A new, small-scale study of children in Sweden has found a quarter of the seemingly healthy children studied had underlying metabolic problems that put them at risk for diabetes and heart disease later in life.

While the study, which only involved 212 6-year-olds, may not be statistically significant, it does challenge the idea that only obese or overweight children will face metabolic and cardiovascular problems. Though obese and overweight children in the study were most likely to experience insulin resistance, a risk factor for developing type 2 diabetes, 5% of normal-weight children in the study displayed insulin resistance, too.

It’s a good reminder that weight is not the only sign of or contributing factor to metabolic problems, especially for South Asian families, who already have a predisposition to insulin resistance — a fact thought to contribute to India’s fast-growing diabetes rate, especially among its urban population.

“Diabetes is a condition in which blood sugar levels can become dangerously high because the pancreas either produces no or not enough insulin, the hormone that regulates blood sugar. In the cases where a person’s pancreas produces some, but still not enough insulin, the person is often unable to respond to what little insulin there is circulating in his or her bloodstream. This is decreased insulin sensitivity, aka insulin resistance, and it means that even healthy, skinny people can get diabetes,” explains endocrinologist Dr. Farah Naz Khan.

While a predisposition isn’t something parents can control, the lifestyle factors that contribute to childhood obesity — and insulin resistance — are. Unfortunately, while adult Indians seem to be limiting their own sugar intake, we don’t seem to be limiting kids’. (Or encouraging them to limit their own.) Hopefully this study, and more like it, will be a wake-up call that a healthy diet is as important for normal-weight kids, as it is for kids with bigger waistlines.