Low-quality carbs: India derives nearly two-thirds of its daily calories from low-quality carbohydrates, chiefly white rice and processed grains, placing millions at greater risk of diabetes and obesity, according to a large analysis published in Nature Medicine.
The study, led by researchers from the Madras Diabetes Research Foundation and the Indian Council of Medical Research (ICMR), analysed dietary and health data from the ICMR-INDIAB survey, a door-to-door assessment of adults aged 20 and above across 30 states and union territories and the National Capital Territory of Delhi.
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The authors report that carbohydrates contribute 62.3% of total daily energy intake nationwide, with refined cereals accounting for 28.5% and milled whole grains for 16.2%. Total fat contributes 25.2% of calories, while protein intake remains low at 12%.
Individuals with the highest carbohydrate intake had a 30% greater likelihood of developing type 2 diabetes, a 22% higher risk of general obesity and a 15% higher risk of abdominal obesity compared with those consuming the least carbohydrates. Notably, simply swapping refined cereals for whole-wheat or millet flour without reducing overall carbohydrate intake was not associated with a lower risk of type 2 diabetes.
The findings land against the backdrop of India’s outsized diabetes burden, with roughly a quarter of the world’s diabetics estimated to live in the country. Lifestyle patterns further compound risk: the study found 61% of participants were physically inactive; 43% were overweight, and 26% were obese.
Regional differences were pronounced, with North India showing the highest prevalence of overweight (54%), obesity (37%) and abdominal obesity (48%), while the eastern region recorded the lowest rates (31%, 16% and 29%, respectively). Nearly one-third of the population, around 27%, had hypertension, with little inter-regional variation. Overall, 83% of participants had at least one metabolic risk factor, including newly diagnosed type 2 diabetes, prediabetes, dyslipidaemia, general or abdominal obesity, or hypertension.
The researchers say public health strategies should focus on cutting overall carbohydrate and saturated fat intake while increasing consumption of plant and dairy proteins.
