White rice intake and incident diabetes: A study of 132,373 participants in 21 countries

Abstract

<b>Objective: </b>Previous prospective studies on association of white rice intake with incident diabetes have shown contradictory results but were conducted in single countries and predominantly in Asia. We report on the association of white rice with risk of diabetes in the multinational Prospective Urban Rural Epidemiology (PURE) study. <p><b>Research design and methods: </b><a>Data on 132,373 individuals aged 35-70 years, from 21 countries. were analysed</a>. White rice consumption (cooked) was categorised as <150, ≥150 to <300, ≥300 to <450 and ≥450 grams/day, based on 1 cup of cooked rice = 150 grams. The primary outcome was incident diabetes. Hazards ratios were calculated using multivariable Cox frailty model.</p> <p><b>Results: </b>During a mean follow up period of 9.5 years, 6,129 individuals without baseline diabetes developed incident diabetes. <a></a><a>In the overall cohort, higher intake of white rice (</a>≥450g/d compared with <150g/d) was associated with increased risk of diabetes (HR: 1.20; 95% CI: 1.03-1.41 p for trend=0.003). However, the highest risk was seen in South Asia (HR: 1.65; 95% CI: 1.17-2.34, p for trend=0.02), followed by other regions of the world (which included South East Asia, Middle East, South America, North America/Europe and Africa) (HR: 1.41; 95% CI: 1.08-1.85, p for trend =0.01), while in China there was no significant association (HR: 1.05; 95% CI: 0.78-1.41, p for trend = 0.38). </p> <p><b>Conclusions: </b>Higher consumption of white rice is associated with an increased risk of incident diabetes with the strongest association being observed in South Asia, while in other regions, a modest, non-significant association was seen.</p>