At an annual family dinner, one of my uncles said he forgot his diabetes medicine. The room filled with laughter as everyone offered their medicine. At this moment, I realized that almost all of my family members are diabetic. Some are lucky because they do not have any additional health problems related to it.  Sometimes people look to the past to find out about the future. Doctors see it as a prediction rather than a possibility for many South Asians. Colonial control over the South Asian subcontinent left many of the current population with insulin resistance-related diseases. South Asians now have an opportunity to develop combative traits for future generations.

Years of colonization in the South Asian subcontinent caused a direct impact on the current South Asians' struggle with insulin resistance-related diseases. In the 1800s, European powers introduced new foods to the Indian subcontinent that changed the balance in the indigenous diet. Food products were well integrated into the cuisine and allowed the British to maintain direct control over the native population’s diet. This meant that the foods the population became dependent on were not a reliable resource.  The British withheld diet staples/production of agriculture in times of war which led to famine (Rowlatt). Which caused genetic adaptation because of repeated famine after famine. The population can adapt to those events by focusing on processing food in a way to meet its required nutrients. It lowers the threshold that the body can process beyond what it needs to function. Numerous South Asians have this evolutionary trait but no longer live in such conditions that would require them. The human body had adapted such traits to ensure it could survive in those conditions.  The famines were prevalent across generations and further prolonged because of the influence of British rule.

The South Asian struggle with insulin resistance was under the control of their colonial rulers. In total, there were 31 famines in the 120 years of the British Raj. The last famine and the deadliest killed “4 million people and dealt a colossal blow on its agrarian population, leaving it traumatized for decades” (Sanyal). The famines caused many shifts in the population's bodies for generations to come. The famines made South Asians more susceptible to developing the genetic adaptation of insulin resistance. Such adaptions can develop and become stronger in each generation. A study revealed that “starvation causes insulin resistance which is partly due to decrease of insulin action on glucose transport in target cells” (Cigolini). The South Asian population suffered deep genetic effects from constant exposure to starvation. One generation’s conditions can impact the following until those conditions change. This led to the population having a greater risk of diabetes, hyperglycemia, and cardiovascular diseases (Bakar). The population is at greater risk of these diseases because of genetic adaptation happening generations before them. The body begins to evolve and passes down those traits throughout the next generations to improve its chances of survival. The current generation of South Asians has reached a turning point in which the genetic path will develop with many opportunities to improve or worsen the situation drastically.

Consequently, the South Asian population is dealing with a paradox of choice that can impact future descendants. South Asians in the past struggled with genetic conditioning outside of their control. South Asians as Dr. Syed puts it “starvation adapted” but as we are in modern times and lifestyles are not equipped with the adaptation that South Asians are given (Bakar). Although many in the population are now in control of their environments, it is difficult to The current stationary-focused work environments in the middle class provide limited room for improvement for the insulin-resistance genes. With our modern day lifestyles, most abroad do not have to do rigorous amounts of physical labor as our ancestors once did, causing higher risks of insulin resistance-related diseases because the body produces more sugar, and the sugar not going anywhere because of resistance diseases. The same lifestyle changes also give more time and resources to change genetic predetermination. 

Current changes in standards of living also provide opportunities to evolve against previous insulin resistance traits. Many South Asians are challenging this evolutionary genetic predetermination. As more evidence comes forward that such genetic evolution can occur, many are trying to change the ways their bodies respond to excess consumption in a more beneficial way. Dr. Syed puts it as “risks are avoidable, we just have to pay closer attention to diet, exercise/fitness, sleep, stress and other substances” (Bakar). Increased focus on a balanced diet and exercise can decrease the current generation’s risks of developing insulin resistance-related diseases. Such changes can decrease the future generation’s likelihood of inheriting insulin resistance. The future of such diseases is in our hands, being disposed of does not mean being predetermined. 

Though it is strange to think about what happened hundreds of years ago that affects your dinner table. After dinner, my dad now has to inject a medicine that helps him process sugar; I see the multiple medicines that both of my parents take. My sisters and I always have to keep watch on what we’re eating to try to remain healthy thinking about the probable long-term effects; trying our best to hold the sugar to decrease the odds for the generation to come.