The Indian population is at high risk for obesity and its related diseases. Paradoxically, there is also a high prevalence of low birth weight in this population. Throughout life, factors associated with these abnormalities reflect genetic, environmental and lifestyle patterns.World-wide, the Indian population is largely non-meat-eating which could compromise the quantity and quality of the diet in macronutrients (proteins) and micronutrients (vitamin B12). Vitamin B12 has been suggested to increase the risk for the metabolic syndrome (dyslipidemia, insulin resistance, hypertension and central adiposity). Factors measured in this pilot study designed to examine the differences between meat-eating and non-meat-eating Indian preadolescent girls were body composition, dietary food and nutrient analysis, physical activity patterns and biomarkers of diet and metabolic syndrome.Six non-meat-eating (9.8±0.9 y) and six meat-eating (10.0±0.6 y) Indian preadolescent girls participated in the two weeks study. Mothers and their daughters in each group had followed the same dietary pattern from birth. Anthropometry, hand-to-foot bioelectrical impedance and resting energy expenditure were measured. Biomarkers associated with one carbon metabolism; serum B12, methylmalonic acid (MMA) and folate were measured. Inflammatory markers; high sensitivity C-reactive protein and ferritin were measured. Serum lipids, fasting glucose and haematological parameters were measured. Time spent in sedentary activities and dietary information was extracted from seven day physical activity and food diaries respectively.There was an overall trend towards higher values for the non-meat-eaters as compared to the meat-eaters in body fat percent (29.7±6.6 vs. 29.0±6.2%, p = 0.85), and waist to hip ratio (0.89±0.12 vs. 0.84±0.07, p = 0.37) but the meat-eaters weighed more (31.2±5.5 vs. 33.3±9.6kg, p = 0.65). Compared to British reference ranges, girls in both groups had a higher BF% of 29±6% which was 34 percentile points above the British median (McCarthy et al., 2006) adjusted for age.Both groups spent 21 hours each day in non-moving/sedentary activities. Dietary consumption of vitamin B12 was higher in meat-eaters compared to non-meat-eaters (2.5±0.8 vs 1.8±0.6μg.day-1, p = 0.11). Serum vitamin B12 was substantially higher in the meat-eaters (543±212 vs. 232±95 pmol/L, p = 0.01) with lower serum concentrations of MMA (0.2 ± 0.1 vs 0.3 ± 0.2 μmol/L, p=0.3). Serum folate was adequate in all girls ranging from 16.5-45.0 pmol/L, which was within the normal reference values. Two non-meat-eating girls were vitamin B12 deficient (<170pmol/L). These differences were associated with high fibre and less protein intake in the nonmeat-eaters (30±8 vs. 20±7 g day-1; 64±12 vs. 66±11 g.day-1).The initial findings in this pilot study provide early evidence that risk factors for metabolic disease associated with body composition, diet and activity are accumulating in preadolescent Indian girls. Imbalance in one carbon metabolism is clearly a factor to be considered. In those with a low consumption of meat and/or animal products, B12 monitoring, dietary recommendations and if necessary supplementation should be considered and where possible intervention before pregnancy (as for folate) be a priority. New Zealand Indian people would be a priority group.It is time for serious action in this area of health so that the risk accumulated through an imbalance in nutrition and physical activity is reduced and the health of those as yet unborn is improved.