A nationwide survey by the Indian Council of Medical Research–India Diabetes (ICMR-INDIAB) project reveals a worsening health crisis in India, linking diet and lifestyle changes to rising diabetes, obesity, and heart disease. The study, published in Nature Medicine, analyzed over 18,000 adults and found 83% have at least one metabolic risk factor, such as hypertension, high cholesterol, obesity, or diabetes. The survey showed nearly one-third have hypertension, 9% newly diagnosed with type 2 diabetes, and an alarming 41% with prediabetes. Though India’s median BMI is moderate, 43% of adults are overweight and 26% obese, with 36% having harmful abdominal obesity. Cholesterol abnormalities affected half the participants. Urban residents face higher risks due to sedentary habits, while dietary patterns dominated by high carbohydrate intake—mainly white rice, refined wheat, and added sugars—contribute significantly. Replacing some carbohydrates with protein from plant, dairy, egg, or fish sources reduces diabetes and prediabetes risks substantially. The study recommends public health policies to lower carbohydrate and saturated fat consumption while increasing protein intake to curb India’s growing metabolic disease epidemic. Without urgent intervention, the healthcare burden will intensify dramatically. Reference: Anjana, R.M., Sudha, V., Abirami, K. et al. Dietary profiles and associated metabolic risk factors in India from the ICMR–INDIAB survey-21. Nat Med (2025). https://doi.org/10.1038/s41591-025-03949-4