Article

White rice consumption and risk of type 2 diabetes

November 2012
Clinical Nutrition 32(3)

DOI:10.1016/j.clnu.2012.11.008

Source
PubMed

Authors:

Natalia Colomo

Hospital Regional Universitario de Málaga

Gabriel Olveira

University of Malaga

Eduardo García-Fuentes

Hospital Universitario Virgen de la Victoria / Biomedical Research Institute of Malaga

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Background & aim: Recent studies suggest that white rice consumption increases risk of diabetes. Aim: to assess the association between white rice intake and the incidence of diabetes in a population from Southern Spain. Methods: A population-based cohort study was undertaken in Pizarra, Spain. At baseline and follow-up, participants underwent an interview and a standardized clinical examination which included an oral glucose tolerance test in those subjects without known diabetes. Incidence and odds ratio (OR) for diabetes were calculated. Multivariate analysis was performed using stepwise logistical regression. Results: Thirty eight percent of subjects reported rice consumption 2-3 times a week, 58.5% once or less a week, and 3.6% no rice consumption. In subjects who reported rice intake 2-3 times a week, incidence of diabetes after 6 years follow-up was 12.0%, and in those who reported once or less a week, 20.2% (p = 0.04, non adjusted). Subjects who ate rice frequently had lower risk to develop diabetes 6 years later (OR = 0.43, p = 0.04; adjusted for age, sex, obesity, and presence of impaired fasting glucose and/or impaired glucose tolerance at baseline). Conclusions: A negative association was found between white rice intake in the way it is consumed in Southern Spain, and the 6 years incidence of diabetes.

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

Article

Full-text available

Sep 2020
DIABETES CARE

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. Hazards ratios 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.

Is white rice consumption a risk for metabolic and cardiovascular outcomes? A systematic review and meta-analysis

Article

Full-text available

Sep 2017

Objective The main objective of this systematic review and meta-analysis was to investigate the association between white rice consumption and risk of metabolic and cardiovascular outcomes. Methods We conducted a comprehensive search of Medline, Embase, Scopus, and the Cochrane Central Register of Controlled Trials from database inception through March 2016. Original studies that reported associations between white rice consumption and cardiovascular outcomes regardless of study design were selected. We extracted study characteristics and outcome data. Conflicts were resolved through consensus. Using the DerSimonian and Laird random effects models, we calculated pooled relative risks with 95% CI. Results Our search identified 721 citations. 18 studies were included with a total of 1 777 059 individuals: 14 348 had type 2 diabetes mellitus (T2DM); 5612 had metabolic syndrome (MetS); 10 839 had coronary heart disease (CHD); and 11 698 had stroke. Compared with the lowest category, the highest category of white rice consumption was only associated with 30% higher risk of MetS (pooled OR 1.30, 95% CI 1.03 to 1.65; p<0.001; I²=65.5%). Conclusions Higher white rice consumption has not been shown to be associated with increased risk of CHD, stroke and T2DM. However, white rice consumption may be associated with increased risk of MetS in certain populations

Low Rice Intake Is Associated with Proteinuria in Participants of Korea National Health and Nutrition Examination Survey

Article

Full-text available

Jan 2017
PLOS ONE

Little is known about the risk factors of proteinuria in the Asian population. On the basis of the association between rice intake patterns and chronic diseases, we hypothesized that rice intake patterns are associated with proteinuria in the Asian population. Data, including data regarding rice intake frequency and dipstick urinalysis results, from the Korea National Health and Nutrition Examination Survey in 1998, 2001, 2005, and 2007 were analyzed. The study involved 19,824 participants who were older than 20 years of age. Low rice intake was defined as consumption of rice ≤ 1 time/day. Proteinuria was defined as dipstick urinalysis protein ≥ 1 positive. Among the 19,824 participants, the prevalence of low rice intake and proteinuria were 17.3% and 2.9%, respectively. The low rice intake group showed a higher rate of proteinuria than the non-low rice intake group did (3.8% vs. 2.7%, P < 0.001). In multivariate logistic regression analysis, the odds ratio (OR) of low rice intake for proteinuria was 1.54 (95% confidence interval (CI): 1.25–1.89; P < 0.001). Low rice intake was also independently associated with high blood pressure (OR: 1.43, 95% CI: 1.31–1.56; P < 0.001) and diabetes (OR: 1.43, 95% CI: 1.27–1.62; P < 0.001). In conclusion, low rice intake was found to be independently associated with proteinuria in the Asian population, which might have been affected by the associations of low rice intake with high blood pressure and diabetes. Future prospective studies are needed to confirm the results of this study.

Rice consumption, incidence of chronic diseases and risk of mortality: meta-analysis of cohort studies

Article

Aug 2016

Objective: Findings from cohort studies investigating the association between rice consumption and risk of chronic diseases or mortality have been inconsistent. We performed a comprehensive systematic review and meta-analysis on all published cohort studies examining white rice consumption in relation to incidence of chronic diseases or risk of mortality. Design: A systematic literature search of MEDLINE, Embase, Cochrane review, Google Scholar and Scopus databases for relevant cohort studies published until July 2014. For systematic review, we found nineteen studies examining the association between rice intake and risk of chronic diseases (obesity, hypertension, metabolic syndrome, diabetes, CVD and cancers) or mortality. Cohort studies which reported relative risk (RR) or odds ratio for highest v. lowest intake of rice and chronic diseases or mortality were included in the meta-analysis. Results: In a meta-analysis on seventeen risk estimates for highest v. lowest category of rice intake, provided from twelve studies, we found a trend towards a positive association (RR; 95 % CI) between rice consumption and risk of all chronic diseases (1·11; 0·96, 1·29); however, significant between-study heterogeneity was found (I 2=70·3 %, P<0·001). Stratified analysis by gender showed a significant positive association between rice consumption and risk of chronic diseases in women (1·40; 1·13, 1·73), but not in men (0·95; 0·72, 1·24). Combining ten effect sizes from five studies showed that high consumption of rice was not significantly associated with mortality (0·97; 0·88, 1·06). Subgroup analysis by gender indicated an inverse association between rice consumption and mortality in men (0·87; 0·81, 0·94), but a trend towards a positive association in women (1·08; 0·97, 1·19). Conclusions: Although white rice consumption was not found to be associated with individual chronic conditions, we observed a positive association between white rice intake and risk of all overall chronic diseases in women. High rice consumption was related to a modest reduction in risk of mortality in men but not in women. Further studies of these relationships, in different populations, are needed.

Whole grain and refined grain consumption and the risk of type 2 diabetes: A systematic review and dose-response meta-analysis of cohort studies

Article

Oct 2013
EUR J EPIDEMIOL

Several studies have suggested a protective effect of intake of whole grains, but not refined grains on type 2 diabetes risk, but the dose–response relationship between different types of grains and type 2 diabetes has not been established. We conducted a systematic review and meta-analysis of prospective studies of grain intake and type 2 diabetes. We searched the PubMed database for studies of grain intake and risk of type 2 diabetes, up to June 5th, 2013. Summary relative risks were calculated using a random effects model. Sixteen cohort studies were included in the analyses. The summary relative risk per 3 servings per day was 0.68 (95 % CI 0.58–0.81, I2 = 82 %, n = 10) for whole grains and 0.95 (95 % CI 0.88–1.04, I2 = 53 %, n = 6) for refined grains. A nonlinear association was observed for whole grains, p nonlinearity < 0.0001, but not for refined grains, p nonlinearity = 0.10. Inverse associations were observed for subtypes of whole grains including whole grain bread, whole grain cereals, wheat bran and brown rice, but these results were based on few studies, while white rice was associated with increased risk. Our meta-analysis suggests that a high whole grain intake, but not refined grains, is associated with reduced type 2 diabetes risk. However, a positive association with intake of white rice and inverse associations between several specific types of whole grains and type 2 diabetes warrant further investigations. Our results support public health recommendations to replace refined grains with whole grains and suggest that at least two servings of whole grains per day should be consumed to reduce type 2 diabetes risk.

Black rice: A super food from north-east India

Article

Full-text available

Feb 2023

Zizania aqatica, sometimes known as black rice, is renowned for being very nutrient-dense. This is also been referred to as forbidden, emperor, and royal rice. Over 50% of people worldwide eat and rely on rice as a staple. This rice primarily comes from Asian nations. China (62%), Sri Lanka (8.6%), Indonesia (6.2%), and India (5.1%), which hold the fourth position, are the wealthiest nations in terms of black rice farming. It has significant amounts of tocopherols, one of the most potent antioxidants commonly known as vitamin E, and anthocyanin, a type of Antioxidant. Antioxidant-rich foods are dark purple or black. Moreover, it is rich in fiber, protein, carbs, potassium, and B vitamins.

A Traditional Costa Rican Adolescents' Diet Score Is a Valid Tool to Capture Diet Quality and Identify Sociodemographic Groups With Suboptimal Diet

Article

Full-text available

Aug 2021

Traditional diet indices may capture diet quality according to local food culture. Higher adherence to traditional diet scores may help prevent disease, yet evidence in adolescents is limited. This cross-sectional study aimed to develop and validate a Traditional Costa Rica Adolescents Diet Score (TCRAD) and determine its association with sociodemographic characteristics, under the hypothesis that girls, adolescents from rural areas, and with low socioeconomic status, have a more traditional healthy diet. A total of 804 urban and rural adolescents (13–18 years old) participated in the study. The TCRAD showed adequate internal validity as shown by significant associations with intake of 14 traditional foods and nutrients (legumes, vegetables, fruits, oils, dairy, and corn tortilla scored as healthy; and white rice, red/processed meat, solid fats, desserts/pastries, sugar-sweetened beverages, snacks, fast food, and bread and cookies scored as unhealthy). A high TCRAD score, indicative of a healthier and more traditional diet, was observed among adolescents in the low socioeconomic group vs. medium or high socioeconomic categories (42.9, 41.2, and 38.2%, respectively, p < 0.05), adolescents living in rural areas vs. urban (47.6 vs. 34.2%, p < 0.05), and among boys vs. girls (46.9 vs. 37.5%, p < 0.05). The TCRAD score is a valid tool to capture diet quality of adolescents in Costa Rica and could be used to measure association of diet with disease outcomes in this and similar populations. Public health nutrition programs in Costa Rica should focus on improving intake of foods and nutrients, and prioritize girls, adolescents in urban areas, and adolescents with high socioeconomic status.

Perspective: Whole and Refined Grains and Health-Evidence Supporting "Make Half Your Grains Whole"

Article

Full-text available

Nov 2019

Research-based dietary guidelines suggest that consumers "make half their grains whole." Yet some advocate ingesting only whole-grain foods (WGFs) and avoiding all refined-grain foods (RGFs). Some even recommend avoiding all grain-based foods (GBFs). This article will provide arguments to counter negative deductions about GBFs and RGFs, especially staple ones, and to support dietary guidance recommending a balance of GBFs-achieved through the right mix, type, and quantity of WGFs and RGFs. Studies looking at early mortality, body weight, and glucose tolerance and diabetes will be used as examples to characterize the literature about GBFs. The following issues are highlighted: 1) inconsistent findings between epidemiological and interventional studies and impacts of GBFs on health outcomes, and the underreporting of findings showing RGFs neither raise nor lower health risks; 2) multiple confounding and potential interactions make adequate statistical adjustment difficult; 3) nonuniform WGF definitions among studies make comparison of results challenging, especially because some WGFs may contain 49-74% refined grain (RG); 4) binary categorization of GBFs creates bias because nearly all categories of WGFs are recommended, but nearly half the RGF categories are not; 5) ingestion of >5 (30-g) servings RGFs/d and <1 serving WFGs/d creates dietary imbalance; 6) pattern names (e.g., "white bread") may impugn RGFs, when names such as "unbalanced" or "few fruits and vegetables" may more fairly characterize the dietary imbalance; 7) avoidance of all enriched RGs may not only impair status of folate and other B vitamins and certain minerals such as iron and zinc but also decrease acceptability of WGFs; 8) extrapolation beyond median documented intakes in high-WGF consumers (∼48 g whole grain/d) in most cohorts is speculative; 9) recommended dietary patterns such as the Mediterranean diet demonstrate that the right mix of WGFs and RGFs contributes to positive health outcomes.

Physiological Multifunctions of Rice Proteins of Endosperm and Bran

Article

Full-text available

Oct 2019

Although it is considered a staple food, rice intake is under serious debate for its physiological usefulness, especially for diabetic patients, because of starch content. However, rice protein, the second major component of rice, has gained attention recently for its newly-discovered functions, which were previously unknown. Rice protein, a plant protein, shows multiple beneficial functions on lipid metabolism and diabetes and its complications, nephropathy, fatty liver and osteoporosis. Rice proteins of endosperm and bran, an ingredient of white rice and an unused product of brown rice, respectively, are valuable components for human health.

Perspective: Refined Grains and Health: Genuine Risk, or Guilt by Association?

Article

Full-text available

Apr 2019

Glenn A Gaesser

Refined grain intake is widely assumed to be associated with adverse health outcomes, including increased risk for cardiovascular disease (CVD), type 2 diabetes (T2D), and obesity. The 2015 Dietary Guidelines Advisory Committee recommended that to improve dietary quality, the US population should replace most refined grains with whole grains. This recommendation was based largely on results from studies that examined dietary patterns, not separate food groups. A Western dietary pattern typically includes red and processed meat, sugar-sweetened foods and beverages, French fries, and high-fat dairy products, as well as refined grains, and has been linked to increased risk of many chronic diseases. However, when evaluated as a distinct food category, 11 meta-analyses of prospective cohort studies, which included a total of 32 publications with data from 24 distinct cohorts, demonstrated that refined grain intake was not associated with all-cause mortality, T2D, CVD, coronary heart disease (CHD), stroke, hypertension, or cancer. By contrast, consumption of red and processed meat was consistently associated with increased risk of these same health outcomes. Refined grain consumption up to 6-7 servings/d (1 serving = 30 g) was not associated with higher risk of CHD, T2D, hypertension, or all-cause mortality. Moreover, total grain intake was not associated with risk of CVD, CHD, stroke, or cancer, but was associated with lower risk of all-cause mortality. Consequently, the recommendation to reduce refined grain intake based on results from studies linking a Western dietary pattern to numerous adverse health outcomes is contrary to a substantial body of published scientific evidence. Future research needs to better define refined grain intake to distinguish between staple grain foods and indulgent grain foods, and to better design randomized controlled trials to resolve discrepancies between results from observational studies and such trials with regard to determining the benefits of whole grains compared with refined grains. Adv Nutr 2019;0:1-11.

Rice consumption is not associated with risk of cardiovascular disease morbidity or mortality in Japanese men and women: A large population-based, prospective cohort study

Article

Apr 2014
AM J CLIN NUTR

Rice consumption has been associated with risk of type 2 diabetes, but its relation with cardiovascular disease (CVD) is limited. We examined the association between rice consumption and risk of CVD incidence and mortality in a Japanese population. This was a prospective study in 91,223 Japanese men and women aged 40-69 y in whom rice consumption was determined and updated from 3 self-administered food-frequency questionnaires, each 5 y apart. Follow-up for incidence was from 1990 to 2009 in cohort I and 1993 to 2007 in cohort II and for mortality was from 1990 to 2009 in cohort I and 1993-2009 in cohort II. HRs and 95% CIs of CVD incidence and mortality were calculated according to quintiles of cumulative average rice consumption. In 15-18 y of follow-up, we ascertained 4395 incident cases of stroke, 1088 incident cases of ischemic heart disease (IHD), and 2705 deaths from CVD. Rice consumption was not associated with risk of incident stroke or IHD; the multivariable HR (95% CI) in the highest compared with lowest rice consumption quintiles was 1.01 (0.90, 1.14) for total stroke and 1.08 (0.84, 1.38) for IHD. Similarly, there was no association between rice consumption and risk of mortality from CVD; the HR (95% CI) for mortality from total CVD was 0.97 (0.84, 1.13). There were no interactions with sex or effect modifications by body mass index for any endpoint. Rice consumption is not associated with risk of CVD morbidity or mortality.

A Critical Review of the Association between Nutrition and Health in Modern Chinese Diet

Article

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Aug 2020

White rice, brown rice and the risk of type 2 diabetes: a systematic review and meta-analysis

Article

Full-text available

Sep 2022

Objective Intake of white rice has been associated with elevated risk for type 2 diabetes (T2D), while studies on brown rice are conflicting. To inform dietary guidance, we synthesised the evidence on white rice and brown rice with T2D risk. Design Systematic review and meta-analysis. Data sources PubMed, EMBASE and Cochrane databases were searched through November 2021. Eligibility criteria Prospective cohort studies of white and brown rice intake on T2D risk (≥1 year), and randomised controlled trials (RCTs) comparing brown rice with white rice on cardiometabolic risk factors (≥2 weeks). Data extraction and synthesis Data were extracted by the primary reviewer and two additional reviewers. Meta-analyses were conducted using random-effects models and reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Risk of bias was assessed using the Newcastle Ottawa Scale for prospective cohort studies and the Cochrane Risk of Bias Tool for RCTs. Strength of the meta-evidence was assessed using NutriGrade. Results Nineteen articles were included: 8 cohort studies providing 18 estimates (white rice: 15 estimates, 25 956 cases, n=5 77 426; brown rice: 3 estimates, 10 507 cases, n=1 97 228) and 11 RCTs (n=1034). In cohort studies, white rice was associated with higher risk of T2D (pooled RR, 1.16; 95% CI: 1.02 to 1.32) comparing extreme categories. At intakes above ~300 g/day, a dose–response was observed (each 158 g/day serving was associated with 13% (11%–15%) higher risk of T2D). Intake of brown rice was associated with lower risk of T2D (pooled RR, 0.89; 95% CI: 0.81 to 0.97) comparing extreme categories. Each 50 g/day serving of brown rice was associated with 13% (6%–20%) lower risk of T2D. Cohort studies were considered to be of good or fair quality. RCTs showed an increase in high-density lipoprotein-cholesterol (0.06 mmol/L; 0.00 to 0.11 mmol/L) in the brown compared with white rice group. No other significant differences in risk factors were observed. The majority of RCTs were found to have some concern for risk of bias. Overall strength of the meta-evidence was moderate for cohort studies and moderate and low for RCTs. Conclusion Intake of white rice was associated with higher risk of T2D, while intake of brown rice was associated with lower risk. Findings from substitution trials on cardiometabolic risk factors were inconsistent. PROSPERO registration number CRD42020158466.

Healthful Plant-Based Diet and Incidence of Type 2 Diabetes in Asian Population

Article

Full-text available

Jul 2022

Plant-based diets have been suggested to be beneficial for type 2 diabetes (T2D). However, studies investigating the association between the healthiness of a plant-based diet and T2D risk are limited. This study explored the prospective association between scores from three different plant-based diet indices and risk of T2D and investigated whether associations differ by demographic and lifestyle factors in the Korean population. Data were derived from the Korean Genome and Epidemiology Study (KoGES), a prospective cohort study initiated between 2001 and 2002. Dietary intakes were assessed using a validated food frequency questionnaire. Scores for three plant-based diet indices (overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI)) were measured. A total of 7363 Korean adults aged 40-69 years without T2D and related chronic diseases at baseline were included. Incident T2D was defined as elevated plasma glucose (≥126 mg/dL), self-report of a doctor's diagnosis of T2D, or use of oral hypoglycemic drug. Multivariable Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% CIs for T2D risk. During a follow-up period of 14 years, 977 participants developed T2D. A 10-point higher score in hPDI was associated with a 14% lower risk of T2D (HR: 0.86, 95% CI, 0.77-0.95), adjusting for potential confounders. In subgroup analysis, inverse associations between hPDI and T2D risk were stronger in participants with a family history of T2D (HR: 0.58, 95% CI, 0.44 0.76) or history of hypertension (HR: 0.73, 95% CI, 0.60 0.89) than those without a family history of T2D (p interaction = 0.01) or history of hypertension (p interaction = 0.04). Considering the quality of the plant foods may be important for the prevention of T2D in the Korean population, which habitually consumes diets rich in plant foods.

Rice-based breakfast improves fasting glucose and HOMA-IR in Korean adolescents who skip breakfast, but breakfast skipping increases aromatic amino acids associated with diabetes prediction in Korean adolescents who skip breakfast: a randomized, parallel-group, controlled trial

Article

Full-text available

Aug 2022

Background/objectives: Adolescents who skip breakfast have an increased prevalence of chronic diseases. Thus, we aimed to evaluate whether the intake of rice-based breakfast had positive effects on blood glucose indices and to determine the possibility of diabetes prevalence in Korean youths who habitually skip breakfast. Subjects/methods: In this randomized parallel-group controlled trial, 81 subjects who were suitable for compliance among 105 middle-and high-school students aged 12-18 years who usually skipped breakfast were included in this study (rice-meal group [RMG], n = 26; wheat-meal group [WMG], n = 29; general-meal group [GMG], n = 26). The RMG and WMG received a rice-based breakfast and a wheat-based breakfast for 12 weeks, respectively. The anthropometric indices, blood glucose indices, and metabolites were measured at baseline and the endpoint, respectively. Results: The mean body weights in the RMG, WMG, and GMG groups at the endpoint were 62.44 kg, 61.80 kg, and 60.28 kg, respectively, and the mean body weights of the WMG and GMG groups at the endpoint were significantly higher than that at baseline (P < 0.05). The levels of fasting insulin and homeostasis model assessment of insulin resistance (HOMA-IR) values were significantly decreased in the RMG group at the endpoint compared to baseline (P < 0.05, P < 0.05, respectively). The levels of tryptophan and tyrosine in the WMG group at the endpoint were significantly higher than that those at baseline (P < 0.01, P < 0.05, respectively). Conclusions: Rice-based breakfast has positive effects on fasting insulin levels and HOMA-IR in Korean adolescents who skip breakfast. Additionally, it was found that a skipping breakfast could increase the prevalence of diabetes in adolescents who skip breakfast. Therefore, in addition to reducing breakfast skipping, it is vital to develop a rice-based menu that fits teenage preferences to prevent chronic diseases such as diabetes. Trial registration: Clinical Research Information Service Identifier: KCT0004089.

Developing an Ingredient Branding Strategy Applied to Pigmented Rice Commodity

Article

Full-text available

Jun 2022

Pigmented rice agroindustry has just started its market development, thus require a branding strategy. It may apply an ingredient branding strategy that can increase brand awareness and equity of pigmented rice by highlighting the ingredients. This paper discussed the developing strategy of pigmented rice products using the Customer-Based Brand Equity Model (CBBE). The brand awareness and loyalty survey was conducted to analyze the pigmented rice brand equity. The survey also explored branding media to increase consumers’ brand equity. The survey captured 261 respondents from various cities in Indonesia. The results of the t-test showed a significant difference between regular and occasional consumers. The CBBE diagnosis indicated that the producer should highlight antioxidants, anthocyanin, and other health benefits through advertising, word of mouth, health-related campaigns, and informative packaging.

Investigation on Functional, Thermo-Mechanical, and Bread-Making Properties of Some White and Black Rice Flours

Article

Full-text available

Apr 2022

The flour from white rice, Arborio (ARF) and Basmati (BRF) varieties, and the black rice Negro (NRF) variety, were investigated in this study in terms of proximate composition, solvent retention capacity (SRC), and thermo-mechanical properties of dough and bread quality. The flours fell into the classes with very low (NRF) and low amylose content (ARF and BRF); NRF flour had the highest contents of protein (11.16%), crude fiber (4.75%), ash (1.30%), and fats (3.42%). Correlations were obtained between CaCl2-SRC and fiber content, and between NaCl-SRC and lactic acid-SRC and protein content. The dough prepared from BRF had a lower value of the thermo-mechanical weakening, which suggests a higher resistance of the proteins to kneading. On the other hand, NRF exhibited a higher value of thermo-mechanical weakening, suggesting a lower protein resistance. Increasing the amount of water used to prepare the dough resulted in the decrease of the rate of starch retrogradation, while the breakdown decreased for BRF and remained constant for ARF and NRF. The specific volume and texture of the bread have been improved by using a larger amount of water in the preparation of the dough. The texture was negatively correlated (p < 0.05) with the specific volume of the bread. The best quality bread was obtained when the NRF was used.

Association between dietary patterns and glycemic control in a middle-aged Chinese population

Article

Full-text available

Sep 2021

Objective The present work was performed to analyze the association of dietary patterns with glycemic control (hemoglobin(Hb)A1c<7%) in a large group of Chinese adults aged between 45 and 59 years. Design Habitual dietary intakes in the preceding 12 months were assessed by well-trained interviewers using a validated semi-quantitative food frequency questionnaire(FFQ). Factor analysis with principal component method was used to obtain the dietary patterns, and the associations between dietary patterns and glycemic control were determined using multivariable logistic regression models. Poor glycemic control was defined as HbA1c≥7.0. Setting Despite decades of research, data on the relationship between dietary patterns and glycemic control(HbA1c<7%) in China are sparse. Participants A total of 1739 participants aged 45-59 years from Hangzhou were included in the final analysis. Results Three dietary patterns were ascertained and labeled as traditional southern Chinese, Western, and grains-vegetables patterns. After controlling of the possible confounders, participants in the highest quartile of Western pattern scores had greater odds ratio(OR) for HbA1c≥7.0(OR=1.05; 95% confidence interval(CI):1.000-1.095; P =0.048) than did those in the lowest quartile. Compared with those in the lowest quartile of grains-vegetables pattern, participants in the highest quartile had lower OR for HbA1c≥7.0(OR=0.82; 95% CI:0.720-0.949; P =0.038). Besides, no significant relationship between the traditional southern Chinese pattern and HbA1c≥7.0 was observed( P >0.05). Conclusions This study indicated that the Western pattern was associated with a higher risk, and the grains-vegetables pattern was associated with a lower risk for HbA1c≥7.0. Future prospective studies are needed to confirm our findings.

Dietary patterns and cardiovascular disease risk among Chinese adults: a prospective cohort study

Article

Full-text available

Dec 2020

Background and objective: We aimed to examine the prospective association between dietary patterns and cardiovascular disease (CVD) risk in Chinese adults. Methods: Adults aged ≥20 years in the China Health and Nutrition Survey (open cohort) were followed between 1991 and 2011. Participants may enter the cohort at any wave. Dietary intakes were obtained from a 3-day, 24-h recall combined with household weighing for oil and condiments. CVD was defined as having either myocardial infarction or stroke. Two sets of dietary patterns were derived using reduced rank regression and factor analysis. Iron-related dietary pattern (IDP) was generated using iron intake as a response variable. Multivariable Cox regression was used to analyse the relation between dietary patterns and CVD risk. Results: In total, 13,055 adults were followed for a median of 9 years. During 115,368 person years of follow-up, 502 participants developed CVD. Two dietary patterns were derived and labeled as traditional dietary pattern (high intake of rice, pork, fish, poultry, and fresh vegetable but low intake of wheat) and modern dietary pattern (high intake of fruit, soymilk, and fast food). Across the quartiles of intake, the hazard ratio (95% CI) for CVD were 1.0, 0.84 (0.64-1.10), 0.57 (0.42-0.77), and 0.58 (0.42-0.79) for traditional pattern (p for trend <0.001) and 1.0, 1.56 (1.16-2.09), 1.56 (1.13-2.14), and 1.68 (1.16-2.44) (p for trend = 0.118) for modern pattern. IDP was characterised by high intake of fresh vegetable, wheat, legume, beverage, offal, rice, and whole grain. IDP intake was not associated CVD. Comparing extreme quartiles, high rice intake was associated with halved while wheat intake was associated with a doubled risk of CVD. Conclusions: Traditional dietary pattern and rice intake are inversely but modern dietary pattern and wheat is directly associated with CVD risk. IDP is not related to CVD in Chinese adults.

Rice Intake and Emerging Concerns on Arsenic in Rice: a Review of the Human Evidence and Methodologic Challenges

Article

Full-text available

Dec 2019

Purpose of Review Rice is a major staple food worldwide and a dietary source of arsenic. We therefore summarized the state of the epidemiologic evidence on whether rice consumption relates to health outcomes associated with arsenic exposure. Recent Findings While epidemiologic studies have reported that higher rice consumption may increase the risk of certain chronic conditions, i.e., type 2 diabetes, most did not consider specific constituents of rice or other sources of arsenic exposure. Studies that examined rice intake stratified by water concentrations of arsenic found evidence of increasing trends in cardiovascular disease risk, skin lesions, and squamous cell skin cancers and bladder cancer associated with higher rice consumption. Summary Further studies are needed to understand the health impacts of arsenic exposure from rice consumption taking into account all sources of rice intake and potential confounding by other dietary constituents or contaminants and arsenic exposure from sources such as water.

A Review on Green Revolution, Nutritional Transition, Diabetes and Millet Movement in India

Article

Full-text available

Oct 2019

p>The advent of the green revolution in the early 1960s in India, when high yielding varieties were introduced into the farm coupled with enhanced irrigation facilities and fertilizers resulted in massive agricultural output. The over emphasis on high yielding crops such as wheat, maize and rice not only improved the harvest index and per capita food availability, but also showed a nutritional transition among people. The indigenous whole grains such as amaranth, barley, sorghum and millets were commonly consumed by people prior to the green revolution. Among these, millet found a dramatic decline in cultivation. Various reasons can be attributed to this shift from millet to other crops. However today, the typical diet of an Indian is of high carbohydrate and low protein since the majority of consumers prefer rice and wheat in their diet. This transition in nutrition from complex carbohydrates of indigenous crops to high glycemic index foods such as wheat and rice is correlated with the incidence of diabetes mellitus. The incidence of diabetes in India is growing exponentially and to combat it, a demand for food containing complex carbohydrates with a higher level of dietary fiber is needed. This review deals with the idea of ‘The Millet Movement’ in India, a strategy through which the dietary management of diabetes can be handled in a better way considering the nutritive value of the millet.</p

Korean Diet Prevents Obesity and Ameliorates Insulin Resistance in Mice Fed a High-fat Diet

Article

Full-text available

Feb 2017

Background: Korean diet has received considerable attention because of the low prevalence of obesity and metabolic disorders in Korea. Although the Korean diet has been shown to have health benefits, these effects have been investigated by analyzing individual nutrients or food components. In this study, we used a dietary pattern approach to investigate the effect of the Korean diet on obesity and glucose homeostasis in mice fed a high-fat diet (HFD). Methods: C57BL/6 mice were fed the HFD for 7 weeks to induce obesity and then fed either the HFD or Korean diet for the next 7 weeks. The Korean diet was based on food frequency data obtained from the 4th Korean National Health and Nutrition Examination Survey and adjusted to have the same energy content as the HFD. Serum insulin and leptin were quantified by enzyme-linked immunosorbent assay, and glucose clearance was assessed using the oral glucose tolerance test. Lipogenic gene expression was determined by quantitative reverse transcription-polymerase chain reaction. Results: The Korean diet significantly decreased the HFD-induced body weight increase and body fat accumulation and improved serum lipid profiles. Hepatic mRNA levels of lipogenic genes were lower in Korean diet-fed mice, which also showed decreased fasting blood glucose, insulin, and leptin levels, and improved glucose clearance. The Korean diet also ameliorated HFD-induced islet hypertrophy and elevated pancreatic insulin level. Conclusions: Korean diet prevented obesity and ameliorated insulin resistance in mice fed a HFD. Therefore, Korean diet may be useful as a therapeutic diet to control metabolic disorders.

Beneficial effects of rice endosperm protein intake in Japanese men with risk factors for metabolic syndrome: a randomized, crossover clinical trial

Article

Full-text available

May 2016

Background Rice protein is proved to have hypocholesterolemic and anti-atherosclerotic effects, and a few experimental studies showed its renoprotective effects, using animal diabetic models. However, no clinical studies have investigated its benefits for human health. We aimed to clarify how the intake of rice endosperm protein affects markers correlating to lipid dysfunction in human. Methods We recruited 18 male volunteers, 26–64 years of age, with risk factors for metabolic syndrome and allocated randomly into two groups. Half of them were administered test food containing rice endosperm protein and other half were administered control food containing sodium caseinate for 4 weeks. The dose of supplemental protein was 10 g/day. After medical examinations, the study foods were switched and the intervention was continued for another 4 weeks. Lipid metabolism markers were evaluated as primary outcome measures. Cross-over analysis was performed for 18 subjects using physical and clinical values measured before and after each intervention period. ResultsThe serum high-density lipoprotein cholesterol (HDL-C) level was increased at 0.08 mmol/L [interquartile range (IQR) from −0.05 to 0.19 mmol/L] during the period when rice endosperm protein was administered (the rice endosperm protein period), whereas it was decreased at −0.04 mmol/L [IQR from −0.13 to 0.05 mmol/L] during the period when casein was administered (the casein period). Treatment effect was significant with P = 0.047. Changes in total cholesterol, low-density lipoprotein cholesterol and triglycerides were not different between treatments. Among the secondary outcome measures, decrease in serum uric acid (UA) during the rice endosperm protein period [−24 μmol/L (IQR from −39 to −6 μmol/L)] was greater than that during the casein period [0 (IQR from −6 to 13 μmol/L)] with a significant treatment effect (P = 0.030). Conclusion Supplemental intake of rice endosperm protein may elevate serum HDL-C level and lower serum UA level in male subjects with risk factors for metabolic syndrome. Trial registrationClinical Trials Registry: UMIN000008923.

Rice Intake, Weight Change and Metabolic Syndrome

Chapter

Mar 2014

Rice is the main staple food for more than half of the world's population, mostly in Asian countries. In recent years, concerns have been raised regarding the potential effect of high glycemic-index white rice on diabetes. Existing studies suggest rice intake is inversely associated with obesity, blood pressure, and triglycerides (TG), but positively associated with elevated blood glucose and abnormal high density lipoprotein (HDL). Overall, there seems to be no association between rice consumption and metabolic syndrome. However, there are few studies that have examined the association between rice consumption and weight change and metabolic syndrome, and only one cohort study in this area; hence more prospective research is needed.

White Rice Intake Varies in Its Association with Metabolic Markers of Diabetes and Dyslipidemia Across Region among Chinese Adults

Article

Jun 2015
ANN NUTR METAB

There are inconsistent associations between white rice consumption and diabetes and dyslipidemia, perhaps due to the nature of samples studied and quality of diet data. Using regionally diverse data from adults enrolled in the China Health and Nutrition Survey (n = 7,878) with diet data from three repeated 24-hour recalls and fasting blood to derive diabetes and dyslipidemia, we examined the odds of diabetes and dyslipidemia in participants across region-specific tertiles of percent energy from white rice consumption. The prevalence of undiagnosed diabetes, high triglycerides, high low-density lipoprotein (LDL), low high-density lipoprotein (HDL), and atherogenic dyslipidemia (AD) was 4.7%, 31.8%, 31.3%, 25.9%, and 14.6%, respectively. We found an inverse association between the highest (versus lowest) tertile of rice intake and diabetes in Central China (odds ratio (OR): 0.59, 95% confidence interval (CI): 0.36-0.99). The highest rice consumption was also associated with high triglycerides (OR: 1.46, 95% CI: 1.09-1.95), low HDL (OR: 1.38, 95% CI: 1.03-1.85), and AD (OR: 1.63, 95% CI: 1.15-2.31) in North China, and low LDL (OR: 0.54, 95% CI: 0.42-0.69) in Central China. The association between white rice consumption and diabetes and dyslipidemia markers varied across regions of China, suggesting a role of other dietary and health-related exposures, beyond rice. © 2015 S. Karger AG, Basel.

Formulating low glycaemic index rice flour to be used as a functional ingredient

Article

Nov 2014
J CEREAL SCI

Amylose and resistant starch (RS) content in rice flour were manipulated. The experiment was conducted using a full factorial design. Rice flour with average amylose content of 20 and RS content of 0.5 g/100 g dry sample was fortified with pure amylose from potato and high RS modified starch to reach the final amylose content of 30, 40 and 50 and RS content of 2, 4 and 6 g/100 g dry sample. The fortified rice flours were examined for their gelatinisation properties, in-vitro enzymatic starch digestion and gel textural properties. It was found that amylose and RS significantly affect all the fortified rice flour properties (p<0.05). High amylose and RS improved starch digestion properties, reducing the rate of starch digestion and lowering the glycaemic index (GI) values. Amylose had a more pronounced effect on the fortified rice starch properties than RS. In this study, the fortified rice flour which contained amylose and RS of approximately 74 and 9 g/100 g dry sample respectively was used to produce rice noodles. The noodles exhibited low GI values (GI<55). However, amylose and RS affected the textures of rice noodles providing low tensile strength and break distance (extensibility).

Weighing the evidence of low glycemic index dietary intervention for the management of gestational diabetes mellitus: An Asian perspective

Article

Full-text available

Mar 2014
INT J FOOD SCI NUTR

Abstract This review aims to evaluate the effectiveness of low glycemic index (GI) dietary intervention for the treatment of gestational diabetes mellitus (GDM), specifically from the Asian perspective. A systematic review of the literature using multiple databases without time restriction was conducted. Three studies were retrieved based upon a priori inclusion criteria. While there was a trend towards improvement, no significant differences were observed in overall glycemic control and pregnancy outcomes in GDM women. However, a tendency for lower birth weight and birth centile if the intervention began earlier was noted. Low GI diets were well accepted and had identical macro-micronutrient compositions as the control diets. However, due to genetic, environment and especially food pattern discrepancies between Western countries and Asians, these results may not be contributed to Asian context. Clearly, there are limited studies focusing on the effect of low GI dietary intervention in women with GDM, particularly in Asia.

Impact of a Culturally Targeted Lifestyle Course on Dietary and Weight Outcomes of Chinese Americans in Texas

Article

Dec 2024
AM J HEALTH PROMOT

Purpose This study aimed to assess the impact of a culturally targeted lifestyle course on the dietary and weight outcomes of Asian Americans. Design This was an observational study of participants for a culturally targeted lifestyle course taught online by a Nutrition Scientist and Board-Certified Holistic Health Practitioner. Setting From 2021 to 2022, 284 participants were recruited through 4 community organizations in Texas and completed the informed consent. Subjects 140 Chinese Americans finished 3 surveys before, after, and 6 months after the course. Measures Participants’ fruit and vegetable consumption was assessed using the questionnaire from the Behavioral Risk Factor Surveillance System and their physical activities were evaluated by the Godin-Shephard Leisure-Time Exercise Questionnaire. Analysis We conducted repeated measures ANOVA to compare participants’ dietary and weight outcomes before, after, and 6 months after the course. Paired t-tests were performed to investigate how the outcomes differed from the baseline. Results The participants’ weights and BMI values at the 6-month follow-up were significantly lower than the baseline, though the changes were not significant immediately after the course. Rice consumption dropped significantly both after the class and at the 6-month follow-up. Participants also significantly reduced their intake of 100% juice and fried potatoes immediately after the class. Conclusion Community-based Participatory Approaches might be used to improve the dietary and weight outcomes of Asian Americans.

White rice consumption and risk of cardiometabolic and cancer outcomes: A systematic review and dose-response meta-analysis of prospective cohort studies

Article

Jul 2022

White rice is the food more than half of the world’s population depends on. White rice intake can significantly increase the glycemic load of consumers and bring some adverse health effects. However, the quality of evidence implicating white rice in adverse health outcomes remains unclear. To evaluate the association between white rice consumption and the risk of cardiometabolic and cancer outcomes, a systematic review and dose-response meta-analysis of the relevant publications were performed. Twenty-three articles including 28 unique prospective cohorts with 1,527,198 participants proved eligible after a comprehensive search in four databases. For the risk of type 2 diabetes mellitus (T2DM), the pooled RR was 1.18 (16 more per 1000 persons) for comparing the highest with the lowest category of white rice intake, with moderate certainty evidence. Females presented a higher risk (23 more per 1000 persons) in subgroup analysis. And every additional 150 grams of white rice intake per day was associated with a 6% greater risk of T2DM (5 more per 1000 persons) with a linear positive trend. We found no significant associations between white rice intake and risk of cardiovascular diseases (CVD), CVD mortality, cancer, and metabolic syndrome. In conclusion, moderate certainty evidence demonstrated that white rice intake was associated with T2DM risk, with a linear positive trend. However, low to very low certainty of evidence suggested that no substantial associations were found between white rice intake and other cardiometabolic and cancer outcomes. More cohorts are needed to strength the evidence body.

The characteristics of postprandial glycemic response patterns to white rice and glucose in healthy adults: Identifying subgroups by clustering analysis

Article

Full-text available

Oct 2022

Objectives Large interpersonal variability in postprandial glycemic response (PGR) to white rice has been reported, and differences in the PGR patterns during the oral glucose tolerance test (OGTT) have been documented. However, there is scant study on the PGR patterns of white rice. We examined the typical PGR patterns of white rice and glucose and the association between them. Materials and methods We analyzed the data of 3-h PGRs to white rice (WR) and glucose (G) of 114 normoglycemic female subjects of similar age, weight status, and same ethnic group. Diverse glycemic parameters, based on the discrete blood glucose values, were calculated over 120 and 180 min. K-means clustering based on glycemic parameters calculated over 180 min was applied to identify subgroups and representative PGR patterns. Principal factor analysis based on the parameters used in the cluster analysis was applied to characterize PGR patterns. Simple correspondence analysis was performed on the clustering categories of WR and G. Results More distinct differences were found in glycemic parameters calculated over 180 min compared with that calculated over 120 min, especially in the negative area under the curve and Nadir. We identified four distinct PGR patterns to WR (WR1, WR2, WR3, and WR4) and G (G1, G2, G3, and G4), respectively. There were significant differences among the patterns regard to postprandial hyperglycemia, hypoglycemic, and glycemic variability. The WR1 clusters had significantly lower glycemic index (59 ± 19), while no difference was found among the glycemic index based on the other three clusters. Each given G subgroup presented multiple patterns of PGR to WR, especially in the largest G subgroup (G1), and in subgroup with the greatest glycemic variability (G3). Conclusion Multiple subgroups could be classified based on the PGR patterns to white rice and glucose even in seemingly homogeneous subjects. Extending the monitoring time to 180 min was conducive to more effective discrimination of PGR patterns. It may not be reliable to extrapolate the patterns of PGR to rice from that to glucose, suggesting a need of combining OGTT and meal tolerance test for individualized glycemic management.

Refined Grain Intake and Risk of Type 2 Diabetes

Article

Full-text available

Jul 2022
MAYO CLIN PROC

Glenn A Gaesser

White Rice Consumption and Risk of Colorectal Cancer Among Japanese Americans: The Multiethnic Cohort Study

Article

Full-text available

Aug 2021

Background: White rice is a staple food for Japanese, a population at high risk for colorectal cancer (CRC). We investigated the association between white rice intake and CRC among Japanese Americans in the Multiethnic Cohort (MEC) study. Methods: The Multiethnic Cohort Study is a prospective study established in Hawaii and California in 1993-1996. Usual dietary intake was assessed by a validated quantitative food frequency questionnaire at baseline. Cox proportional hazards models were used to compute hazard ratios (HR) and 95% confidence intervals (CI) for quartiles of intake and to perform trend tests across sex-specific quartiles with adjustment for relevant confounders. Results: We identified 1,553 invasive CRC cases among 49,136 Japanese Americans (23,595 men and 25,541 women) during a mean follow-up of 19 years. White rice consumption was not associated with overall CRC incidence in men (p-trend = 0.11) or women (p-trend = 0.56). After excluding participants with a history of diabetes, the inverse associations were significant for CRC (p-trend = 0.03, HR for quartile 4 (Q4) vs. 1 = 0.81; 95% CI: 0.64-1.03) and tumors of the distal colon (p-trend = 0.006, HR for Q4 vs. Q1: 0.66; 0.44-0.99) among men but not women. Conclusions: White rice consumption was not associated with an increased risk of overall CRC among Japanese Americans. An inverse association was observed with risk of CRC and distal colon cancer in men without a history of diabetes.

Neither low salivary amylase activity, cooling cooked white rice, nor single nucleotide polymorphisms in starch-digesting enzymes reduce glycemic index or starch digestibility: a randomized, crossover trial in healthy adults

Article

Jul 2021
AM J CLIN NUTR

Background: It was suggested that low salivary-amylase activity (SAA) and cooling or stir-frying cooked starch decreases its digestibility and glycemic index. Objective: We determined the effects of SAA, cooling, and single-nucleotide polymorphisms (SNPs) in the salivary amylase (AMY1), pancreatic amylase (AMY2A, AMY2B), maltase-glucoamylase (MGAM), and sucrase-isomaltase (SI) genes on starch digestibility and glycemic index of cooked polished rice. Methods: Healthy subjects [pilot, n = 12; main, n = 20 with low-SAA (<50 U/mL), and n = 20 with high-SAA (>105 U/mL)] consumed test meals containing 25 g (pilot) or 50 g (main) available carbohydrate at a contract research organization using open-label (pilot) or assessor-blinded (main), randomized, crossover, Latin-square designs (trial registration: NCT03667963). Pilot-trial test meals were dextrose, freshly cooked polished rice, cooked rice cooled overnight, stir-fried hot rice, or stir-fried cold rice. Main-trial test meals were dextrose, dextrose plus 10 g lactulose, plain hot rice, or plain cold rice. In both trials, blood glucose was measured fasting and at intervals over 2 h. In the main trial, breath hydrogen was measured fasting and hourly for 6 h to estimate in vivo starch digestibility. Data were analyzed by repeated-measures ANOVA for the main effects of temperature and stir-frying (pilot trial) or the main effects of SAA and temperature (main trial) and their interactions. Effects of 24 single nucleotide polymorphisms (SNPs) were assessed separately. Means were considered to be equivalent if the 95% CI of the differences were within ±20% of the comparator mean for glucose response/glycemic index or ±7% for digestibility. Results: Pilot: neither temperature nor stir-frying significantly affected glucose incremental AUC (primary endpoint, n = 12). Main: mean ± SEM glycemic index (primary endpoint, n = 40) was equivalent for low-SAA compared with high-SAA (73 ± 3 vs. 75 ± 4) and cold rice compared with hot rice (75 ± 3 vs. 70 ± 3). Estimated starch digestibility (n = 39) was equivalent for low-SAA compared with high-SAA (95% ± 1% vs. 92% ± 1%) and hot rice compared with cold rice (94% ± 1% vs. 93% ± 1%). No meaningful associations were observed between genotypes and starch digestibility or glycemic index for any of the SNPs. Conclusions: The results do not support the hypotheses that low-SAA, cooling, and common genetic variations in starch-digesting enzymes affect the glycemic index or in vivo carbohydrate digestibility of cooked polished rice. This trial was registered at clinicaltrials.gov as NCT03667963.

Association between intake of white rice and incident type 2 diabetes – An updated meta-analysis

Article

Jan 2021
DIABETES RES CLIN PR

Aims Meta-analyses on the association between white rice intake and incident type 2 diabetes (T2D) have been inconsistent. Since the last meta-analysis, more studies have been published with inconsistent results. We aimed to examine the rice-T2D association in Asian populations in an updated meta-analysis. Methods We systematically searched the Medline and Embase databases between January 2012 (the date of the first meta-analysis) and December 2020 for prospective studies examining T2D risk and baseline rice intake. Random-effects models were applied to pool relative risks (RRs). Meta regression analyses were used to evaluate the influence of sex. Results Six articles with eleven comparisons in Asian countries were included in the current meta-analysis. A total of 12,395 incident T2D cases were ascertained from 256,818 participants. The pooled RR was 1.25 (95% confidence interval [CI]: 1.17–1.33) comparing extreme categories of rice intake with higher heterogeneity (I² = 88%, P < 0.0001). When stratified by sex, the RR was 1.58 (1.26–1.99) among women and 1.30 (0.85–1.98) among men (P-interaction = 0.42). Conclusions A positive association between rice intake and incident T2D in Asian populations was found, especially among women.

Effect of a Moderate Carbohydrate-Restricted Diet on DPP-4 Inhibitor Action among Individuals with Type 2 Diabetes Mellitus: A 6-Month Intervention Study

Article

Apr 2020

To decrease body weight and insulin resistance, a calorie-restricted diet—with minimal caloric intake required for daily activities—is the primary treatment strategy for patients with type 2 diabetes (T2D) in Japan. However, many patients cannot continue with this diet for long, because calorie restriction is difficult and nutritional balance is hard to understand. Carbohydrate-restricted diets are easier for patients than conventional calorie-restricted diet. In this study we aimed to elucidate the effects of a moderate carbohydrate-restricted diet on glucose metabolism and renal function in patients with T2D on dipeptidyl peptidase-4 (DPP-4) inhibitors. Nineteen outpatients with T2D continued on a moderate carbohydrate-restricted diet (targeting 50% of calories) for 6 mo. Meanwhile, 10 other outpatients with T2D on DPP-4 inhibitors had the conventional calorie-restricted diet using the food exchange table. No change in prescription drugs occurred for both groups during the study period. After the intervention, the carbohydrate content in dietary intake was lowered significantly from 56.8±8.3 to 46.8±10.1%, while the lipid concentration, primarily n-6 polyunsaturated fatty acids, was significantly increased. There was no significant change in protein intake. Hemoglobin A1c (HbA1c) fell from 7.22±0.74% to 6.95±0.72% (mean±SD). Furthermore, salt intake decreased significantly from 6.8±2.5 g prior to the intervention, to 5.7±1.9 g after the intervention. The estimated glomerular filtration rates (eGFR) decreased slightly, while serum creatinine levels did not change. These findings suggest that a moderate carbohydrate-restricted diet (50%) is effective in patients with T2D, without affecting kidney function.

Effect of extrusion processing on the microstructure and in vitro digestibility of broken rice

Article

Nov 2019
LWT-FOOD SCI TECHNOL

During rice dehulling and polishing, about 14% of the rice will be broken. How to utilize those low-value broken rice effectively is a critical issue. In this study, extrusion technology was applied to restructure the broken rice. The morphology, molecular structure and digestibility of intact, broken and extruded rice were investigated with SEM, XRD, FT-IR as well as simulated in vitro gastrointestinal digestion technique. The extruded rice showed a rough surface and the crystalline structure transformed its diffraction type from an A-type to a mixture of B- and V-types. The equilibrium starch hydrolysis (C∞) and kinetic constant (k) of extruded rice was significantly lower than that of the broken rice, which was 76.10%, 2.91 × 10⁻² (min⁻¹) and 80.90%, 6.42 × 10⁻² (min⁻¹), respectively. Our results indicated that extrusion processing could modify the microstructure and digestibility of rice effectively, and be an optional way to produce staple rice with lower digestibility.

Fortification of rice with vitamins and minerals for addressing micronutrient malnutrition

Article

Oct 2019

Background: Rice fortification with vitamins and minerals has the potential to increase the nutrition in rice-consuming countries where micronutrient deficiencies exist. Globally, 490 million metric tonnes of rice are consumed annually. It is the dominant staple food crop of around three billion people. Objectives: To determine the benefits and harms of rice fortification with vitamins and minerals (iron, vitamin A, zinc or folic acid) on micronutrient status and health-related outcomes in the general population. Search methods: We searched CENTRAL, MEDLINE, Embase, CINAHL, and 16 other databases all up to 10 December 2018. We searched ClinicalTrials.gov, and World Health Organization International Clinical Trials Registry Platform (ICTRP) on 10 December 2018. Selection criteria: We included randomised and quasi-randomised trials (with either individual or cluster randomisation) and controlled before-and-after studies. Participants were populations older than two years of age (including pregnant women) from any country. The intervention was rice fortified with at least one micronutrient or a combination of several micronutrients (iron, folic acid, zinc, vitamin A or other vitamins and minerals) compared with unfortified rice or no intervention. Data collection and analysis: We used standard methodological procedures expected by Cochrane. Two review authors independently screened studies and extracted data. Main results: We included 17 studies (10,483 participants) and identified two ongoing studies. Twelve included studies were randomised-controlled trials (RCTs), with 2238 participants after adjusting for clustering in two cluster-RCTs, and five were non-randomised studies (NRS) with four controlled before-and-after studies and one cross-sectional study with a control (8245 participants). Four studies were conducted in India, three in Thailand, two in the Philippines, two in Brazil, one each in Bangladesh, Burundi, Cambodia, Indonesia, Mexico and the USA. Two studies involved non-pregnant, non-lactating women and 10 involved pre-school or school-age children. All 17 studies reported fortification with iron. Of these, six studies fortified rice with iron only; 11 studies had other micronutrients added (iron, zinc and vitamin A, and folic acid). One study had one arm each with vitamin A alone and carotenoid alone. Elemental iron content ranged from 0.2 to 112.8 mg/100 g uncooked rice given for a period varying from two weeks to 48 months. Thirteen studies did not clearly describe either sequence generation or allocation concealment. Eleven studies had a low attrition rate. There was no indication of selective reporting in the studies. We considered two RCTs at low overall risk of bias and 10 at high overall risk of bias. One RCT was at high or unclear risk of bias for most of the domains. All controlled before-and-after studies had a high risk or unclear risk of bias in most domains. The included studies were funded by Government, private and non-governmental organisations, along with other academic institutions. The source of funding does not appear to have altered the results. We used the NRS in the qualitative synthesis but we excluded them from the quantitative analysis and review conclusions since they provided mostly contextual information and limited quantitative information. Rice fortified with iron alone or in combination with other micronutrients versus unfortified rice (no micronutrients added) Fortification of rice with iron (alone or in combination with other micronutrients) may make little or no difference in the risk of having anaemia (risk ratio (RR) 0.72, 95% confidence interval (CI) 0.54 to 0.97; I2 = 74%; 7 studies, 1634 participants; low-certainty evidence) and may reduce the risk of iron deficiency (RR 0.66, 95% CI 0.51 to 0.84; 8 studies, 1733 participants; low-certainty evidence). Rice fortification may increase mean haemoglobin (mean difference (MD) 1.83, 95% CI 0.66 to 3.00; I2 = 54%; 11 studies, 2163 participants; low-certainty evidence) and it may make little or no difference to vitamin A deficiency (with vitamin A as one of the micronutrients in the fortification arm) (RR 0.68, 95% CI 0.36 to 1.29; I2 = 37%; 4 studies, 927 participants; low-certainty evidence). One study reported that fortification of rice (with folic acid as one of the micronutrients) may improve serum or plasma folate (nmol/L) (MD 4.30, 95% CI 2.00 to 6.60; 215 participants; low-certainty evidence). One study reported that fortification of rice with iron alone or with other micronutrients may slightly increase hookworm infection (RR 1.78, 95% CI 1.18 to 2.70; 785 participants; low-certainty evidence). We are uncertain about the effect of fortified rice on diarrhoea (RR 3.52, 95% CI 0.18 to 67.39; 1 study, 258 participants; very low-certainty evidence). Rice fortified with vitamin A alone or in combination with other micronutrients versus unfortified rice (no micronutrients added) One study had one arm providing fortified rice with vitamin A only versus unfortified rice. Fortification of rice with vitamin A (in combination with other micronutrients) may increase mean haemoglobin (MD 10.00, 95% CI 8.79 to 11.21; 1 study, 74 participants; low-certainty evidence). Rice fortified with vitamin A may slightly improve serum retinol concentration (MD 0.17, 95% CI 0.13 to 0.21; 1 study, 74 participants; low-certainty evidence). No studies contributed data to the comparisons of rice fortification versus no intervention. The studies involving folic acid and zinc also involved iron in the fortification arms and hence we reported them as part of the first comparison. Authors' conclusions: Fortification of rice with iron alone or in combination with other micronutrients may make little or no difference in the risk of having anaemia or presenting iron deficiency and we are uncertain about an increase in mean haemoglobin concentrations in the general population older than 2 years of age. Fortification of rice with iron and other micronutrients such as vitamin A or folic acid may make little or no difference in the risk of having vitamin A deficiency or on the serum folate concentration. There is limited evidence on any adverse effects of rice fortification.

Brown Rice, a Diet Rich in Health Promoting Properties

Article

Full-text available

Oct 2019

As a staple food crop rice caters to the energy needs of more than 4 billion people around the globe. Since the 1980s, rice breeding focused on breeding for superior grain quality with good texture, taste, palatability and aroma. The recent rise in double burden nutrition challenges suggests that there is a pressing need to focus on incorporating nutritional traits also in rice breeding efforts. The present rice based diet contains nutritional gaps mainly due to the milling process which removes health promoting compounds present in rice bran. Therefore, less milled or brown rice consumption is highly recommended to achieve nutrition sustainability. Brown rice contains relatively higher amounts of dietary fibre, moderate amount of proteins, unsaturated lipids, micronutrients and several bioactive compounds. Some landraces consumed as brown rice have low glycemic index properties; hence they might be helpful to counter the growing type II diabetes. Colored rice varieties with red or purple pericarps are known to possess high levels of bioactive compounds such as cyanidin-3-glucoside, various flavanoids and γ-oryzanol. Germinated brown rice has more potential health benefits, for example, 10-fold of γ-aminobutyric acid than milled rice. For future nutritional intervention, we recommend further explorations into the nutritional value of brown rice as well as to modify the endosperm for enhanced nutrition without altering the texture to ensure consumer acceptance.

Black rice (Oryza sativa L.): A review of its historical aspects, chemical composition, nutritional and functional properties, and applications and processing technologies

Article

Jul 2019
FOOD CHEM

Black rice is a variety of pigmented rice. It contains numerous nutritional and bioactive components, including essential amino acids, functional lipids, dietary fibre, vitamins, minerals, anthocyanins, phenolic compounds, γ-oryzanols, tocopherols, tocotrienols, phytosterols and phytic acid. There have been several studies of black rice due to its alleged beneficial health effects when consumed regularly. This review focuses on the historical aspects, chemical composition, and nutritional and functional properties of black rice. Furthermore, a discussion of the development of new foods and beverages with applications and processing technologies designed to improve their quality attributes. The nutritional value of black rice means that it has the potential to be used in the production of healthy foods and beverages, such as functional products and gluten-free cereals, thereby providing extra health benefits to consumers.

Effect of high hydrostatic pressure on the bioactive compounds, antioxidant activity and in vitro digestibility of cooked black rice during refrigerated storage

Article

Mar 2019

Extractable phenols, total flavonoid, total anthocyanin, antioxidant activity and in vitro digestibility of cooked black rice (BR) following high hydrostatic pressure (HHP) treatments (200–500 MPa/15 min) during 40 days of storage at 4 °C were evaluated in this study. Results showed that extractable phenols significantly (p < 0.05) increased between 12.07% and 4.89% for treated samples with 400 MPa and 500 MPa at day 1. Similar trends occurred in flavonoid, anthocyanin and antioxidant activity of cooked BR regardless of storage days, suggesting that HHP had a better retention of the above-mentioned compounds. However, all the samples showed a significant (p < 0.05) reduction in these antioxidant compounds during storage time. Compared with the control, higher in vitro hydrolysis, increased amount of rapidly digestible starch (RDS) and slowly digestible starch (SDS), as well as lower levels of resistant starch (RS) were observed in BR samples with HHP treatments. These findings indicate that HHP treatment could be a potentially applicable technique for producing cooked BR with enhanced nutrition and high quality.

Rice intake and risk of type 2 diabetes: the Singapore Chinese Health Study

Article

Full-text available

Dec 2019
EUR J NUTR

Purpose The prevalence of type 2 diabetes (T2D) is increasing in Asian populations. White rice is a common staple food in these populations and results from several studies suggest that high white rice consumption increases T2D risk. We assessed whether rice, noodles and bread intake was associated with T2D risk in an ethnic Chinese population. Methods We included data from 45,411 male and female Chinese participants of the Singapore Chinese Health Study cohort aged 45–74 years at baseline. Usual diet at baseline was evaluated by a validated 165-item semi-quantitative food frequency questionnaire. Physician-diagnosed T2D was self-reported during two follow-up interviews. Multivariable Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results During a mean follow-up of 11 years, 5207 incident cases of T2D were documented. Rice intake was not associated with higher T2D risk [HR for extreme quintiles, 0.98 (95% CI 0.90, 1.08)] despite the large variation in intake levels (median intake for extreme quintiles: 236.5 g/day vs. 649.3 g/day), although the precise risk estimate depended greatly on the substitute food. Replacing one daily serving of rice with noodles [HR 1.14 (95% CI 1.07, 1.22)], red meat [HR 1.40 (95% CI 1.23, 1.60)] and poultry [HR 1.37 (95% CI 1.18, 1.59)] was associated with higher T2D risk, whereas the replacement of rice with white bread [HR 0.90 (95% CI 0.85, 0.94)] or wholemeal bread [HR 0.82 (95% CI 0.75, 0.90)] was associated with lower T2D risk. Conclusions Higher rice consumption was not substantially associated with a higher risk of T2D in this Chinese population. Recommendations to reduce high white rice consumption in Asian populations for the prevention of T2D may only be effective if substitute foods are considered carefully. Clinical Trial Registry number and website NCT03356340, http://www.clinicaltrials.gov.

Effect of pressure-soaking treatments on texture and retrogradation properties of black rice

Article

Mar 2018
LWT-FOOD SCI TECHNOL

Cooking properties and retrogradation process of black rice (BR) with high hydrostatic pressure (HHP, 200–400 MPa/15 min) soaking were evaluated in this study. Results showed that the water absorption capacity of BR with HHP soaking was higher than that of control one. The HHP soaking also generated the lower leached amylose and hardness, while the higher springiness, cohesiveness, and resilience for cooked BR. In addition, the DSC data revealed that the enthalpy of cooked BR was influenced by HHP treatment, and the degree of retrogradation was decreed from 91% to 71% (storage for 21 days). Furthermore, the analysis of X-ray diffraction (XRD) revealed that the HHP treatment weakened the intensity of the peak of the 14 day-retrograded samples and decreased the relative crystallinity from 19.92% to 15.94% (storage for 21 days). These findings suggest that the HHP soaking could be a potentially applicable pretreatment for producing cooked BR with high quality.

Supplement: Global burden of tuberculosis 2015

Data

Full-text available

Mar 2018

This is the supplement for DOI: 10.1016/S1473-3099(17)30703-X

Supplementary Material

Data

Full-text available

Jan 2017

Type 2 Diabetes: Demystifying the Global Epidemic

Article

Full-text available

Jun 2017

Shashank Joshi

Type 2 Diabetes: Demystifying the Global Epidemic

Article

Full-text available

Jun 2017
DIABETES

Type 2 diabetes (T2D) has attained the status of a global pandemic, spreading from affluent industrialized nations to the emerging economies of Asia, Latin America, and Africa. There is significant global variation in susceptibility to T2D, with Pacific Islanders, Asian Indians, and Native Americans being considerably more prone to develop the disorder. Although genetic factors may play a part, the rapidity with which diabetes prevalence has risen among these populations reflects the far-ranging and rapid socioeconomic changes to which they have been exposed over the past few decades. Traditionally, obesity and its correlate, insulin resistance, have been considered the major mediators of T2D risk; however, recent evidence shows that early loss of β-cell function plays an important role in the pathogenesis of T2D, especially in nonobese individuals such as South Asians. Knowledge of the modifiable risk factors of T2D is important, as it forms the basis for designing cost-effective preventive and therapeutic strategies to slow the epidemic in populations at increased risk. Lessons learned from randomized prevention trials need to be implemented with appropriate cultural adaptations, accompanied by empowerment of the community, if the diabetes epidemic is to be slowed or halted.

Rice and Type 2 Diabetes

Article

Mar 2014

A recent meta-analysis of four articles observed that rice intake was associated with type 2 diabetes risk. In particular, among Asian populations who consume more rice, the increased risk of type 2 diabetes associated with rice intake was stronger than those among Western populations. Although rice is rich in carbohydrates, the association between carbohydrate intake and type 2 diabetes is controversial. Because the amount of rice intake and the amount or sources of carbohydrate intake differ between Asian and Western populations, the association of these intakes with type 2 diabetes risk might differ. However, there are few studies which have examined the association between them among Asian populations. Not only quantity but also quality of the carbohydrate (GI and GL) may play a role in development of type 2 diabetes or glucose intolerance.

Rice protein hydrolysates stimulate GLP-1 secretion, reduce GLP-1 degradation, and lower the glycemic response in rats

Article

Jun 2015

Rice has historically been consumed in Asia as a major source of carbohydrates, however, little is known regarding the functional roles of rice proteins as dietary factors. In the present study, we investigated whether peptides derived from rice proteins could stimulate GLP-1 secretion, which results in reducing glycemia via the incretin effect in normal rats. Hydrolysates were prepared from the protein fraction of rice endosperm or rice bran, and the effects of these hydrolysates on GLP-1 secretion were examined in a murine enteroendocrine cell line GLUTag. Plasma was collected after oral administration of the rice protein hydrolysates, under anesthesia, or during glucose tolerance tests in rats. In anesthetized rats, plasma dipeptidyl peptidase-IV (DPP-IV) activity was measured after ileal administration of the rice protein hydrolysates. GLP-1 secretion from GLUTag cells was potently stimulated by the rice protein hydrolysates, especially by the peptic digest of rice endosperm protein (REPH) and that of rice bran protein (RBPH). Oral administration of REPH or RBPH elevated plasma GLP-1 concentrations, which resulted in the reduction of glycemia under the intraperitoneal glucose tolerance test. In addition, the plasma DPP-IV activity was attenuated after ileal administration of REPH or RBPH, which resulted in a higher ratio of intact (active) GLP-1 to total GLP-1 in the plasma. These results demonstrate that rice proteins exert potent stimulatory effects on GLP-1 secretion, which could contribute to the reduction of postprandial glycemia. The inhibitory effect of these peptides on the plasma DPP-IV activity may potentiate the incretin effect of GLP-1.

Therapeutic properties of rice constituents and derivatives (Oryza sativa L.): A review update

Article

Aug 2014
TRENDS FOOD SCI TECH

Rice is used in traditional medicines as a remedy against inflammation, gastrointestinal ailments, hypercholesterolemia, diabetes, and skin diseases. Experimental and clinical evidence indicate that brown rice and bran oil reduce hypercholesterolemia and cardiovascular risk, rice bran is antinflammatory and immunostimulatory, the monacolin-rich red yeast rice regulates hypercholesterolemia, and the GABA-rich germinated brown rice has chemopreventive effects. The rice constituent γ-oryzanol has been intensively investigated for cholesterol regulation and antioxidant/antinflammatory activities. Bran derivatives and other products are used for dermatologic and cosmetic applications. Pharmacologically relevant compounds could be extracted from rice byproducts, providing an economic boost to rice farming and processing.

Long-term intake of rice improves insulin sensitivity in mice fed a high-fat diet

Article

Jul 2014
NUTRITION

Objective This study was designed to evaluate the effects of rice as a carbohydrate source and its molecular mechanisms on insulin resistance induced by a high-fat diet (HFD). Methods C57BL/6J mice were divided into 3 groups and were fed for 12 weeks with a low fat diet (LFD); a HFD (with 18% fat, 0.5% cholesterol, 51.5% w/w corn starch and sucrose); or a HFD with rice (HFD-CR, with 18% fat, 0.5% cholesterol and 51.5% w/w rice powder). In the HF-CR diet, cooked rice powder was substituted for corn starch and sucrose in the HFD as a carbohydrate source. Results HFD-CR-fed mice had significantly lower body weights, blood glucose, insulin and leptin levels and ameliorated glucose responses with decreased homeostasis model assessment-insulin resistance (HOMA-IR) compared with the HFD-fed mice. Hepatic mRNA levels of phosphoenolpyruvate carboxykinase (PEPCK) and glucose-6-phosphatase (G6Pase) were down-regulated in the HFD-CR group. The hypertrophied islet size and the decreased pancreatic mRNA expression of glucose transporter 2 (Glut2) in the HFD group were normalized with cooked rice consumption. Rice promoted glucose uptake by activating AMP-activated protein kinase (AMPK) and downstream glucose transporter 4 (Glut4) in the skeletal muscle. Conclusion Rice consumption as a carbohydrate source might potentiate improvements in glucose uptake via AMPK activation and Glut4 expression in the skeletal muscles, thereby improving insulin sensitivity.

White rice consumption and risk of type 2 diabetes: Meta-analysis and systematic review

Article

Full-text available

Jan 2012

White rice consumption and risk of type 2 diabetes: Meta-analysis and systematic review

Article

Full-text available

Mar 2012
Br Med J

To summarise evidence on the association between white rice consumption and risk of type 2 diabetes and to quantify the potential dose-response relation. Meta-analysis of prospective cohort studies. Searches of Medline and Embase databases for articles published up to January 2012 using keywords that included both rice intake and diabetes; further searches of references of included original studies. Included studies were prospective cohort studies that reported risk estimates for type 2 diabetes by rice intake levels. Relative risks were pooled using a random effects model; dose-response relations were evaluated using data from all rice intake categories in each study. Four articles were identified that included seven distinct prospective cohort analyses in Asian and Western populations for this study. A total of 13,284 incident cases of type 2 diabetes were ascertained among 352,384 participants with follow-up periods ranging from 4 to 22 years. Asian (Chinese and Japanese) populations had much higher white rice consumption levels than did Western populations (average intake levels were three to four servings/day versus one to two servings/week). The pooled relative risk was 1.55 (95% confidence interval 1.20 to 2.01) comparing the highest with the lowest category of white rice intake in Asian populations, whereas the corresponding relative risk was 1.12 (0.94 to 1.33) in Western populations (P for interaction=0.038). In the total population, the dose-response meta-analysis indicated that for each serving per day increment of white rice intake, the relative risk of type 2 diabetes was 1.11 (1.08 to 1.14) (P for linear trend<0.001). Higher consumption of white rice is associated with a significantly increased risk of type 2 diabetes, especially in Asian (Chinese and Japanese) populations.

Prevalence of diabetes mellitus and impaired glucose regulation in Spain: The Di@bet.es Study

Article

Full-text available

Oct 2012
DIABETOLOGIA

The Di@bet.es Study is the first national study in Spain to examine the prevalence of diabetes and impaired glucose regulation. A population-based, cross-sectional, cluster sampling study was carried out, with target population being the entire Spanish population. Five thousand and seventy-two participants in 100 clusters (health centres or the equivalent in each region) were randomly selected with a probability proportional to population size. Participation rate was 55.8%. Study variables were a clinical and demographic structured survey, lifestyle survey, physical examination (weight, height, BMI, waist and hip circumference, blood pressure) and OGTT (75 g). Almost 30% of the study population had some carbohydrate disturbance. The overall prevalence of diabetes mellitus adjusted for age and sex was 13.8% (95% CI 12.8, 14.7%), of which about half had unknown diabetes: 6.0% (95% CI 5.4, 6.7%). The age- and sex-adjusted prevalence rates of isolated impaired fasting glucose (IFG), isolated impaired glucose tolerance (IGT) and combined IFG-IGT were 3.4% (95% CI 2.9, 4.0%), 9.2% (95% CI 8.2, 10.2%) and 2.2% (95% CI 1.7, 2.7%), respectively. The prevalence of diabetes and impaired glucose regulation increased significantly with age (p < 0.0001), and was higher in men than in women (p < 0.001). The Di@bet.es Study shows, for the first time, the prevalence rates of diabetes and impaired glucose regulation in a representative sample of the Spanish population.

Intake and home use of olive oil or mixed oils in relation to healthy lifestyles in a Mediterranean population. Findings from the prospective Pizarra study

Article

Full-text available

Sep 2009
BRIT J NUTR

Discordances exist in epidemiological studies regarding the association between the intake of nutrients and death and disease. We evaluated the social and health profile of persons who consumed olive oil in a prospective population cohort investigation (Pizarra study) with a 6-year follow-up. A food frequency questionnaire and a 7 d quantitative questionnaire were administered to 538 persons. The type of oil used in food preparation was determined by direct measurement of the fatty acids in samples obtained from the kitchens of the participants at baseline and after follow-up for 6 years. The fatty acid composition of the serum phospholipids was used as an endogenous marker of the type of oil consumed. Total fat intake accounted for a mean 40 % of the energy (at baseline and after follow-up). The concordance in intake of MUFA over the study period was high. The fatty acid composition of the serum phospholipids was significantly associated with the type of oil consumed and with fish intake. The concentration of polar compounds and polymers, indicative of degradation, was greater in oils from the kitchens where sunflower oil or refined olive oil was used, in oils used for deep frying and in oils that had been reused for frying five times or more. Consumption of olive oil was directly associated with educational level. Part of the discordance found in epidemiological studies between diet and health may be due to the handling of oils during food preparation. The intake of olive oil is associated with other healthy habits.

Glycemic Index, Postprandial Glycemia, and the Shape of the Curve in Healthy Subjects: Analysis of a Database of More than 1000 Foods

Article

Full-text available

Jan 2009
AM J CLIN NUTR

The glycemic index (GI) characterizes foods by using the incremental area under the glycemic response curve relative to a similar amount of oral glucose. Its ability to differentiate between curves of different shapes, the peak response, and other aspects of the glycemic response is debatable. The objective was to explore the association between a food's GI and the shape of the curve in healthy individuals. A large database of 1,126 foods tested by standardized GI methodology in 8-12 healthy subjects was analyzed systematically. Each food's absolute and incremental blood glucose concentrations were compared at individual time points with the GI. The average curve was generated for low-GI (< or = 55), medium-GI (56-69), and high-GI (> or = 70) foods within major food categories. The GI of individual foods was found to correlate strongly with the incremental and actual peak (Spearman's correlations of r = 0.76 and r = 0.73, respectively), incremental and actual glucose concentration at 60 min (r = 0.70 and r = 0.66, respectively), and maximum amplitude of glucose excursion (r = 0.68) (all P < 0.001). In contrast, there was only a weak correlation between the food's GI and the 120-min glucose concentration (incremental r = 0.20, P < 0.001; absolute r = 0.16, P < 0.001). Within food groups, the mean GI, 30- and 60-min glucose concentrations, and maximum amplitude of glucose excursion varied significantly for foods classified as having a low, medium, or high GI (P < 0.001). The GI provides a good summary of postprandial glycemia. It predicts the peak (or near peak) response, the maximum glucose fluctuation, and other attributes of the response curve.

International Table of Glycemic Index and Glycemic Load Values

Article

Full-text available

Jul 2002

Reliable tables of glycemic index (GI) compiled from the scientific literature are instrumental in improving the quality of research examining the relation between GI, glycemic load, and health. The GI has proven to be a more useful nutritional concept than is the chemical classification of carbohydrate (as simple or complex, as sugars or starches, or as available or unavailable), permitting new insights into the relation between the physiologic effects of carbohydrate-rich foods and health. Several prospective observational studies have shown that the chronic consumption of a diet with a high glycemic load (GI x dietary carbohydrate content) is independently associated with an increased risk of developing type 2 diabetes, cardiovascular disease, and certain cancers. This revised table contains almost 3 times the number of foods listed in the original table (first published in this Journal in 1995) and contains nearly 1300 data entries derived from published and unpublished verified sources, representing > 750 different types of foods tested with the use of standard methods. The revised table also lists the glycemic load associated with the consumption of specified serving sizes of different foods.

Oleic acid from cooking oils is associated with lower insulin resistance in the general population (Pizarra study)

Article

Full-text available

Feb 2004

To evaluate the relation between type of dietary fatty acid and degree of insulin resistance. A cross-sectional study. Anthropometrical data were measured in 538 subjects, aged 18-65 Years, selected randomly from the municipal census of Pizarra (Spain). An oral glucose tolerance test (OGTT) was given to all subjects and measurements were made of glycemia, insulinemia and the proportion of fatty acids in plasma phospholipids. Insulin resistance (IR) was estimated by homeostasis model assessment. Samples of cooking oil being used were obtained from the kitchens. The strength of association between variables was measured by calculating the odds ratio (OR) from logistic models, and the relationships were measured by linear correlation coefficients. Insulin resistance was significantly less in people who used olive oil compared with those who used sunflower oil or a mixture. Statistical significance remained in the group of people with normal OGTT after adjusting for obesity. In the whole sample, IR correlated negatively with the concentration of oleic acid (r=-0.11; P=0.02) and positively with that of linoleic acid (r=0.10; P=0.02) from the cooking oil. In subjects with normal OGTT, IR correlated negatively with oleic acid from cooking oil (r=-0.17; P=0.004) and from plasma phospholipids (r=-0.11; P=0.01) and positively with the concentration of linoleic acid in cooking oil (r=0.18; P=0.004) and plasma phospholipids (r=0.12; P=0.005). The risk (OR) of having raised IR was significantly lower in people who consumed olive oil, either alone (OR=0.50) or mixed (OR=0.52) compared with those who consumed only sunflower oil. There is an association between the intake of oleic acid, the composition of oleic acid in plasma phospholipids and peripheral insulin action.

Glycemic index, glycemic load, and dietary fiber intake and incidence of type 2 diabetes in younger and middle-aged women

Article

Full-text available

Sep 2004

Increasing evidence suggests an important role of carbohydrate quality in the development of type 2 diabetes. Our objective was to prospectively examine the association between glycemic index, glycemic load, and dietary fiber and the risk of type 2 diabetes in a large cohort of young women. In 1991, 91249 women completed a semiquantitative food-frequency questionnaire that assessed dietary intake. The women were followed for 8 y for the development of incident type 2 diabetes, and dietary information was updated in 1995. We identified 741 incident cases of confirmed type 2 diabetes during 8 y (716 300 person-years) of follow-up. After adjustment for age, body mass index, family history of diabetes, and other potential confounders, glycemic index was significantly associated with an increased risk of diabetes (multivariate relative risks for quintiles 1-5, respectively: 1, 1.15, 1.07, 1.27, and 1.59; 95% CI: 1.21, 2.10; P for trend = 0.001). Conversely, cereal fiber intake was associated with a decreased risk of diabetes (multivariate relative risks for quintiles 1-5, respectively: 1, 0.85, 0.87, 0.82, and 0.64; 95% CI: 0.48, 0.86; P for trend = 0.004). Glycemic load was not significantly associated with risk in the overall cohort (multivariate relative risks for quintiles 1-5, respectively: 1, 1.31, 1.20, 1.14, and 1.33; 95% CI: 0.92, 1.91; P for trend = 0.21). A diet high in rapidly absorbed carbohydrates and low in cereal fiber is associated with an increased risk of type 2 diabetes.

Effect of the interaction between the fatty acid-binding protein 2 gene Ala54Thr polymorphism and dietary fatty acids on peripheral insulin sensitivity: A cross-sectional study

Article

Full-text available

Nov 2007

The intestinal fatty acid-binding protein (FABP2) is involved in the intracellular transport and metabolism of fatty acids and may affect insulin sensitivity and glucose metabolism. The objective was to study the effect of interaction between the Ala54Thr polymorphism of the FABP2 gene (FABP2) and the type of dietary cooking oil used on peripheral insulin sensitivity in a population from southern Spain. The study was cross-sectional. Anthropometric measurements were obtained for 1226 persons aged 18-65 y selected randomly from the municipal census of Pizarra, Spain. An oral-glucose-tolerance test was given to 1020 of these persons. Insulin resistance was measured by homeostasis model assessment. Samples of the cooking oil being used were taken from the kitchens of a random subset of 538 persons. Persons who consumed sunflower oil and who also had the Thr54 variant had higher insulin resistance than did those who consumed olive oil (P = 0.01). We detected an interaction between the Ala54Thr polymorphism and the type of oil consumed that accounted for the variance in insulin resistance (P = 0.02). The effect of dietary fatty acids on the populational pattern of insulin resistance is not independent of the Ala54Thr polymorphism of FABP2. An interaction existed between this polymorphism and the intake of dietary fats in a population with a high intake of monounsaturated fatty acids.

Effects of different protein content and glycaemic index of ad libitum diets on diabetes risk factors in overweight adults: The DIOGenes multicentre, randomized, dietary intervention trial

Article

Oct 2011
DIABETES-METAB RES

Background Dietary regimens providing different levels of protein and glycemic index (GI) foods when prescribed for weight management may also influence insulin sensitivity.Procedures and OutcomesOverweight/obese adults in 8 European countries who lost ≥ 8% of initial body-weight (BW) after following a low calorie diet (LCD) were later randomly assigned with a 2x2 factorial design into 4 ad libitum dietary groups with two different protein content levels and dissimilar glycemic index, which were compared to a healthy reference diet. Specific markers assessing insulin resistance were measured. The LCD was initially applied to 932 adults and 773 were randomised to the 5 ad libitum diets. The 6-months programme was completed by 548 participants. The assignment to the Low Protein /High Glycemic Index diet induced a statistically higher HOMA-IR increase during the 6 months period as compared to the control. Contrariwise, the insulin response was lower in the High Protein/Low Glycemic Index diet after 60 and 90 min of an Oral Glucose Tolerance test subsequently carried out after the 6-months intervention. The Low Glycemic Index diets (either with high or low protein content) also lead to a decrease in fructosamine levels during the trial.Conclusion/InterpretationAfter a weight loss period, an increase in the dietary protein proportions and a decrease in the consumption of foods with a high Glycemic Index within an ad libitum dietary intervention aiming to weight maintenance produced favorable effects on glycaemic control and insulin sensitivity in overweight/obese subjects. Copyright © 2011 John Wiley & Sons, Ltd.

Prevalence of Diabetes among Men and Women in China

Article

Mar 2010
NEW ENGL J MED

Because of the rapid change in lifestyle in China, there is concern that diabetes may become epidemic. We conducted a national study from June 2007 through May 2008 to estimate the prevalence of diabetes among Chinese adults. A nationally representative sample of 46,239 adults, 20 years of age or older, from 14 provinces and municipalities participated in the study. After an overnight fast, participants underwent an oral glucose-tolerance test, and fasting and 2-hour glucose levels were measured to identify undiagnosed diabetes and prediabetes (i.e., impaired fasting glucose or impaired glucose tolerance). Previously diagnosed diabetes was determined on the basis of self-report. The age-standardized prevalences of total diabetes (which included both previously diagnosed diabetes and previously undiagnosed diabetes) and prediabetes were 9.7% (10.6% among men and 8.8% among women) and 15.5% (16.1% among men and 14.9% among women), respectively, accounting for 92.4 million adults with diabetes (50.2 million men and 42.2 million women) and 148.2 million adults with prediabetes (76.1 million men and 72.1 million women). The prevalence of diabetes increased with increasing age (3.2%, 11.5%, and 20.4% among persons who were 20 to 39, 40 to 59, and > or = 60 years of age, respectively) and with increasing weight (4.5%, 7.6%, 12.8%, and 18.5% among persons with a body-mass index [the weight in kilograms divided by the square of the height in meters] of < 18.5, 18.5 to 24.9, 25.0 to 29.9, and > or = 30.0, respectively). The prevalence of diabetes was higher among urban residents than among rural residents (11.4% vs. 8.2%). The prevalence of isolated impaired glucose tolerance was higher than that of isolated impaired fasting glucose (11.0% vs. 3.2% among men and 10.9% vs. 2.2% among women). These results indicate that diabetes has become a major public health problem in China and that strategies aimed at the prevention and treatment of diabetes are needed.

Lipid, protein, and calorie content of different Atlantic and Mediterranean fish, shellfish, and molluscs commonly eaten in the south of Spain

Article

Jul 1997

We undertook a systematic evaluation of the lipid, protein, calorie, and fatty acid composition in 35 species of fish, shellfish and molluscs commonly consumed throughout the four seasons of the year in Andalusia, Spain. Using a portion of muscle tissue the following were measured in each study unit: total lipids (extraction using Folch's method and gravimetry), protein concentration (Kjehldal's method), total calories (direct calorimetry), and composition of fatty acids (gas chromatography). The lipid, protein, and different fatty acid concentrations found are presented in table form. There was a high degree of inter-species variability in the concentration of lipids and the various fatty acids. There was also a high degree of intra-species seasonal variability in some cases. The relative proportion of fatty acids was not independent of the total concentration of lipids, independently of the season studied. This systematic study of a large group of species shows that the cataloguing of fish as 'white' or 'blue' depends especially on the time of year they are captured. For example, in spring the mackerel (Scomber scombrus), a fish considered traditionally to be 'blue' (fatty), has the same lipid concentration as the dover sole (Solea vulgaris), commonly considered to be 'white' (little fat), and the sea pike (Merluccius merluccius) has a higher lipid concentration in autumn than the jack mackerel (Trachurus trachurus). Even greater differences existed when the fish were classified according to their richness in n-3 fatty acids. These differences in the total lipid concentration and the composition of fatty acids, as well as the inter-relations between them, may, under certain circumstances, be important for the calculation of dietary calories and nutritional values, and may explain the differences found between the various tables of food composition, as well as the divergent results in epidemiological studies on the association between fish in diets and various diseases, such as diabetes or ischaemic cardiopathy.

Incidence of type 2 diabetes in southern Spain (Pizarra Study)

Article

Mar 2008
EUR J CLIN INVEST

Few European studies have used an oral glucose tolerance test (OGTT) to examine the incidence of type 2 diabetes. We determined the incidence of impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and type 2 diabetes in a population from southern Spain. A population-based cohort study was undertaken in Pizarra, Spain. Baseline data were recorded on age, sex, weight, height, waist and hip circumferences, and diabetes status for 1051 persons, of whom 910 were free of type 2 diabetes (at-risk sample). Of these, 714 completed the 6-year follow-up study. Body mass index, waist-to-hip ratio and weight increase since baseline were calculated. The homeostasis model assessment equations were used to estimate the indices of insulin resistance and beta-cell function. Each person received an OGTT at baseline and after 6 years. Type 2 diabetes developed in 81 people for a total of 4253 person-years, representing an incidence of 19.1 cases per 1000 person-years (95% confidence interval, 15.3-23.6). Age and the presence of obesity, central obesity and carbohydrate metabolism disorders [IFG (cut off = 100 mg dL(-1), capillary blood glucose level), IGT or both] at baseline were significant markers for the onset of type 2 diabetes during follow-up. After adjusting for these variables, multivariate analysis showed weight increase, waist-to-hip ratio and the indices of insulin resistance and beta-cell function were significantly associated with the risk for type 2 diabetes. The incidence of type 2 diabetes in a population from southern Spain is high. It is probably associated with the high prevalence of obesity and weight increase in this population.

Effect of the interaction between the fatty acid binding protein 2 gene Ala54Thr polymorphism and dietary fatty acids on peripheral insulin sensitivity: a cross-sectional study.

Jan 2007
1232-1237

Morcillo S.
Rojo-Martinez G.
Cardona F.
Almaraz Mde L.
de Adana Mde L.
Esteva I.

White rice consumption and risk of type 2 diabetes

Abstract

No full-text available

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