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

BMJ 2012; 344 doi: http://dx.doi.org/10.1136/bmj.e1454 (Published 15 March 2012) Cite this as: BMJ 2012;344:e1454

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

Neeta Kumar1, Neeru Gupta1, Pratik Kumar2, Jugal Kishore3
1. Indian Council of Medical Research, India
2. All India Institute of Medical Sciences
3. Maulana Azad Medical College, India

Using the word “Asian” while quoting the effect of white rice from analyzing studies done in metro cities of Japan and Shanghai is not adequate. The authors have failed to consider the very fact that the quality of rice varies in varying regions of Asia, which is not merely a city in Japan or China. There are hundreds of strains in the whole of Asia of white rice as well as brown rice.

The glycemic index of a food item is the measure of its physiologic impact on the body to produce insulin. If GI is more the food is considered high glycemic and risky for producing Diabetes. The Glycemic index of brown rice has been found to be more than that of white rice on page no 18-21 of the article in reference number one.

“Many people have raised concerns about the variation in published GI (glycemic Index) values for apparently similar foods. This variation may reflect both methodologic factors and true differences in the physical and chemical characteristics of the foods. One possibility is that 2 similar foods may have different ingredients or may have been processed with a different method, resulting in significant differences in the rate of carbohydrate digestion and hence the GI value. Two different brands of the same type of food, such as a plain cookie, may look and taste almost the same, but differences in the type of flour used, in the moisture content, and in the cooking time can result in differences in the degree of starch gelatinization and consequently the GI values. International table of glycemic index. Rice, for example, shows a large range of GI values, but this variation is due to inherent botanical differences in rice from country to country rather than to methodologic differences. Differences in the amylose content could explain much of the variation in the GI values of rice (and other foods) because amylose is digested more slowly than is amylopectin starch. GI values for rice cannot be reliably predicted on the basis of the size of the grain (short or long grain) or the type of cooking method. Rice is obviously one type of food that needs to be tested brand by brand locally. Carrots are another example of a food with a wide variation in published GI values.

Indian studies do not imply particular food item for increased Diabetes risk (2) since a variety of food, variety of cooking methods, socioeconomic conditions, quality of life, sun exposure, mental stress, physical activity are applied in the region. So Indian scientists find 'Fast food culture’ and ‘Sedentarinism’- the main drivers of diabetes epidemic in India (3).

1. International table of glycemic index and glycemic load values: 2002,Kaye Foster-Powell, Susanna HA Holt, and Janette C Brand-Miller. Am J Clin Nutr January 2002 vol. 76 no. 1 5-56

2. Risk factors and complications of type 2diabetes in Asians. Rajbharan Yadav, Pramil Tiwari* and Ethiraj Dhanaraj. Review Article CRIPS Vol. 9 No. 2 April-June 2008.

3. Epidemiology of type 2 diabetes: Indian scenario. V. Mohan, S. Sandeep, R. Deepa, B. Shah. Indian J Med Res 125, March 2007, pp 217-230

Competing interests: No competing interests
12 November 2012
Neeta Kumar
Medical Scientist
Neeru Gupta, Pratik kumar, Jugal Kishore
Scientist
Indian Council of Medical Research, Ansari Nagra, New Delhi-110029
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