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White rice linked to diabetes, especially in South Asia, says 21-nation study done over 10 yrs

Study involved 1.3 lakh people who were followed up on for a decade across 21 countries in Asia, Europe, Africa and North and South America.

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Bengaluru: An analysis of over 1,30,000 adults from 21 countries over nearly a decade has indicated a high risk of diabetes linked with the consumption of white rice. The risk is most prominent for the South Asian population, according to findings from a new, large-scale, long-term study.

The study was an international collaboration between researchers from various countries — including India, China, and Brazil — in Asia, North and South America, Africa and Europe.

Led by Bhavadharini Balaji of the Population Health Research Institute, Hamilton Health Sciences and McMaster University, Canada, the study was a part of the institute’s Prospective Urban Rural Epidemiology (PURE) project.

The findings were published in the Diabetes Care journal in its September issue.

White rice and diabetes

White rice is milled rice that has its germ (the part that sprouts), bran (hard outer layer), and husk (outer covering) removed. The polishing of rice further results in a bright and shiny appearance. While white rice has an appealing appearance and can be stored longer, the milling and polishing process remove nutrients such as vitamin B.

White rice has been linked to an outbreak of beriberi in Asia, caused by vitamin B-1 deficiency. It also causes the blood sugar levels to spike upon consumption due to its high glycemic index.

Globally, 42.5 crore people currently have diabetes, and this number is expected to increase to 62.9 crore by 2045, according to the International Diabetes Federation.

Studies have alluded to risk of diabetes associated with white rice for a few decades now, although findings have been contradictory. A 2012 study found that each extra serving of white rice increased the risk for diabetes by 11 per cent.

However, findings change depending on which country studies were conducted in. For example, a study of over 45,000 participants in Singapore found no substantial increase in diabetes was associated with white rice consumption.

Most such studies were limited to single countries. To beat this barrier, the authors of the new study extended it to 21 nations — Argentina, Bangladesh, Brazil, Canada, Chile, China, Colombia, India, Iran, Malaysia, ‘occupied Palestine territory’, Pakistan, Philippines, Poland, South Africa, Saudi Arabia, Sweden, Tanzania, Turkey, United Arab Emirates, and Zimbabwe.

However, the South Asian population seems to show a pattern with white rice consumption and diabetes, despite a number of other lifestyle factors that increase the disease risk.

“South Asians are genetically more predisposed to get diabetes, so there are both lifestyle as well as biological reasons for the high diabetes incidence,” said Bengaluru-based physician Dr Gowri Kulkarni.

To understand the link between white rice and diabetes in South Asia, the researchers compared the data from India, Bangladesh, and Pakistan with the rest of the world.

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Study findings

The study involved 132,373 individuals between the ages of 35 and 70, from these 21 countries, who were monitored for nine and a half years. Of these, 6,129 developed diabetes over the course of the study.

Participants were considered if they consumed more than one cup or 150g of cooked rice a day. Overall, the average white rice consumption was 128g a day among the study participants.

However, the team found that the highest consumption of white rice was seen in South Asia at 630g a day, followed by South East Asia at 239g and China at 200g per day. High consumption of rice resulted in lower consumption of other foods like wheat, fibre, red meat, and dairy products.

Carbohydrates make up nearly 80 per cent of calories consumed in many South Asian countries. Since the 1970s, carbs have become increasingly polished and refined as well, losing a lot of nutrition in the process.

Rapid urbanisation and economic development, especially in low- and middle-income countries, have led to a dramatic change in dietary intake and increased physical inactivity, which are related to the obesity epidemic.

Talking about the findings, Mumbai-based nutritionist Priya Kathpal said, “I wouldn’t say every white rice-eating family would have a diabetic person in their family… A lot depends on the quantity of rice eaten, what it’s eaten with, and how frequently.”

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China anomaly

China and India are two of the world’s largest countries where rice is the staple food. Both also lead in the incidence of diabetes. However, the researchers found that there wasn’t a significant association with white rice consumption and diabetes in China.

There could be many reasons for this, apart from other lifestyle factors. The scientists believe that the kind of rice the Chinese eat (sticky rice) could make a difference.

In India, studies have shown that during the last four to five decades of replacing hand-pounded rice with industrially milled white rice, the prevalence of diabetes in urban areas in India increased from 2 per cent in the 1970s to 25 per cent in 2015, and in rural areas from 1 per cent to 14–16 per cent, respectively. White rice is considered to be one of the many main drivers of the trend, which followed improved socioeconomic growth and lifestyle modifications.

Studies have shown that substituting white rice with unpolished brown rice decreases the glycemic response by 23 per cent and the fasting insulin response by 57 per cent in overweight Asian Indians, but consumers do not tend to prefer brown rice due to its inconvenience of longer cooking duration, greater chewing difficulty, and lack of visual appeal.

“Several patients that I’ve asked to switch to brown rice have faced difficulty, as everyone’s grown up eating white rice,” said Kathpal.

“Taste is a huge factor, and brown rice often doesn’t taste the same as white with vegetable curries and dals. Sometimes, white rice alternatives like even millets can be more expensive or not as easily available too,” she said.

Doctors and dieticians are hesitant to recommend diets that are more expensive and less easily available even if they are healthier, as patients tend not to adopt them successfully.

“A daily diet should always be easy to maintain and easily available. Only then can it be sustainable,” said Kulkarni. “Indians in general have poor protein intake in diet, and this has to do with available resources and choices. Most calories are from carbohydrates as they are cheap.”

According to the researchers, in countries where rice is consumed the most or as a staple, the risk of increased diabetes among the public can be lowered by substituting white rice with alternate forms of healthier rice versions and adding more legumes or pulses to food.

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  1. A lot of people think it is some conspiracy. It is not. Problem is people nowadays things everything they can’t understand is a conspiracy.

    The criticism is not against rice, but the processing. White rice is very bad for you, but brown rice and boiled rice are great.
    The same is true for wheat also. White flour (maida) is very bad for you, but whole wheat flour is great.
    This is not a promotion for wheat over rice, but showing that milling and removing too much germ layer is bad.
    Milling makes storage easy and reduces losses and so reduces costs. But it is not healthy over time.

  2. They want to promote wheat it seems.. some company might have paid for this research.. may God curse them for fake researches.. may God give them impotence and infertility..

    • Stop saying “paid” for everything you can’t understand. This has become a disease.
      Rice is alright. Just don’t use white rice. Polishing rice is a very new process. All processed food has some problem, even white flour from wheat. Use boiled rice or brown rice.

  3. Any demographic that consumes 630g’s a day will see a much higher incidence of diabetes than the/a group that consumes 220g’s. Academics need to get out more.

    • That’s right Gerry.

      I would advice eat 100 to 200 grams white rice a day max.
      Bodybuilders tend to eat white rice a lot also. No problems there.
      You have to move a lot, if you take in lots of carbs then you need to use the body also.
      Not sitting around all day.
      The taste of brown rice… tried it many times. No thank you.
      Whole grain bread on the other hand tastes fine to me.
      White rice tastes delicious though.
      Bruce Lee ate white rice as well. As if all asians are having diabetes now .
      Such nonsense.

  4. This is the biggest lie of the century.
    The multiple billion dollar pharma industry of the USA are the ones driving this campaign.
    They are the minds of the devil.
    They are the cause of millions of deaths across the world with the use of poisonous drugs and chemicals in the name of medicine.
    Natural remedies are available for every disease, but this information is being suppressed.

    • Nothing is being suppressed.
      Stop calling conspiracy for everything. It is stupid.
      No pharma company gets a benefit from you switching from white rice to brown rice.

    • I agree with Som here.
      Many bodybuilders eat white rice several times a day. With good effect.
      Bruce Lee , one of the most famou martial artists also.
      There’s too much fear mongering these days.

  5. Add Ghee to the rice before consuming, it will take care of the high glycemic levels and enjoy it…..

  6. Realising that consuming polished rice twice a day might cause diabetes, there are many families who consumechapati in their dinner.
    My family has been practicing this habit for atleast 10-12 yrs now.

    It is not just the white rice that is curlprit in this whole saaga. If you notice the eating habits, with white rice we usually have list of items in our plate. We consume white rice with curry/dal, chutney, rasam/sambhar and curd . With this big list we naturally consume more rice.
    But with chapati this is not the case. We usually have one curry with chapati.
    This difference in quantity of consumption, we can experience it after every meal. This makes us feel heavy after consuming rice, while not that heavy (very lite feel many times) after consuming chapati.

  7. Diabetis is something that comes with hereditary,its totally illogical to link it to rice eating. If thts true then states like Andhra, Telangana, Tamilnadu and Odisha should be filled with people with diabetes,which isn’t the case. Our metabolism,age and daily activities also need to taken into account as all these things constantly differ in every individual, therefore rice eating doesn’t really matter to such an extent the way it’s been exaggerated in this article.

    • The case rates are exploding in these states.
      We did not traditionally eat white rice which came only after machine processing.
      Brown and boiled rice is better. We also ate low glycemic millets previously.

      • Eating a lot of millet can bring on thyroid issues for some. As is the case with soy. Mostly women are effected by this. But no one is safe.
        Get the oatmeal out , much better choice.

  8. An article involves database I would be easier to understand if it has INFOGRAPHIC method. This is completely in text format not looks good.

  9. Do you want to change the country to HINDI speaking people

    Stop damaging and occupying our south india.. and trying to bring in North Indian culture

    • Dear Sir, no where in the article there is mention of anything against South India.Stop having unreasonable hatred against North India and Hindi

    • This is a study, not politics.
      Its saying white rice is bad, not all rice is bad.
      Boiled rice, brown rice and millets are traditional in South India and they are much better for diabetes.

  10. Most diabetic population is the US by percentage… One of the lowest white rice consuming country.
    Stop putting out lies… Just stop

    Watch Fat Fiction…

    • US is diabetic because they eat too much sugar.
      India is diabetic because we eat white rice.
      Note that white rice was not what we traditionally ate. Its newer than white sugar.

  11. Useful and practical information..
    Please let me know any alternative to white rice like oats… Can diabetics family and children take oats instead…

    • It’s confusing as so many things are sprouting.I have read a book called..what your doctor doesn’t know about NUTRITIONAL MEDICINES AND MAY BE KILLING you..BY Dr Ray D Strand.I came across this book while my 80 yrs old diabetic insulin dependant mother was having pleural effusion,asthma and generalized anasarca.Although her sister’s husband is a diabetologist and so many doctors could do nothing.But following the principles of this book,she is absolutely correct.we are also doind the same.9437032554,Dr Nihar Ranjan sinha.

  12. Junk science. Sugar consumption is the culprit. South asians consume more sugar than the Chinese, hence their higher diabetic profile. Give up sugar and your rice consumption will pose less of a danger for diabetes. Better still, exercise and watch your weight for better diabetic outcomes.

    • Sugar is carbohydrate just the same way rice is carbohydrate, another similarity is they both are simple carbohydrate as refered in the article as white rice. Issue is complicated, blaming one over another is not going to get us anywhere.

      • No rice is not same as sugar. Fructose in sugar gets metabolized quite differently than rice.
        I don’t think the study is junk science, but Ramjeesingh does have a point.
        Sugar can be considered a confounder for the study, but they have to start somewhere.

  13. Fake research findings. Absolute BS. This type of biased and dirty games had dealt a death blow to coconut oil in favour of palm oil earlier.
    Does Sekhar Gupta have the balls to oppose rice bran oil marketed by Saurav Ganguly, whic is actually mineral oil, the greatest cause for pancreatic diseases. The revolution is here and now, we resist the evil corporation that runs these publications.

  14. Fake research findings. Absolute bull shit. This type of biased and dirty games had dealt a death blow to coconut oil in favour of palm oil.
    Does Sekhar Gupta have the balls to oppose rice bran oil marketed by Saurav Ganguly, whic is actually mineral oil, the greatest cause for pancreatic diseases. The revolution is here and now, we resist the evil corporation that runs these publications.

  15. 6100 people out of. 132000, which is 4.5 %. But look at the title of article. This is how media give twist to the fact and truth

  16. The aurhor as I have been noticing, writes like a paid agent for big pharma companies. If her statement would have been true, entire South India would been diabetic by now. Instead of blaming rice, blame the lifestyle, blame crazy regulators with pharma companies decide what is diabetic measuring point. Like they did for cholesterol once, FDA went to remove that myth recently after billions of statins made pharma and share market billionaires. Highly unethical that the standards of journalism falls. My post may get deleted, but at least it will Shekar Gupta whom I have very high regards.

  17. This kind of study about food habits of some of the oldest part of the world is somewhat suspect. One wonders, who sponsored this study across 21 countries, which would cost a bomb? Is it an attempt of Western food processing companies to push their products into big asian markets? Rice is not consumed throughout India, but mainly in south India and Bengal. This is not the staple food in north India or even in Gujarat. So bracketing entire South Asia (meaning thereby India+Pakistan) seems to be too sweeping a statement. One should not readily give up food habits which have prevailed in a region for many centuries or even millennia. Ayurveda advises that one should consume locall grown food and eat all seasonal fruits and vegetables for good health. One must not change established food habits based on suspect researches.

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