The purpose of the present paper is to examine the prevalence of metabolic syndrome (MetS) and its components using the harmonized definition in an interviewed sub-sample of diverse, low-income, adult South Asians (SA) of both sexes residing in Maryland. We also wanted to derive a BMI cut-off value that was highly correlated with the recommended waist circumference (WC) that we could apply to a larger sample of SA Americans for whom only BMI values were available from clinic files. We also examined differences in MetS prevalence among various Asian ethnic groups (defined by country of origin) and the clustering pattern of their MetS components.

Clinical data extraction on subjects (n 1002) and interviewees (n 401) were used in a cross-sectional study of SA Americans.

Two community health centres in Montgomery and Baltimore County, MD, USA.

SA adult males and females (n 1403) aged 20–68 years.

The prevalence of MetS using harmonized WC cut-offs (90 cm in men and 80 cm in women) was 47 % in men and 54 % in women. Using a BMI of 23·0 kg/m2 gave a similar prevalence of MetS for males (48 %) and females (47 %). Of the five MetS components, the prevalence pattern differed among the ethnic groups, particularly for SA Indians.

The prevalence of MetS in a diverse, low-income, SA American immigrant group using the harmonized definition was 51 %. Derived lowered BMI cut-off of 23·0 kg/m2 should be used by clinicians in studies on SA when WC values are not available for detecting metabolic risk. SA Indians had a higher prevalence of abnormal TAG and blood glucose values compared with other SA, and therefore results for SA Indians should not be generalized to all SA ethnic groups.