AbstractBackground: Asian populations exhibit a significant positive association between high carbohydrate intake and diabetes risk due to lower insulin secretory capacity and refined starch staples. This review synthesizes recent evidence across five carbohydrate intake intervals and integrates it with a behavioral model. Methods: A narrative review of large‑scale Asian cohort studies, randomized controlled trials (RCTs), and major clinical guidelines up to 2026 was conducted. Results: Long‑term risk significantly increased (HR = 3.228) with 65–80% carbohydrate intake 1. In the 60–75% range, Asian‑specific risk increased by 29% (RR = 1.29) 2. The 45–60% range represents an elevated risk warning zone with a 37.0% hyperglycemia prevalence 3. Conversely, restricting carbohydrate intake to 26–44% provides preventive potential, while a short‑term low‑carbohydrate diet (<26% or ≈90 g/day) significantly improved HbA1c by 1.6% and promoted diabetes remission 4,5. Additionally, adherence to the Mediterranean diet reduces type 2 diabetes risk by 11–18%, lowers HbA1c by 1.0%, and decreases cardiovascular events by 16% 6,7. To facilitate long‑term adherence, these dietary targets are integrated into the "FEED ATOMS" behavioral model (encompassing Food, Exercise, Eliminate weight/fat, Drugs, Devices; and the dietary metrics of Amount, Type, Order of meals, and Speed). Conclusion: Managing carbohydrate proportions is critical for Asian metabolic health. Transitioning from high‑carbohydrate patterns to a personalized low‑carbohydrate or Mediterranean diet, structured through the micro‑habits of the FEED ATOMS framework, appears to offer a scalable and sustainable pathway for type 2 diabetes prevention and clinical remission. This narrative review presents a synthesized analysis of evidence-based data and is not intended as formal clinical guidelines. Readers should consult healthcare professionals for individual medical advice. KeywordsCarbohydrate ratio; Diabetes risk; Asian population; Low‑carbohydrate diet; Mediterranean diet; Preprint; FEED ATOMS Version: 12.0 (Preprint) Upload date: Jun.03.2026
CHEN CHIN CHEN (Wed,) studied this question.