Published Oct 23, 2026 | 1:30 PM ⚊ Updated Oct 23, 2026 | 1:30 PM
Among adults consuming medium- or high-quality diets, researchers found no statistically significant differences in cholesterol levels. (AI generated)
Synopsis: A study of 1,020 adults in Chennai found that healthier eating may help mitigate inherited cardiometabolic risks, although the findings do not establish causation. The study highlights the importance of culturally relevant dietary interventions.
A study involving 1,020 adults in Chennai has found that the same genetic predisposition may not translate into the same cholesterol levels in everyone.
The findings showed that people with a higher genetic risk had significantly higher total cholesterol and low-density lipoprotein (LDL — or bad cholesterol) levels than those with a lower genetic risk. But with a caveat: this was only among participants whose diets were classified as poor quality.
Among adults consuming medium- or high-quality diets, researchers found no statistically significant differences in cholesterol levels between the higher- and lower-genetic-risk groups.
“An important message from this study is that our genes need not determine our metabolic destiny. We found that individuals with a higher genetic predisposition had significantly higher cholesterol levels when their diet quality was poor. However, these differences were not observed among those consuming healthier diets,” said Dr V Mohan, chairman of MDRF and Dr Mohan’s Diabetes Specialities Centre, and a co-author of the study.
The study, titled Low diet quality increases the genetic risk of high blood cholesterol levels in Asian Indian adults, was published in the journal PLOS One on 14 October 2026. It was conducted by researchers from the Madras Diabetes Research Foundation (MDRF), Dr Mohan’s Diabetes Specialities Centre in Chennai, and the University of Reading, United Kingdom.
The study analysed 1,020 adults aged 25 to 80 years, comprising 452 men and 568 women, from the Chennai Urban Rural Epidemiology Study (CURES).
“To the best of our knowledge, this is the first study to examine the interaction between genetic risk and diet quality on multiple cardiometabolic disease (CMD)-related outcomes in the Asian Indian population using a culturally tailored DQS,” the authors wrote.
The culturally tailored DQS used was the Indian Diet Quality Score (IDQS), which measures consumption across eight food groups relevant to Indian eating patterns.
Researchers examined three genetic variants in two genes, TCF7L2 and FTO, that have previously been associated with metabolic traits, including diabetes risk. They combined these variants into a genetic risk score to assess the participants’ relative susceptibility.
In this study, participants carrying one or fewer risk alleles were classified as having lower genetic risk, while those carrying more than one were classified as having higher genetic risk. The score was limited to three variants and was not intended to capture every genetic factor that could influence cholesterol.
The analysis revealed that the differences between genetic-risk groups emerged in the low-diet-quality category but were not statistically significant in the medium- and high-quality categories.
They noted that the interaction accounted for approximately 1.1% of the variation in total and LDL cholesterol after adjustment for other factors in the statistical models. Although modest, the effect was statistically significant, the researchers said, and could be relevant when considered alongside other genetic and lifestyle influences on metabolic health.
The study did not examine a single food or nutrient in isolation. Instead, it assessed the overall pattern of consumption, using a score that considers both food groups associated with better metabolic health and those classified as less favourable within the scoring system.
The eight groups included pulses and legumes, milk and milk products, fruits and vegetables, white rice, edible fats and oils, added sugar, added salt, and poultry and eggs. Higher consumption of pulses and legumes, milk products, fruits and vegetables contributed positively to the score.
The scoring system used the reverse approach for white rice, edible fats and oils, added sugar, added salt, and poultry and eggs, reflecting the associations on which the index was developed.
Dietary information was collected using a validated food-frequency questionnaire containing 222 items. Participants reported their usual portion sizes and how often they consumed different foods over the preceding year.
Professor KS Vimaleswaran, senior scientist at the University of Reading and a co-author, said the findings reinforced the importance of improving eating habits even when genetic susceptibility cannot be changed.
“While we cannot change the genes we inherit, we can certainly improve our dietary habits. A balanced diet with adequate fruits, vegetables, pulses and other nutritious foods, along with moderation in refined carbohydrates, added sugars, salt and unhealthy fats, remains an important strategy for improving metabolic health. This research also provides a foundation for future studies on personalised nutrition for the Indian population,” he said.
The authors argued that a dietary score adapted to Indian food habits could provide a more relevant way of assessing diet-related metabolic risk than relying exclusively on dietary indices developed in Western populations.
However, they underlined that the score is a study-specific measure, not proof that every food in a negatively scored category is inherently harmful. The study also did not isolate which individual foods or dietary changes were responsible for the observed interaction between genetic risk and cholesterol levels.
The researchers found that a higher genetic risk score was associated with higher fasting plasma glucose and glycated haemoglobin (HbA1c) levels.
Participants with more than one risk allele had higher fasting glucose and HbA1c measurements than those with one or no risk alleles. The associations remained statistically significant after adjustments for relevant factors, including age, sex and diabetes status.
Fasting plasma glucose measures the level of sugar in the blood after a period without food. HbA1c reflects average blood glucose levels over approximately two to three months. Both are used in assessing blood sugar regulation and diabetes.
Dr Manahil M Bineid of the University of Reading, the first author of the study, said the findings were relevant to the existing burden of metabolic disease among Indians.
“This reinforces the importance of healthy eating habits, particularly in Indians who are already at increased risk of diabetes and cardiovascular disease,” she said.
However, the researchers found that the interaction between genetic risk and diet quality for HbA1c did not remain statistically significant after correction for multiple testing.
They also found no significant independent association between the genetic risk score and total cholesterol, LDL cholesterol, triglycerides, high-density lipoprotein (HDL) cholesterol, body mass index or waist circumference when diet quality was not considered as an interacting factor.
The findings therefore point to two distinct observations: higher genetic risk was associated with higher blood sugar markers, while the relationship between genetic risk and cholesterol depended on diet quality in the statistical analysis.
India faces a substantial burden of diabetes, abnormal cholesterol levels and cardiovascular disease.
The researchers noted that changes in dietary patterns, including increased consumption of refined grains and inadequate intake of fibre, fruits and vegetables, have raised concerns about the quality of diets consumed by Indian adults.
They argued that understanding how genetic susceptibility interacts with lifestyle factors could help researchers develop more targeted approaches to preventing cardiometabolic disease.
“CMD risk is significantly influenced by the interaction between genetic predisposition and lifestyle factors, such as dietary patterns and physical inactivity,” the authors wrote in the paper’s introduction.
They said further research examining genetic risk alongside lifestyle factors could help inform precision nutrition strategies aimed at reducing susceptibility to metabolic disorders.
The findings could contribute to the growing field of nutrigenetics, which examines how genetic variations influence responses to dietary factors. Precision nutrition seeks to tailor dietary advice to an individual’s characteristics, potentially including genetic information, metabolic measurements and existing health conditions.
However, the study did not test a personalised nutrition programme or establish that genetic testing is necessary before recommending healthier eating habits. Nor did it demonstrate that a higher-quality diet prevents heart attacks, strokes or the development of abnormal cholesterol levels over time.
The researchers recommended examining additional lipid-related genetic variants and investigating the biological mechanisms through which dietary exposures may influence lipid metabolism.
“Well-designed dietary intervention trials are needed to assess the effects of targeted dietary modifications and specific DQS components (e.g., refined grains, edible fats, added sugar) on genetic susceptibility and lipid metabolism,” the researchers wrote in their conclusion.
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(Edited by R Rajesh Kumar.)
