|Metabolic syndrome is defined as a clustering of abdominal obesity, hypertension, insulin resistance and dyslipidemia. Obesity guidelines based on Western populations markedly underestimate the risk of coronary artery disease (CAD) among all Asians. This is because Asians have a greater body fat at a given BMI. The World Health Organization (WHO) has, therefore, issued a lower cutoff point for overweight (BMI>23) and obesity (BMI>25) for all Asians. Even among Caucasians, substantial risk of premature CAD occurs at a waist circumference (WC) of >90 cm underscoring the dangers of abdominal obesity. Conversely,Asian men and women tend to have more metabolic abnormalities at a lower waist circumference (WC) than Caucasians. The WHO and International Diabetes Federation (IDF) have also issued a lower cutoff point for the diagnosis of abdominal obesity through WC for Asian men (90 cm) and women (80 cm).