Dietary composition shows measurable links with metabolic health in Indian adults. The Indian Study to Assess Real World CarboHydrate Consumption (I-STARCH), published in the International Journal of Clinical Metabolism and Diabetes, evaluated macronutrient intake patterns in adults with and without T2DM across India to generate real-world dietary evidence relevant to diabetes prevention and management.

This multicentric, cross-sectional observational study enrolled participants from 33 healthcare centers nationwide. A structured three-day dietary recall quantified macronutrient intake as a percentage of total energy. Clinical data were obtained from authenticated medical records. Associations were examined with HbA1c, FBG, PPBG, and lipid parameters. Subgroup analyses compared urban and semi-urban populations.

Dietary energy distribution varied between adults with and without T2DM. Higher carbohydrate contribution was associated with less favorable glycemic indices, including elevated HbA1c. Differences in meal frequency, water intake, and consumption of ultra-processed foods were observed across demographic subgroups. Lipid profile variations aligned with dietary fat intake patterns.

These findings establish contemporary dietary benchmarks in India. The results support targeted nutritional strategies aligned with regional eating behaviors and metabolic risk profiles.