Among 1,104 Indian adults drawn from 29 healthcare centres across 14 states, carbohydrates supplied 62.1% of total energy — mirroring national ICMR-INDIAB figures — yet fibre intake sat at a critically low ~15 g/day while simple carbohydrates comprised 20.3% of all carbohydrate consumed. Adults with type 2 diabetes (T2DM, n=690) derived slightly less energy from carbohydrates than non-diabetic controls (61.0% vs. 64.1%), but overall carbohydrate quality as measured by exploratory Diet-Quality Index and Protein-Fat Quality Index scores remained suboptimal across both groups. Compared to the 2014 STARCH cohort, fat intake has risen and both quality indices have worsened.
This preprint — posted to medRxiv and not yet peer-reviewed — adds granular, multi-state dietary data to a landscape where most Indian nutrition surveillance aggregates by region rather than metabolic status. The finding that T2DM patients consume marginally fewer carbohydrates but not better-quality ones is clinically important: it suggests dietary counselling is shifting quantity without improving fibre density or limiting refined sugars, the variables most mechanistically tied to glycaemic control and gut microbiome health. The ~15 g/day fibre figure is roughly half the WHO-recommended 25–30 g, a gap with real consequences for postprandial glucose excursions. Limitations are significant — clinic-based convenience sampling constrains generalisability, the cross-sectional design precludes causal inference, and 24-hour recalls carry well-documented underreporting bias. Still, the multicentre scope and diabetes-stratified analysis make this an incrementally valuable, policy-relevant dataset for India's escalating diabetes burden.
