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White Rice Linked to Type 2 Diabetes

Posted: Monday, March 26, 2012

Eating more white rice may up the risk of type 2 diabetes by 27%, especially for Asian populations.
Patients who ate the greatest amounts of the grain had a 27% greater risk of developing the disease than those who ate the least, and the relative risk was higher among Asian patients.

Qi Sun, PhD, of Harvard, wrote, "Although rice has been a staple food in Asian populations for thousands of years, this transition [to more sedentary lifestyles and greater availability of food] may render Asian populations more susceptible to the adverse effects of high intakes of white rice." "But at the same time people should pay close attention to the other things they eat." "It's very important to address not just a single food but the whole pattern of consumption."

These studies followed 350,000 people over a timescale from four to 22 years. More than 13,000 people developed type 2 diabetes. In the studies carried out in China and Japan, those who ate most rice were 55% likelier to develop the disease than those who ate least. In the United States and Australia, where consumption of rice is far lower, the difference was 12%.

During that time, there were 13,284 incident cases of type 2 diabetes. Asians generally had a higher level of white rice consumption than Western populations. Overall, they said, they found a positive association between white rice intake and type 2 diabetes (RR 1.27, 95% CI 1.04 to 1.54, P=0.001), which was stronger in Asian populations.

Asians with the highest intake had a 55% greater risk of diabetes than Asian patients who ate the least rice (RR 1.55, 95% CI 1.20 to 2.01).

The glycemic index of white rice is higher than that of other whole grains, largely due to processing. It's also the primary contributor to dietary glycemic load for populations that consume rice as a staple food, such as Asians.

The risk was also heightened in Western populations, but the confidence interval straddled 0 and wasn't significant (RR 1.12, 95% CI 0.94 to 1.33). They also found a dose-response effect -- with each increase in rice serving per day, risk of type 2 diabetes rose by 11% (95% CI 1.08 to 1.14, P<0.001). In secondary analyses, the association appeared to be more pronounced in women than in men, they added.

They cautioned, however, that the meta-analysis was limited by the observational nature of the included studies and by their reliance on food frequency questionnaires to assess dietary intake. Also, they did not analyze consumption of brown rice, since only one of the four studies examined this food.

Still, they concluded that the dose-response relationship may indicate that "even for Western populations with typically low intake levels, relatively high white rice consumption may still modestly increase risk of diabetes."

Practice Pearls:
  • Note that the association was highest for the Asian population.
  • A meta-analysis of four cohort studies found that consumption of higher amounts of white rice was associated with an increased risk of type 2 diabetes compared to eating the lowest amounts.

Source:, Hu EA, et al "White rice consumption and risk of type 2 diabetes: Meta-analysis and systematic review" BMJ 2012; DOI: 10.1136/bmj.e1454.

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