Tejal Somvanshi
There is a phrase circulating in health discussions right now: “40 is the new 60” for Indian metabolism. It is a striking line. It is also a social media shorthand, not a medical measurement. The data behind it, though, is real.
Apollo Hospitals released its Health of the Nation 2026 report, drawing on more than three million preventive health assessments conducted across its network in 2025. Among the working populations assessed — averaging 38 years old — nearly half had prediabetes or diabetes. Eight in ten were overweight. Two in three young adults were already at risk for non-communicable diseases. One in five people under 30 were prediabetic.
Separately, the International Diabetes Federation estimated that 89.8 million adults aged 20 to 79 in India had diabetes in 2024. An estimated 43% of those cases were undiagnosed. These are estimates, not census counts.
Why does this happen at younger ages and lower body weights compared to global averages?
Researchers call it the “thin-fat” phenotype. This is not a social media label — it is a medically described pattern. Some South Asian individuals carry higher proportions of fat around internal organs and lower muscle mass, even when their overall body weight appears normal. The number on a scale does not tell the full story.
Asian-Indian clinical guidance has used BMI 23 kg/m² as an overweight threshold and 25 kg/m² as an obesity threshold because cardiometabolic risk can occur at lower BMI levels in Asian populations. A person at BMI 24 would appear normal in most global charts but overweight under South Asian-specific guidelines.
BMI alone does not show where fat is distributed. Visceral fat around the liver and abdominal organs carries greater metabolic risk than fat stored under the skin. Fasting glucose, HbA1c and other clinically appropriate measurements can be used to assess glycaemic status; additional testing should be determined by a healthcare professional based on individual risk.
A 2026 research review described excess visceral fat and elevated cardiovascular risk at lower BMI thresholds in Asian populations.
One correction to popular discussions: the “designed for famine” explanation should not be presented as an established scientific explanation for India’s metabolic-risk profile. The research describes how fat is distributed and how cells respond to insulin — it does not constitute a proven genetic adaptation.
The WHO recommends physical activity, healthy eating, maintaining appropriate body weight, and avoiding tobacco as core approaches to reducing diabetes risk. What the Apollo data and research context add is a reason not to wait until 40 or 50 to start paying attention.
