In a study examining dietary patterns and their associated metabolic risks across India, researchers found that most Indians derive about 62% of their calories from carbohydrates — primarily white rice in the southern, eastern and north-eastern regions, and wheat in northern and central regions. Overall protein intake remains suboptimal, averaging 12% of daily calories.
As a part of the Indian Council of Medical Research-Indian Diabetes (ICMR-INDIAB) study, a cross-sectional survey was conducted in collaboration with the Madras Diabetes Research Foundation (MDRF). It included 1,21,077 adults from urban and rural areas across 36 States and Union Territories. Every fifth participant underwent dietary assessment, and the data was used to characterise India’s dietary profile across regions and examine inter-and intra-regional differences in macronutrient intakes and associated metabolic risk. The findings were published in Nature Medicine.
Healthy eating
The data from the study was used to characterise India’s dietary profile across regions and examine inter-and intra-regional differences in macronutrient intakes and associated metabolic risk
Key findings
Nationwide intake (62.3%) of low-quality carbohydrates (refined cereals and added sugar) is high
Saturated fatty acids consumption was beyond the recommended limits for most States
Only three States consumed dairy protein higher than the national average (2.1%)
Northeast on the whole consumes high carbohydrates, lower fat, and higher protein than national average
Replacing 5% from carbohydrates with 5% from plant, dairy, egg, or fish protein was associated with lower risk of newly diagnosed diabetes and prediabetes
Policy Implications
Public health strategies focusing on practical and sustainable approaches to decrease carbohydrates intake and increase consumption of protein
Encourage the use of healthier edible oils, which are low in saturated fats
Government subsidies from the Public Distribution System to prioritise healthier protein sources such as pulses and legumes over highly refined grains such as white rice
Increase availability of protein sources under the minimum support prices scheme could enhance protein and its quality
Source: Madras Diabetes Research Foundation
R.M. Anjana, lead author and president, MDRF, said, “This is not about rice or wheat, but how much of these you eat. Substituting one for the other does not reduce the risk. We recommend replacing 5% of daily calories from carbohydrates (rice or wheat) with protein.”
It found that replacing with protein, specifically from plants, pulses and legumes or dairy (both fermented and non-fermented), was associated with a lower likelihood of newly-diagnosed type 2 diabetes and prediabetes. The replacement of carbohydrate with animal protein was not associated with a lower risk of newly-diagnosed type 2 diabetes or prediabetes except when the source of animal protein was fish or egg.
Key findings
Refined cereal (white rice) was the primary choice in the northeast (99%), south (87%) and east (78%), and whole wheat (milled as flour) in the north (90%) and central (70%) regions. Millets as a main staple were consumed only in three States — Karnataka, Gujarat and Maharashtra.
Dr. Anjana said that as far as sugar intake was concerned, 21 States exceeded the recommended intake of no more than 5% of total daily intake.
Saturated fat intake surpassed the recommended threshold for metabolic health (less than 7% of energy) in all but four States — Jharkhand, Chhattisgarh, Arunachal Pradesh and Manipur. Consumption of monounsaturated and omega-2 polyunsaturated fats remain low across regions.
The total protein intake in India was low (12%), with the northeast having the highest intake (13.6%), the study found. Dr. Anjana noted that 9% of it came from plant protein followed by dairy protein and animal protein. “The northeastern region accounted for the highest carbohydrate intake, but had low diabetes prevalence, because they are substituting with protein intake,” she said. Talking about the association between total carbohydrates and metabolic risk factors, she said, “More carbohydrates mean significantly more diabetes, pre-diabetes, obesity, and abdominal obesity.”
V. Mohan, senior author of the paper and MDRF’s chairman, said that these nationwide findings should inspire policy reforms, especially regarding food subsidies and public health messaging to help Indians shift towards diets richer in plant-based and dairy proteins, and lower in carbohydrates and saturated fats. Sudha Vasudevan, joint first author and senior scientist and head, department of Foods Nutrition and Dietetics, MDRF was also present.
Published – October 01, 2025 04:13 am IST
