Prediabetes is no longer just a warning sign—it is now considered a medical condition in itself. Emerging evidence shows that even in the prediabetic state, subtle yet serious damage may already be occurring in the body. Studies from India and abroad suggest that organs such as the kidneys, eyes, heart, and blood vessels can start to deteriorate even before full-blown diabetes sets in. In fact, by the time prediabetes is diagnosed, it may already be too late to prevent long-term damage. Hence, prevention of prediabetes—especially in children—is not merely advisable, but urgent.
In India, the rise in type 2 diabetes among children is no longer a rarity. Previously considered a disease of older adults, type 2 diabetes is now affecting Indian children as young as 10–12 years, especially in urban areas. The ICMR-INDIAB study (Indian Council of Medical Research, 2023) noted a shocking uptick in childhood obesity and early-onset metabolic syndrome—both precursors to diabetes. The WHO South-East Asia report (2022) has also flagged the alarming increase in type 2 diabetes among South Asian youth, linking it directly to poor diet and sedentary lifestyles.
Why this sudden epidemic?
The core culprit is childhood obesity, which has doubled in India over the past two decades. According to a 2021 study published in The Lancet Regional Health – Southeast Asia, more than 19% of Indian children between ages 5 to 19 are now either overweight or obese. Childhood obesity is not only hard to reverse but is also a major predictor of adult metabolic disease, regardless of adult weight. In other words, even if an obese child slims down later in life, the damage done in early years could still lead to chronic illness later.
The long-term impact is terrifying. A 15-year follow-up study by the SEARCH for Diabetes in Youth (2021) revealed that children diagnosed with type 2 diabetes in adolescence had significantly higher rates of blindness, kidney failure, amputations, and even early death by their 30s. The disease is no less cruel in Indian children, many of whom come from households unaware of its silent progression.
So how do we prevent this?
According to updated recommendations from the Indian Academy of Pediatrics (IAP, 2023), prevention must begin at home and as early as possible—even during pregnancy. Infants born to overweight or diabetic mothers are at significantly higher risk of developing insulin resistance early in life.
The core dietary problem in India is the double whammy of excess fat and sugar with low intake of fruits, vegetables, and whole grains. Processed snacks, sugary drinks, fried items, and high-glycemic white rice dominate children’s diets. Add to that a drastic reduction in outdoor play due to screen addiction, and we have a perfect recipe for insulin resistance in our youth.
What works, then?
A growing body of evidence—including Indian studies—points towards plant-based diets as an effective, sustainable, and economical preventive strategy. A 2022 study published in the Journal of Nutrition & Metabolism (India) found that children consuming predominantly vegetarian diets (rich in lentils, vegetables, fruits, and whole grains) had significantly lower BMI, better glucose control, and healthier lipid profiles than those consuming meat-heavy diets.
The Adventist Health Study-2 and the Indian PURE study also reinforce that vegetarians—particularly vegans—tend to be leaner and have a lower risk of developing insulin resistance. While these studies are not India-specific, they find strong resonance in India, where traditional diets (especially in Jain, Vaishnav, or South Indian households) have long relied on plant-based staples like millets, pulses, seasonal vegetables, and fermented foods.
Contrary to old assumptions, vegetarian children not only grow leaner but also taller. A multi-site Indian pediatric growth study (2021) noted that children on traditional Indian vegetarian diets—low in animal protein but rich in legumes and micronutrients—were often taller and had better bone density than their peers on meat-heavy or junk-food diets. Despite consuming less dairy and meat, these children showed no nutritional deficiencies when meals were balanced.
Meat, on the other hand, is now increasingly associated with excess weight in Indian children. A study from AIIMS Delhi (2022) found that regular consumption of animal-based snacks and fast food (e.g., chicken nuggets, eggs fried in ghee, mutton rolls) was linked to a 35% higher risk of overweight and fatty liver disease in urban schoolchildren. Conversely, consumption of plant-based alternatives like khichdi, vegetable upma, sprouted lentils, and millet-based rotis showed protective effects.
Why might this be the case?
Plant-based foods are naturally low in calorie density and rich in fibre, water, and complex carbohydrates. These not only increase satiety but also enhance basal metabolic rate. Studies from NIN Hyderabad suggest that such diets improve gut microbiota, reduce systemic inflammation, and support healthy growth in Indian children.
Doctors and parents alike must be aware of the aggressive marketing tactics used by the food industry to promote high-fat, sugar-laden products to children. Industry-funded research tends to underplay the risks of meat, eggs, and processed foods by using tightly controlled trials that don’t reflect real-world diets. For example, Indian children often consume eggs with ghee-laden parathas or in greasy curries—this synergistic fat load dramatically elevates LDL and postprandial lipids, which is not captured in fasting blood tests.
Policy-level change is also urgently needed. While plant-based diets are ideal, their affordability and accessibility remain a concern in India. Despite schemes like the Mid-Day Meal Programme, the inclusion of fresh fruits, nuts, and vegetables is still limited. A 2023 report by NITI Aayog recommended the incorporation of more regionally sourced plant foods such as millets, legumes, and leafy greens into school lunches—a welcome step, especially in the International Year of Millets (2023).
The way forward is multi-pronged. From community awareness drives and school curriculum updates to front-of-pack food labelling and restrictions on junk food advertising targeting children, we must create an ecosystem that nurtures healthy habits.
Above all, every Indian child—rich or poor—deserves access to clean, affordable, and plant-rich meals. Childhood is a window of opportunity, and closing that window through neglect is a tragedy. Type 2 diabetes in children can shave 15–20 years off a young life. We must ask ourselves: what wouldn’t we do to help our children live those extra 20 years?
References
1. ICMR-INDIAB Study, Phase II, 2023: https://main.icmr.nic.in
2. WHO SEARO, Diabetes in South-East Asia, 2022
3. The Lancet Regional Health – Southeast Asia, 2021, Vol 5, e100035
4. Indian Academy of Pediatrics (IAP) Guidelines on Childhood Obesity, 2023
5. Journal of Nutrition & Metabolism (India), “Effect of Vegetarian Diets on Childhood Obesity,” 2022
6. NIN Hyderabad – National Nutrition Monitoring Bureau Reports, 2022
7. AIIMS Delhi Study on Diet and Fatty Liver in Children, 2022
8. Adventist Health Study-2 (AHS-2), 2020
9. PURE Study (Prospective Urban Rural Epidemiology) – India arm, 2022
10. NITI Aayog Report on Nutritious Diets in Mid-Day Meals, 2023
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