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Multicenter Study
. 2020 Nov;43(11):2643-2650.
doi: 10.2337/dc19-2335. Epub 2020 Sep 1.

White Rice Intake and Incident Diabetes: A Study of 132,373 Participants in 21 Countries

Balaji Bhavadharini  1 , Viswanathan Mohan  2 , Mahshid Dehghan  1 , Sumathy Rangarajan  1 , Sumathi Swaminathan  3 , Annika Rosengren  4   5 , Andreas Wielgosz  6 , Alvaro Avezum  7 , Patricio Lopez-Jaramillo  8 , Fernando Lanas  9 , Antonio L Dans  10 , Karen Yeates  11 , Paul Poirier  12 , Jephat Chifamba  13 , Khalid F Alhabib  14 , Noushin Mohammadifard  15 , Katarzyna Zatońska  16 , Rasha Khatib  17 , Mirac Vural Keskinler  18 , Li Wei  19 , Chuangshi Wang  19 , Xiaoyun Liu  19 , Romaina Iqbal  20 , Rita Yusuf  21 , Edelweiss Wentzel-Viljoen  22 , Afzalhussein Yusufali  23 , Rafael Diaz  24 , Ng Kien Keat  25   26 , P V M Lakshmi  27 , Noorhassim Ismail  28 , Rajeev Gupta  29 , Lia M Palileo-Villanueva  30 , Patrick Sheridan  1 , Andrew Mente  1 , Salim Yusuf  1
Affiliations
Multicenter Study

White Rice Intake and Incident Diabetes: A Study of 132,373 Participants in 21 Countries

Balaji Bhavadharini et al. Diabetes Care. 2020 Nov.

Abstract

Objective: Previous prospective studies on the 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.

Research design and methods: Data on 132,373 individuals aged 35-70 years from 21 countries were analyzed. White rice consumption (cooked) was categorized as <150, ≥150 to <300, ≥300 to <450, and ≥450 g/day, based on one cup of cooked rice = 150 g. The primary outcome was incident diabetes. Hazard ratios (HRs) were calculated using a multivariable Cox frailty model.

Results: During a mean follow-up period of 9.5 years, 6,129 individuals without baseline diabetes developed incident diabetes. In the overall cohort, higher intake of white rice (≥450 g/day compared with <150 g/day) was associated with increased risk of diabetes (HR 1.20; 95% CI 1.02-1.40; P for trend = 0.003). However, the highest risk was seen in South Asia (HR 1.61; 95% CI 1.13-2.30; 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 1.08-1.86; P for trend = 0.01), while in China there was no significant association (HR 1.04; 95% CI 0.77-1.40; P for trend = 0.38).

Conclusions: 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, nonsignificant association was seen.

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Figures

Figure 1
Figure 1
Consumption of white rice (g/day) in different geographic regions. South Asia includes India, Pakistan, and Bangladesh. South East Asia includes Malaysia, Philippines.
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References

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