Substituting Brown Rice For White Rice: Effect On Diabetes Risk Factors In India
Condition: Diabetes Mellitus
MeSH terms: Diabetes Mellitus
Study type: Interventional

Summary: 
      Currently, India has the largest absolute number of people with diabetes in the world, and
      evidence indicates that consumption of whole-grains can decrease diabetes by improving
      glycemic control. Our study will evaluate the efficacy of substituting brown rice, a
      whole-grain, for white rice in Chennai, India, on biomarkers of diabetes risk. The ultimate
      goal of this research is to provide data for use in designing a global dietary intervention
      study aimed at reducing diabetes risk through simple, culturally appropriate, feasible and
      sustainable dietary changes.
    

Detailed description: 
      Currently, India has the largest absolute number of people with diabetes in the world and the
      escalation in diabetes incidence is occurring as global free trade continues to fuel rapid
      economic and nutrition transitions, especially in urban settings. These transitions are
      accompanied by a shift in dietary consumption towards more highly refined carbohydrates,
      fats, and animal products. Evidence indicates that consumption of whole-grains can decrease
      diabetes by improving glycemic control. The proposed proof-of-concept trial herein will
      evaluate the efficacy of substituting brown rice, a whole-grain, for white rice in Chennai,
      India, on biomarkers of diabetes risk and also will obtain glycemic index values of local
      rice and other staples. The long-term goal is to develop a multi-center
      nutritional-intervention in India, China, Africa and Latin America to create sustainable
      diabetes prevention strategies through improving carbohydrate quality. The investigators
      propose to conduct a 4-month randomized parallel-group intervention trial to evaluate the
      effects of substitution of brown rice for white rice in two meals per day six days per week
      on biomarkers for diabetes risk among adults in Chennai, India who are at high risk for the
      development of diabetes. The first aim of this research is to determine the glycemic index of
      different local rice varieties (brown, red, and fully polished white) and preparations
      (regular or parboiled). The second aim is to determine the effects of brown rice substitution
      on fasting biomarker measurements of glucose metabolism (i.e., glucose, insulin, hemoglobin
      A1c, homeostasis model assessment for insulin resistance), dyslipidemia (i.e., triglycerides,
      total cholesterol, LDL- cholesterol, and HDL-cholesterol), and inflammation (i.e., C-reactive
      protein). This trial will also demonstrate the feasibility and cultural appropriateness of
      this type of intervention in the local environment to which results may be translated in the
      future. This study will have important implications for policy and help local governments
      develop national nutrition strategies for diabetes prevention such as wide- spread education
      campaigns about the health benefits of whole-grains, and school lunch programs which serve
      whole-grains. Such policies could also encourage ministries of agriculture to support
      production of whole grains, thereby improving accessibility and regulate costs. This work is
      intended to be part of a larger global initiative to identify local, feasible and sustainable
      dietary interventions to reduce diabetes risk in countries experiencing epidemiologic
      transition by improving the carbohydrate quality of staple foods. Initiatives have already
      been launched by our group in China, and are planned for Tanzania, Nigeria, Puerto Rico and
      Mexico. PUBLIC HEALTH RELEVANCE: Currently, India has the largest absolute number of people
      with diabetes in the world, and evidence indicates that consumption of whole-grains can
      decrease diabetes by improving glycemic control. Our study will evaluate the efficacy of
      substituting brown rice, a whole-grain, for white rice in Chennai, India, on biomarkers of
      diabetes risk. The ultimate goal of this research is to provide data for use in designing a
      global dietary intervention study aimed at reducing diabetes risk through simple, culturally
      appropriate, feasible and sustainable dietary changes.
    

Intervention name(s): Brown rice; White rice
Intervention type(s): Other; Other
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Prevention