Macronutrient Intake and Dietary Patterns in Indian Adults with and without Type 2 Diabetes: Findings From the Multicentric I-STARCH-1 Study Article Swipe
Nitin Kapoor
,
Sanjay Kalra
,
Neeta Deshpande
,
Sheryl S. Salis
,
Smriti Gadia
,
Thamburaj Anthuvan
·
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1101/2025.11.04.25339356
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1101/2025.11.04.25339356
The I-STARCH (Indian Study to Assess Real-World CarboHydrate Consumption) investigation quantified decadal changes in macronutrient intake and carbohydrate quality among Indian adults by benchmarking a 2025 multicentric cross-sectional survey against STARCH 2014. A total of 1,104 adults were enrolled from twenty-nine healthcare centres across fourteen Indian states. Each participant completed three non-consecutive 24 h dietary recalls, harmonised using the ICMR–NIN Food Composition Tables. Temporal contrasts treated 2014 cohort means as fixed benchmarks. In 2025, carbohydrates contributed 62.1% of total energy (2014: 65.8%), fat 25.1% (2014: 21.4%), and protein 12.8% (2014: 12.8%). Carbohydrate quality declined, with simple sugars comprising 20.3% of total carbohydrate (2014: 10.5%) and fibre providing only 1.8% of energy. Across all geographic zones including north, south, east, and west, macronutrient patterns remained suboptimal, indicating persistent dietary imbalance regardless of regional cereal dominance. Adults with type 2 diabetes reported lower carbohydrate intake (61.0%E) than those without diabetes (64.1%E), although both exceeded the recommended 50–55%E range. The composite Diet-Quality Index (protein%E + fibre%E − simple carbohydrate%E; higher = better) was lower in 2025, reflecting refined carbohydrate substitution without improvements in fibre or protein density. A secondary Protein–Fat Quality Index (PFQI = Protein % E ÷ Fat % E) was also computed to assess balance between protein and fat energy. These findings indicate a continuing nutrition transition in India, characterised by persistent carbohydrate predominance, higher dietary fat, and declining carbohydrate quality. Region-specific dietary policies and clinical practices that promote fibre and protein-rich foods, complex carbohydrate sources, and balanced macronutrient quality are needed to support better metabolic health in India.
Related Topics
Concepts
Carbohydrate
Medicine
Cohort
Glycaemic index
Starch
Nutrition transition
Type 2 diabetes
Food science
Diabetes mellitus
Dietary fibre
Food group
Body mass index
Cohort study
Glycemic index
Physiology
Carbohydrate metabolism
Resistant starch
Low carbohydrate
Biology
Animal science
Protein quality
Metadata
- Type
- article
- Landing Page
- https://doi.org/10.1101/2025.11.04.25339356
- https://www.medrxiv.org/content/medrxiv/early/2025/11/13/2025.11.04.25339356.full.pdf
- OA Status
- green
- References
- 36
- OpenAlex ID
- https://openalex.org/W7105651673
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W7105651673Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1101/2025.11.04.25339356Digital Object Identifier
- Title
-
Macronutrient Intake and Dietary Patterns in Indian Adults with and without Type 2 Diabetes: Findings From the Multicentric I-STARCH-1 StudyWork title
- Type
-
articleOpenAlex work type
- Publication year
-
2025Year of publication
- Publication date
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2025-11-13Full publication date if available
- Authors
-
Nitin Kapoor, Sanjay Kalra, Neeta Deshpande, Sheryl S. Salis, Smriti Gadia, Thamburaj AnthuvanList of authors in order
- Landing page
-
https://doi.org/10.1101/2025.11.04.25339356Publisher landing page
- PDF URL
-
https://www.medrxiv.org/content/medrxiv/early/2025/11/13/2025.11.04.25339356.full.pdfDirect link to full text PDF
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YesWhether a free full text is available
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greenOpen access status per OpenAlex
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https://www.medrxiv.org/content/medrxiv/early/2025/11/13/2025.11.04.25339356.full.pdfDirect OA link when available
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Carbohydrate, Medicine, Cohort, Glycaemic index, Starch, Nutrition transition, Type 2 diabetes, Food science, Diabetes mellitus, Dietary fibre, Food group, Body mass index, Cohort study, Glycemic index, Physiology, Carbohydrate metabolism, Resistant starch, Low carbohydrate, Biology, Animal science, Protein qualityTop concepts (fields/topics) attached by OpenAlex
- Cited by
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0Total citation count in OpenAlex
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36Number of works referenced by this work
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