A Global Perspective on White Rice Consumption and Risk of Type 2 Diabetes.

Abstract

Preventive policies to improve diet and physical activity are urgently needed to stem the rising global burden of type 2 diabetes (1). In randomized trials, both high-carbohydrate diets (low in saturated fat and high in fiber), combined with physical activity and caloric restriction, and moderate-fat Mediterranean diets reduced diabetes risk (2). These findings suggest that diets with variable carbohydrate intakes are compatible with diabetes-prevention lifestyles but do not identify the optimal amount and type of dietary carbohydrates. Furthermore, the impact of high carbohydrate intakes in other parts of the world beyond the range studied in Western populations remains unclear. Rice provides ∼20% of the world's calorie intake (3). Of the 10 countries with the largest number of diabetes cases, 6 countries in Asia and South America have rice as the main staple food (4). Rice is predominantly consumed as white rice, a refined grain resulting from a milling process that removes the bran and germ and leaves the starchy endosperm. As a result, white rice is low in fiber, polyphenols, and micronutrients such as magnesium that may benefit glucose metabolism (5–7). White rice also has a high glycemic index (GI) and glycemic load (GL), reflecting high postprandial blood glucose levels (5). In several (8–10) but not all (9–11) prospective cohort studies in Asian countries, higher white rice consumption was associated with a higher risk of type 2 diabetes. Therefore, it is crucial to determine whether white rice consumption contributes to the development of type 2 diabetes, particularly in populations with high intake levels. Bhavadharini et al. (12) evaluated the association between …