White Rice Consumption Linked to Increased Diabetes Risk In 21‑Country Study
Consuming white rice can increase one’s risk of developing diabetes, according to decade-long research spanning 21 nations. The findings of the study, published in Diabetes Care journal, also highlight that South Asians consumed the highest amount of rice in their daily diets, and were at highest risk of developing diabetes.
Carbohydrates such as rice make up 70-75% of South Asians’ total diet. On average, a rural Indian eats 6kgs of rice per month, and an urban Indian eats around 4.5kgs per month. Researchers write that after the 1970s, processed white rice replaced traditional hand-pulled rice as a major part of the Indian diet. To create white rice, the grains are polished post the removal of the husk, bran and germ layers. This alters the grain’s appearance, texture, and storage longevity, but also strips important nutrients like Vitamin B and thiamine. Without these extra nutrients, white rice becomes a simple carbohydrate (like sugar) that the body can digest rapidly. Simple carbohydrates are rapidly converted into glucose, which leads to more glucose in the bloodstream than the body can utilize for energy. This causes a sudden spike in blood sugar, and is the primary reason white rice consumption is linked to diabetes.
To investigate the link between white rice and diabetes, researchers chose 1.3 lakh participants who consumed more than 150g (around a cup) of cooked rice in a day. Researchers found a clear link between eating white rice and an increased risk of diabetes. The highest risk for the same was seen in South Asia, followed by South East Asia and the Middle East. While previous studies studies highlighted a link between rice and prevalent (previously diagnosed diabetes), this study reports a link between consuming rice and incident or new diagnoses of diabetes. More than 6,000 individuals in the cohort developed incident diabetes during the decade.
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“Refined carbohydrates like white rice have a very high glycemic index which contributes to a high glycemic load in the diet,” Dr. V. Mohan, co-author of the paper, told Medical Dialogues. Glycemic index is a relative ranking of carbohydrates like rice, with respect to how they affect blood sugar levels. White rice has a high glycemic index, because it gets digested quickly and thus, quickly spikes the body’s blood sugar levels. Dr. Mohan also describes high rice consumption as a potential contributor to the ‘South Asian phenotype’ — a clinical abnormality in which South Asian individuals have higher insulin resistance, higher waist circumferences, and a greater likelihood of developing Type 2 diabetes.
A focus on eating white rice in South Asia also means there’s decreased consumption of whole/refined wheat products, dairy, meat and fiber. Consuming white rice alongside, say, fibrous foods can balance the blood sugar and energy spike caused by white rice, as fiber takes a longer time to digest. This is called decreasing the glycemic load of a meal. Replacing white rice with unpolished, organic brown rice that still keeps the bran and the germ layers of the rice grain can add more nutrients and fiber to one’s diet.
The authors write, “Replacing highly polished white rice with other cereals or healthier varieties of rice or by adding adequate legumes and pulses may not only help to reduce the [glycemic index] of the meal but also, possibly, to reduce the actual quantity of white rice consumed. These may be important public health strategies to be adopted in South Asian and other populations with rice as the staple food, which, if combined with measures to increase [public awareness], could help to slow down the rapidly rising epidemic of type 2 diabetes in these regions.”