*Corresponding author: maurya.2@osu.edu www.gerfbb.com Keywords: Dietary carbohydrates, Indian diet, Insulin resistance, Metabolic syndrome, Trans fatty acids, Review Article Indian diet: Implications in recent explosion in insulin resistance and metabolic syndromes in India Santosh Kumar Maurya * and Naresh Chandra Bal Department of Physiology and Cell Biology, Ohio State University, Columbus (OH), USA Abstract It has long been suggested that diet is crucial in the development of insulin resistance although conclusive human data is lacking. Indian population is in general considered to be prone to develop insulin resistance and metabolic syndrome. The recent trend in dietary consumption pattern in most of the Indian populations, have several dietary imbalances including; low intake of MUFA, n-3 PUFA and fibre, and high intake of fats, saturated fats, carbohydrates and trans fatty acids (mostly related to the widespread use of Vanaspati, a hydrogenated oil). Some data indicate that these nutritional imbalances are associated with insulin resistance, dyslipidaemia and subclinical inflammation in Indian population. Specifically, in children and young individuals, a high intake of n-6 PUFA is correlated with fasting hyperinsulinaemia, and in adults, high-carbohydrate meal consumption was reported to cause hyperinsulinaemia, postprandial hyperglycaemia and hypertriacylglycerolaemia. Inadequate maternal nutrition during pregnancy that lead to low birth weight and childhood ‘catch-up’ obesity are also very common in India. Even in rural populations, who usually consume traditional frugal diets, there is increasing prevalence of cardiovascular risk factors and the metabolic syndromes due to rapid pace of change in diets and lifestyle. Dietary supplementation with n-3 PUFA has been shown to improve lipid profile and may have beneficial effect on insulin resistance. Also, low glycaemic index foods and whole grain intake decrease insulin resistance. Among micronutrients, high magnesium and calcium intake have been reported to decrease insulin resistance. This provides a hope that, the grim situation of diet-induced metabolic syndromes can be controlled. Therefore, a nationwide community intervention programmes aimed at creating awareness about the consequences of unhealthy food choices and replacing them by healthy food choices are urgently needed in urban and rural populations in India. Introduction Diabetes is the single most important metabolic disease which can affect nearly every organ system in the body. It has been projected that 300 million individuals would be diabetic by the year 2025. In India it is estimated that presently 19.4 million individuals are affected by this deadly disease, which is likely to go up to 57.2 million by the year 2025. There could be many possible reasons for this escalation including; changes in lifestyle, increase in aged population (people living longer than before) and low birth weight leading to adulthood diabetes. Insulin resistance is associated with the metabolic syn- drome such as, type 2 diabetes mellitus (T2DM) and car- diovascular diseases (CVD). Impaired insulin sensitivity has been shown in subjects known to be at risk for diabe- tes, such as normoglycaemic first-degree relatives of pa- tients with T2DM and women with a history of gesta- tional diabetes. It is now well established that generalised obesity and abdominal obesity (excess subcutaneous and intra- abdominal fat) are associated with insulin resistance (Misra et al., 2004; Misra and Vikram, 2003; Misra et al., 2007). In most individuals who develop T2DM, insulin resistance is generally present for many years before the occurrence of hyperglycemia. After few decades of research it has become apparent that diet and physical activity significantly influence insulin resistance, dyslipidaemia and T2DM. The rapidly increasing prevalence of these disorders in various Indian populations has been largely linked to rapid changes in lifestyle and dietary patterns (Misra et al., 2007; Misra et al., 2007 (II); Wasir and Misra; 2004). Unfortunately, the data regarding the relationship of dietary nutrients with insulin resistance are scarce in Indians. Although some studies have reported an influence of dietary nutrients on insulin resistance and cardiovascular risk factors in Indians. The present study aims to review the influence of dietary nutrients on insulin resistance and related metabolic syndromes in Indian populations. GERF Bulletin of Biosciences December 2010, 1(1): 25-36