Dr. Ben Bikman

So these are ethnicities that can be a little fatter than other ethnicities and yet have lower levels of insulin resistance and type 2 diabetes.

And that's what we see in the U.S.

High rates of obesity, but relatively modest rates of type 2 diabetes.

As much as we think the problem is bad here, I think the U.S.

ranks somewhere in the 70s.

If you look at all the countries in the world and how diabetic they are, we're about number 70.

Whereas Singapore, for example, and Japan is not too far back, Singapore is, I think, number nine.

And all the countries of the Middle East are actually – numbers one through eight are like Oman, Dubai, Jordan, these countries in the Middle East.

And then the other countries sort of round out through Southeast Asia and the Middle East and the Pacific Islands, the most diabetic places.

These ethnicities, especially –

So India has among, it is among the highest most diabetic countries on the planet, East Asia, Southeast Asia.

Their fat cells on average are significant.

The one paper I'm recalling where it looked, it took Caucasian men and South Asian men and did an adipose subcutaneous biopsy.

And it found that the average South Asian man had adipocytes that were about four times larger volumetrically than the fat cells in the Caucasian at the same body size, same body fat percent.

They just had much bigger fat cells.

So to say all this another way, or to start to wrap it all up,

What is more problematic about fat storage?

It's not the mass of fat that matters most, but the size of each fat cell when it comes to slow insulin resistance and the consequences of too much fat mass.

And this explains why, say, an East Asian fellow will just be moderately overweight and

compared to his obese Caucasian counterpart, and yet he has all of the complications of insulin resistance, and this guy just doesn't look good in his Speedo, and is otherwise fine metabolically.