India’s high-carb diets driving surge in diabetes and obesity, study warns

India’s rapid dietary transition is fuelling a surge in cardiometabolic diseases, with new national survey data linking high consumption of low-quality carbohydrates to greater risk of diabetes and obesity, according to a study published in Nature Medicine titled ‘Dietary profiles and associated metabolic risk factors in India from the ICMR–INDIAB survey’.

Findings from the Indian Council of Medical Research–India Diabetes (ICMR–INDIAB) survey, covering 18,090 adults, reveal that Indian diets remain dominated by refined cereals, added sugars and saturated fats, while protein intake continues to be strikingly low.

Researchers found that diets high in carbohydrates were strongly associated with greater likelihood of newly diagnosed type 2 diabetes, prediabetes, generalized obesity and abdominal obesity.

Compared to those with the lowest carbohydrate intake, individuals with the highest intake had a 30% higher risk of diabetes, a 20% higher risk of prediabetes and a 22% higher risk of obesity.

The analysis showed that simply replacing refined cereals like white rice with whole wheat or millet flour did not significantly lower metabolic risk. However, substituting part of carbohydrate intake with protein from plant or dairy sources was linked with a marked reduction in risk. For instance, replacing 5% of daily energy from carbohydrates with dairy protein was associated with an 11% lower likelihood of type 2 diabetes and an 18% lower likelihood of prediabetes.

Northeastern states reported the highest protein intakes, largely from animal sources, while much of the country derived 65–75% of total calories from carbohydrates. Saturated fat intake exceeded national dietary recommendations in most states, and millets—once a traditional staple—were consumed by more than a third of the population in only three states.

Researchers cautioned that the findings are cross-sectional, meaning they cannot establish causality, and that unmeasured factors such as sugar from street foods or trans-fats in commercial products were not fully captured. Still, the national patterns underscore the urgency of dietary reform.

Public health experts say India needs to shift away from carbohydrate-heavy diets and expand access to quality protein sources through policies like reorienting subsidies under the Public Distribution System toward pulses and legumes, and promoting healthier edible oils lower in saturated fats. Expanding minimum support prices to include protein-rich crops could further improve access.

With non-communicable diseases already accounting for 68% of deaths in India, researchers argue that coordinated efforts between healthcare, agriculture and policy sectors are essential. Reducing dependence on refined grains and saturated fats, while boosting plant and dairy protein intake, could play a critical role in reversing the nutrition transition and mitigating India’s growing burden of diabetes and obesity.