Plates across India are full of rice, wheat, and sugar. For many families, these foods form the base of every meal. But new nationwide research shows that these same staples may be driving a sharp rise in diabetes and obesity.
The findings come from the Indian Council of Medical Research–India Diabetes (ICMR-INDIAB) study, which examined diets across 36 states and union territories. It found that Indians get more than 60 percent of their calories from carbohydrates, one of the highest levels in the world. Researchers say this heavy reliance on carbs, paired with low protein intake, is pushing millions toward poor health.
The study showed that people consuming higher proportions of carbohydrates were 14 percent more likely to develop type 2 diabetes.
“Typical Indian diets, heavy in carbohydrates from white rice or wheat flour and low in quality protein, are putting millions at risk,” said Dr. Ranjit Mohan Anjana, lead author of the study and president of the Madras Diabetes Research Foundation.
National survey of over 1.2 lakh adults
The research was based on a cross-sectional survey of 121,077 adults across 36 states, union territories, and Delhi. Conducted in collaboration with the Madras Diabetes Research Foundation, it gathered detailed dietary information from every fifth participant to profile eating habits and health risks.
The findings confirmed strong links between carb-heavy diets and the risk of newly diagnosed diabetes and prediabetes across all regions.
“Similar metabolic risks were observed regardless of whether people ate rice in the south and east or wheat in the north and central regions,” said Dr. Vasudevan Sudha, joint first author and head of nutrition research at MDRF.
Sugar intake exceeds safe levels in most states
The survey revealed high sugar consumption across India. In 21 states and union territories, daily intake of sugar was above the national recommendation of less than 5 percent of total energy.
A pooled analysis across six regions showed refined cereals raised the odds of type 2 diabetes by 13 percent, milled whole grains by 9 percent, and added sugars by 14 percent.
India is one of the world’s largest consumers of sugar. Researchers warn that added sugar intake is underreported, as much of it comes from sweets and processed foods that are not labeled.
Fat and protein gaps
While total fat intake was within national guidelines, saturated fat consumption was above safe limits for metabolic health in nearly all states. This was linked to widespread use of ghee in the north and palm oil and coconut oil in the south.
Healthier fats, such as those from nuts and omega-3 rich foods, remained low in Indian diets.
Protein intake was also found to be insufficient, averaging 12 percent of daily calories, below the national dietary guideline of 15 percent. Most protein came from cereals and pulses, with dairy and animal sources contributing very little.
“Replacing just 5 percent of calories from carbohydrates with protein from plants or dairy significantly lowered the risk of diabetes and prediabetes,” the researchers reported. Substituting with red meat protein or fats did not show protective effects.
The ICMR-INDIAB survey also measured obesity levels. It reported that 28.6 percent of adults were obese and nearly 40 percent had abdominal obesity. Prediabetes was found in 15.3 percent of the population, while diabetes prevalence stood at 11.4 percent.
Urban residents were more likely to be overweight and inactive compared to rural populations, but dietary risks were common to both groups.
By 2060, the economic costs of overweight and obesity in India are projected to reach $839 billion, or 2.47 percent of GDP.
Regional patterns in cereal staples
The study highlighted stark regional differences in staple foods. White rice was dominant in the south, east, and northeast, while wheat flour was common in the north and central regions.
Despite growing government promotion of millets, their consumption was limited to a few states such as Karnataka, Gujarat, and Maharashtra. Researchers noted that even milled whole grains such as wheat or millet flour were linked to higher diabetes risk.
“Milling reduces the particle size of grains, raising their glycemic index,” the paper explained. “This means the body processes them in ways similar to refined rice or flour.”
Experts say the findings underline the urgent need for dietary interventions at the national level.
“Unless total carbohydrate intake is reduced and more calories come from protein-rich foods, the risk remains high,” said Dr. Anjana.
The researchers recommend shifting subsidies from rice and wheat toward pulses and legumes to encourage healthier eating patterns. They also called for stronger regulation of added sugars in processed foods, and promotion of dairy, eggs, and fish as sources of high-quality protein.
Dr. Sudha stressed that public awareness must match policy changes. “People need clear information on how their food choices affect long-term health. Small dietary changes, like including more pulses and dairy, can lower risk significantly.”
Rising burden of noncommunicable diseases
India already accounts for nearly 20 percent of the world’s population and carries a heavy burden of noncommunicable diseases. They are responsible for 68 percent of all deaths in the country.
The new findings confirm that unhealthy diets are a central driver of this crisis.
“Improving diet and physical activity can prevent nearly half of new diabetes cases,” said Dr. Anjana. “This is achievable, but it requires urgent public health action.”
