Indian Killer Belly is a strange and scary phenomenon. Asian Indians have a much higher incidence of diabetes and heart disease that other races even when other risk factors have been factored in.
Indian men, no matter where they live, have one of the highest rates of heart disease in the world, even if they have low levels of traditional risk factors such as cholesterol. In fact, even non-smoking vegetarians under 40 who exercise regularly may be at high risk.
While 60 percent of heart attacks amongst Americans occur after age 55, nearly half of all heart attacks among Indian men strike under the age of 55 and 25 percent under the age of 40. Indian women share these high rates of heart disease. Thousands of Indian American men in their 40s and 50s succumb to a first, fatal heart attack every year.
A new study may shed some light on this problem. It seems that Indians’ fat is fatter. Or more precisely, their fat cells are considerably larger than those of caucasians and this is inversely correlated with ability to cope with blood glucose (ie insulin resistance):
Compared to Caucasians, in spite of similar BMI, South Asians had higher total body fat (22±6 and 15±4% of body weight; p-value<0.0001), higher subcutaneous abdominal (SA) fat (3.5±1.9 and 2.2±1.3 kg, respectively; p-value = 0.004), but no differences in intraperitoneal (IP) fat (1.0±0.5 and 1.0±0.7 kg, respectively; p-value = 0.4). SA adipocyte cell size was significantly higher in South Asians (3491±1393 and 1648±864 µm2; p-value = 0.0001) and was inversely correlated with both glucose disposal rate (r-value = −0.57; p-value = 0.0008) and plasma adiponectin concentrations (r-value = −0.71; p-value<0.0001). Adipocyte size differences persisted even when SA was matched between South Asians and Caucasians.
The bottom line is that big fat cells and high levels of subcutaneous fat (but not visceral fat) were found to be risk factors for insulin resistance and heart disease. More.
Health warning: the innocence of visceral fat is not supported by other studies. Also, this study only included a total of 29 south Asians and 19 Caucasians. More research is needed.
Harpoon 
I’ve always wondered why it seems that people from Indian tend to be heavier than what you’d consider a normal healthy person. Now I know.