with normal body mass index (BMI) frequently display low high-density lipoprotein, high triglycerides and insulin resistance – the characteristic “thin-fat” phenotype – demonstrating the inadequacy of BMI-based screening in India. Cardiovascular disease manifests almost a decade earlier than in high-income countries, with one-third of ST-segment-elevation myocardial infarction patients younger than 50 years and 62% of cardiovascular deaths occurring before age 70. Mechanistic evidence implicates maternal under- or over-nutrition, gestational hyperglycemia and widespread Vitamin D deficiency in shaping early-life epigenetic programming that predisposes individuals to insulin resistance and central adiposity. Emerging AI-enabled risk models using Indian datasets outperform traditional scores by integrating anthropometric, biochemical and lifestyle markers, whereas mobile-health tools offer scalable solutions for population-level screening. This review supports universal cardiometabolic screening from adolescence using central-adiposity indices, nonfasting lipid profiles, Vitamin D assessment, and insulin-resistance markers. Policy priorities include cross-sectoral interventions to promote healthy diets and physical activity, Vitamin D fortification, and coordinated multicenter research to establish normative reference ranges and evaluate AI-driven screening and preventive strategies.
Ramachandra et al. (Wed,) studied this question.
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