Recent data in adults showed that C-reactive protein (CRP) level robustly predicts future coronary heart disease (CHD) and type 2 diabetes mellitus (T2DM). Although data in children are scarce, overweight, obesity, and insulin resistance were shown to be associated with elevated CRP concentrations. Preliminary data in children also show association of CRP with endothelial dysfunction and other cardiovascular risk factors. Adult Asian Indians, highly predisposed to develop CHD and T2DM, have significantly higher CRP levels than do Europeans. Recent studies show that nearly 13% of Asian Indian children and young adults in India have subclinical inflammation, and approximately 20% have insulin resistance, portending high risk for CHD in adulthood. Possible determinants of high CRP levels in Asian Indians might be excess body fat, including high subcutaneous fat, and physical inactivity. The relationships of recurrent infections, protein deficiency, and subclinical inflammation in Asian Indians remain uninvestigated. Finally, prevention of childhood adiposity is critical to decrease future risk for development of T2DM and CHD, particularly in highly predisposed ethnic groups such as Asian Indians and South Asians.