Fig. 2.

The complex interplay between genetic and environmental factors contributing to increased visceral adiposity in Asian populations. Many factors contribute to the Asian propensity to store fat viscerally. Of these, we propose the Malaysian gene-environment multiplier hypothesis in which a population’s genetic foundation—developed over thousands of years and varying according to regional feast-and-famine cycles—is increasingly modified when an individual is exposed to modern-day conditions such as altered diets, urbanization, and reduced physical activity.