Can Indians eat rice, roti, dal and still beat diabetes? Dr Shriram Nene answers

Are rice, roti and dal really to blame for India's diabetes crisis, or does the problem lie in how we eat and live? Dr Shriram Nene explained at the HealthWealth Summit.Dr Shriram Nene at the HealthWealth Summit.New Delhi,Oct 29, 2026 13:14 ISTRice, roti and dal are staples in most Indian households. But with diabetes cases rising and carbohydrates often being singled out as the culprit, should Indians really be rethinking what goes on their plates? Dr Shriram Nene, cardiovascular and thoracic surgeon and founder of Pathfinder Health Sciences, believes the answer lies not in abandoning traditional Indian food, but in understanding how we eat it.Speaking at India Today’s HealthWealth Summit in a session titled '21 Days to Good Health', Nene explained how Indians can build healthier eating habits without giving up their favourite foods.The concern is real. An estimated 10.1 crore Indians have diabetes, while another 13.6 crore have prediabetes, a condition that increases the risk of developing type 2 diabetes. Research from the Madras Diabetes Research Foundation (MDRF) and the Indian Council of Medical Research's ICMR-INDIAB study has also highlighted the significant role of carbohydrates in Indian diets, with 62.3% of total energy intake coming from low-quality carbohydrates, including refined cereals and sugars.So, what needs to change?The problem isn't simply rice and roti According to Nene, the way Indians live and work has changed considerably, but their diets have not always kept pace.“South Asians are at risk for some diseases like heart disease and diabetes,” he said, explaining that India has moved from an agrarian society, where people relied on physical labour, to one increasingly dominated by desk jobs and sedentary lifestyles. High-carb diets increase risk of type 2 diabetes by up to 30%, prediabetes by 20%, and obesity by 22%. (Photo: Getty) “Now we're in an industrial age, and more people are working in IT centres, BPOs, and other places where intellectual capital is more important. Add to that energy-dense food and the ability to order it very, very fast; it compounds the net effect.”In other words, the concern is not just about eating carbohydrates. It is also about how much we eat, the quality of those carbohydrates and how much energy we expend during the day.Nene advocates eating traditional Indian food in the right proportions, while taking individual needs into account. Family history, genetics, socioeconomic background and physical activity levels all matter when deciding what works for someone.An athlete who exercises regularly, for instance, may need more carbohydrates than someone who spends most of their day sitting at a desk.What should a balanced Indian plate look like?Rather than following restrictive diets, Nene recommends a simple plate-based approach.In the model he discusses in his book, half the plate should comprise fibrous vegetables, a quarter should be protein and the remaining quarter should contain non-refined complex carbohydrates.The idea is to make room for a variety of foods instead of allowing refined grains and other carbohydrate-heavy foods to dominate every meal.For Indian households, this could mean pairing roti or rice with a generous serving of vegetables and a source of protein, while being mindful of portions and choosing less-refined carbohydrate options where possible.The approach also needs to be personalised. There is no single diet that works equally well for everyone, and people with diabetes or prediabetes may need individual guidance from a qualified healthcare professional.Can you still eat vada pav?If you think eating healthy means bidding farewell to your favourite Indian snacks and festive treats, Nene has a different approach: rethink the ingredients rather than eliminate the dish altogether.He cited an experiment from his This Versus That series, in which he reworked Mumbai's much-loved vada pav.“It's a carb on carb on carb,” he said, describing how the snack was originally suited to people doing manual labour because it was inexpensive, filling and energy-dense.Instead of removing it from the menu, his team replaced the potato filling with sweet potato, or ratala, which he said offered more fibre and a lower glycaemic index. They also experimented with millet-based alternatives to pav and compared fried, air-fried and baked versions.The result? The sweet potato vada pav was a hit.His point is simple: healthier alternatives do not have to be boring, and familiar foods do not necessarily need to disappear from your diet.That does not mean every traditional dish can be made healthy simply by changing one ingredient. Portion sizes, the overall nutritional composition and how frequently a dish is eaten still matter.What about sugar and sugar-free alternatives?Added sugar is another area where Nene believes small, consistent changes can make a difference.He suggested beginning with a simple habit: stop adding sugar to tea or coffee for a week, extend the experiment to 14 days and then try 21 days.The goal is to gradually reduce the preference for added sweetness rather than rely on willpower every time a craving strikes.But what about sugar-free products?Nene cautioned against assuming that replacing sugar with a sweetener automatically makes an entire meal healthy. He questioned the logic of choosing a diet drink while continuing to consume an excessively large, calorie-dense meal.His broader message was to focus on the overall diet instead of treating sugar-free products as a free pass.Naturally occurring sugars in whole fruit, meanwhile, come alongside fibre and other nutrients. Whole fruit can be part of a balanced diet, unlike routinely reaching for sugary drinks and snacks.Start young, build habits that lastFor Nene, healthier eating should begin early, rather than becoming a priority only after a diagnosis or a change in weight.He cautioned against making cookies and other sugary treats the default reward for children, suggesting that fruit and other nutritious alternatives can be made equally appealing.He also encouraged teaching children to cook and helping them understand how food choices relate to their activity levels and nutritional needs.“You don't need to change your life dramatically,” he said, acknowledging that there will be days when people slip up. What matters is building sustainable habits and understanding why those changes are important.Watch the HealthWealth Summit LIVE here: - Ends