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LETTER TO EDITOR
Year : 2021  |  Volume : 10  |  Issue : 2  |  Page : 175-176

Does higher consumption of white rice increase the risk of type 2 diabetes?


Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy

Date of Submission26-Nov-2020
Date of Decision13-Jan-2021
Date of Acceptance01-Feb-2021
Date of Web Publication18-May-2021

Correspondence Address:
Dr. Chidiebere Emmanuel Okechukwu
Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome 00185
Italy
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijhas.IJHAS_245_20

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How to cite this article:
Okechukwu CE. Does higher consumption of white rice increase the risk of type 2 diabetes?. Int J Health Allied Sci 2021;10:175-6

How to cite this URL:
Okechukwu CE. Does higher consumption of white rice increase the risk of type 2 diabetes?. Int J Health Allied Sci [serial online] 2021 [cited 2021 Jun 17];10:175-6. Available from: https://www.ijhas.in/text.asp?2021/10/2/175/316287



Overconsumption of refined carbohydrates like white rice can raise triglyceride and blood glucose levels, which are major risk factors for obesity, type 2 diabetes (T2D), and cardiovascular diseases.[1] This is expected to be a huge health problem in countries where white rice is their major staple food mostly in south Asian countries such as Bangladesh, India, Pakistan, and Thailand, east Asian countries such as China, Japan, and Taiwan, and west African countries such as Nigeria and Ghana.[1] There is a high intake of white rice in these countries, and the prevalence rate of T2D is high in these countries.[1] White rice, both long grain and short grain, is really a kind of polished/refined rice, during the refining process, the bran and germ of the whole rice grain are separated, leaving only the carbohydrate-rich endosperm of the rice grain.[1] This procedure deprives white rice of vital vitamins, minerals, and dietary fiber, brown rice which is an unrefined rice is rich in vitamins, minerals, and dietary fiber.[1] White rice is a high glycemic food because of its high starch content and its ability to release glucose rapidly.[1]

Lots of individuals from Asia and west Africa consume about four servings of white rice daily, but individuals from Europe and North America consumes <5 servings a week.[2] The more ratios of white rice an individual consumes per day, the more the risk of developing T2D which is associated with lifestyle behavior, overweight, and obesity, there is a 10% increase in the risk of developing T2D for each increase in the ratio of white rice consumed per day.[2] Eating more than three cups of white rice per day significantly increased the risk of T2D when compared with eating lesser quantity, this was the outcome of the multinational, multiethnic Prospective Urban Rural Epidemiology research.[3] Individuals residing in south Asian nations are the most consumers of white rice and consequently have the highest chances of developing T2D.[4] People who ate more than three cups of white rice per day which is >450 g per day had a 20% greater risk of developing T2D when correlated with people who ate <1 cup per day which is equivalent to 150 g of cooked white rice. South Asians who ate an average of 630 g of white rice daily had 61% higher chances of developing T2D compared to those who ate <150 g per day.[4] Higher consumption of white rice, ≥5 servings per week as against <1 per month, was linked with a greater risk of T2D in US adult men, whereas higher consumption of brown rice, ≥2 servings per week as against <1 per month, was associated with a lesser risk of T2D.[5] Replacing 50 g/day of raw white rice, which is equal to one-third serving per day, with the same quantity of brown rice was associated with a 16% decreased in the risk of T2D.[5]

India has a large number of people with T2D, and India is the second after China in the risen incidence of T2D, and epidemiological data show that higher consumption of white rice contributes immensely to India's increased prevalence of T2D.[6] However, replacing white rice with brown rice in a typical Indian daily diet could lessen this disease burden to a significant level.[6] In India, nearly 70%–75% of the food intake comprises carbohydrates in the form of refined white rice, if this could be reduced to 45%–50% and the protein consumption can be upgraded to 20% by adding vegetables and some fruits, the daily diet will be healthier and considerably decreases the occurrence of T2D in India.[6] High consumption of white rice substantially escalates the risks of T2D in Japanese and Chinese people.[7],[8] Substituting brown rice for white rice was active in reducing blood glucose levels among Nigerian adults.[9]

In animal and human experiments, a high consumption of carbohydrates with a high glycemic index, which is a comparative measure of the incremental glucose response per gram of carbohydrate, increases insulin resistance than the consumption of low-glycemic-index carbohydrates.[10] Replacing high-glycemic-index carbohydrates such as white rice with low-glycemic-index carbohydrates such as refined cereal products in patients with T2D improves glycemic control and decreases hypoglycemic episodes among diabetics treated with insulin.[10] The consumption of unrefined whole grain is linked to a reduced risk of T2D, at least two servings of whole grain daily should be used to replace white rice to minimize the risk of T2D.[11]

Brown rice has more fiber and antioxidants, as well as more essential vitamins and minerals than white rice, while white rice is rich in calories and carbohydrates.[12] Substituting brown rice for white rice showed a possible advantage on glycated hemoglobin in individuals with metabolic syndrome and increased body mass index, it also reduced inflammation.w12]

In conclusion, there is a need for extensive community health education and promotion on the benefits of consuming brown rice in south Asian and west African countries, mostly among inhabitants in the rural areas. White rice has a high glycemic index, implying that it can trigger spikes in blood glucose levels, and there is a strong connection between the intake of high glycemic index foods with increased risk of T2D. Excess white rice consumption can lead to postprandial glucose rises, these rises, in turn, causes hyperinsulinemia, which is a homeostatic mechanism to maintain a normal concentration of glucose in the blood, however, with time the β-cells becomes weakened, resulting in β-cell malfunction and failure, subsequently leading to T2D.

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Conflicts of interest



 
  References Top

1.
Boers HM, Seijen Ten Hoorn J, Mela DJ. A systematic review of the influence of rice characteristics and processing methods on postprandial glycaemic and insulinaemic responses. Br J Nutr 2015;114:1035-45.  Back to cited text no. 1
    
2.
Hu EA, Pan A, Malik V, Sun Q. White rice consumption and risk of type 2 diabetes: Meta-analysis and systematic review. BMJ 2012;344:e1454.  Back to cited text no. 2
    
3.
Dehghan M, Mente A, Zhang X, Swaminathan S, Li W, Mohan V, et al. Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): A prospective cohort study. Lancet 2017;390:2050-62.  Back to cited text no. 3
    
4.
Bhavadharini B, Mohan V, Dehghan M, Rangarajan S, Swaminathan S, Rosengren A, et al. White rice intake and incident diabetes: A study of 132,373 participants in 21 countries. Diabetes Care 2020;43:2643-50.  Back to cited text no. 4
    
5.
Sun Q, Spiegelman D, van Dam RM, Holmes MD, Malik VS, Willett WC, et al. White rice, brown rice, and risk of type 2 diabetes in US men and women. Arch Intern Med 2010;170:961-9.  Back to cited text no. 5
    
6.
Mohan V. Why are Indians more prone to diabetes? J Assoc Physicians India 2004;52:468-74.  Back to cited text no. 6
    
7.
Dong F, Howard AG, Herring AH, Popkin BM, Gordon-Larsen P. White rice intake varies in its association with metabolic markers of diabetes and dyslipidemia across region among chinese adults. Ann Nutr Metab 2015;66:209-18.  Back to cited text no. 7
    
8.
Nanri A, Mizoue T, Noda M, Takahashi Y, Kato M, Inoue M, et al. Rice intake and type 2 diabetes in Japanese men and women: The Japan public health center-based prospective study. Am J Clin Nutr 2010;92:1468-77.  Back to cited text no. 8
    
9.
Adebamowo SN, Eseyin O, Yilme S, Adeyemi D, Willett WC, Hu FB, et al. A mixed-methods study on acceptability, tolerability, and substitution of brown rice for white rice to lower blood glucose levels among nigerian adults. Front Nutr 2017;4:33.  Back to cited text no. 9
    
10.
Vega-López S, Venn BJ, Slavin JL. Relevance of the glycemic index and glycemic load for body weight, diabetes, and cardiovascular disease. Nutrients 2018;10:1361.  Back to cited text no. 10
    
11.
Aune D, Norat T, Romundstad P, Vatten LJ. Whole grain and refined grain consumption and the risk of type 2 diabetes: A systematic review and dose-response meta-analysis of cohort studies. Eur J Epidemiol 2013;28:845-58.  Back to cited text no. 11
    
12.
Malik VS, Sudha V, Wedick NM, RamyaBai M, Vijayalakshmi P, Lakshmipriya N, et al. Substituting brown rice for white rice on diabetes risk factors in India: A randomised controlled trial. Br J Nutr 2019;121:1389-97. Letters to Editor  Back to cited text no. 12
    




 

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