Objective:
Previous
prospective studies on 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 analysed. White rice
consumption (cooked) was categorised as <150, ≥150 to <300, ≥300 to
<450 and ≥450 grams/day, based on 1 cup of cooked rice = 150 grams. The
primary outcome was incident diabetes. Hazards ratios were calculated using
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 (≥450g/d compared with <150g/d) was
associated with increased risk of diabetes (HR: 1.20; 95% CI: 1.03-1.41 p for
trend=0.003). However, the highest risk
was seen in South Asia (HR: 1.65; 95% CI: 1.17-2.34, 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:
1.08-1.85, p for trend =0.01), while in China there was no significant
association (HR: 1.05; 95% CI: 0.78-1.41, 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, non-significant association was seen.
Funding
Dr S Yusuf is supported by the Mary W Burke endowed chair of the Heart and Stroke Foundation of Ontario. The PURE study is an investigator-initiated study that is funded by the Population Health Research Institute, Hamilton Health Sciences Research Institute (HHSRI), the Canadian Institutes of Health Research, Heart and Stroke Foundation of Ontario, Support from Canadian Institutes of Health Research’s Strategy for Patient Oriented Research, through the Ontario SPOR Support Unit, as well as the Ontario Ministry of Health and Long-Term Care and through unrestricted grants from several pharmaceutical companies [with major contributions from AstraZeneca (Canada), Sanofi-Aventis (France and Canada), Boehringer Ingelheim (Germany and Canada), Servier, and GlaxoSmithKline], and additional contributions from Novartis and King Pharma and from various national or local organisations in participating countries. These include: Argentina: Fundacion ECLA (Estudios Clínicos Latino America) ; Bangladesh: Independent University, Bangladesh and Mitra and Associates; Brazil: Unilever Health Institute, Brazil; Canada: This study was supported by an unrestricted grant Public Health Agency of Canada and Champlain Cardiovascular Disease Prevention Network; Chile: Universidad de La Frontera [DI13-PE11]; China: National Center for Cardiovascular Diseases and ThinkTank Research Center for Health Development; Colombia: Colciencias (grant 6566-04-18062 and grant 6517-777-58228); India: Indian Council of Medical Research; Malaysia: Ministry of Science, Technology and Innovation of Malaysia (grant number: 100-IRDC/BIOTEK 16/6/21 [13/2007], and 07-05-IFN-BPH 010), Ministry of Higher Education of Malaysia (grant number: 600-RMI/LRGS/5/3 [2/2011]), Universiti Teknologi MARA, Universiti Kebangsaan Malaysia (UKM-Hejim-Komuniti-15-2010); occupied Palestinian territory: the United Nations Relief and Works Agency for Palestine Refugees in the Near East, occupied Palestinian territory; Internationa
