White rice consumption and risk of type 2 diabetes: meta-analysis and systematic reviewBMJ 2012; 344 doi: https://doi.org/10.1136/bmj.e1454 (Published 15 March 2012) Cite this as: BMJ 2012;344:e1454
- Emily A Hu, research assistant1,
- An Pan, research fellow1,
- Vasanti Malik, research fellow1,
- Qi Sun, instructor in medicine12
- 1Department of Nutrition, Harvard School of Public Health, 655 Huntington Avenue, Boston, MA 02115, USA
- 2Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, 181 Longwood Avenue, Boston
- Correspondence to: Qi Sun
- Accepted 19 January 2012
Objectives To summarise evidence on the association between white rice consumption and risk of type 2 diabetes and to quantify the potential dose-response relation.
Design Meta-analysis of prospective cohort studies.
Data sources 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.
Study selection Included studies were prospective cohort studies that reported risk estimates for type 2 diabetes by rice intake levels.
Data synthesis Relative risks were pooled using a random effects model; dose-response relations were evaluated using data from all rice intake categories in each study.
Results 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).
Conclusion Higher consumption of white rice is associated with a significantly increased risk of type 2 diabetes, especially in Asian (Chinese and Japanese) populations.
We thank Allison M Hodge and Ruby Yu for providing data for the meta-analysis.
Contributors: EAH, AP, and QS searched the literature and extracted data. QS had the idea for the analysis. VM, AP, and QS provided statistical expertise. EAH and AP analysed the data. EAH wrote the first draft of the manuscript. All authors contributed to the interpretation of the results and critical revision of the manuscript for important intellectual content and approved the final version of the manuscript. QS is the guarantor.
Funding: QS was supported by career development award K99HL098459 from the US National Heart, Lung, and Blood Institute. The funding sources had no role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the article for publication. The authors are not affiliated with the funding institutions.
Competing interests: All authors have completed the Unified Competing Interest form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.
Ethical approval: Not needed.
Data sharing: No additional data available.
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