South Asians and White Rice
By: Dr Plantel
Tags: Health, South Asian, Diet, Healthy Foods, Diabetes

Original image of the author

Like many South Asians, I have a strong family history of diabetes and cardiovascular disease. In fact, this was a significant personal motivation for me to make sustainable healthy dietary changes in attempts to prevent the development of these diseases. At the age of 31, I saw changes in my own routine blood work (my blood glucose and lipid panel) that were concerning to me. South Asians presents with greater metabolic risk at lower body mass index’s compared with other ethnic groups. South Asians develop type 2 diabetes at a younger age and when we do, we have worse outcomes such as the development of cardiovascular disease and chronic kidney disease. Yes, our genetics play a role in the development of these diseases, BUT there is so much that we can control when it comes to our lifestyle. This is why prevention is so important.

With that said, let’s talk about white rice. Growing up, white rice was a staple part of my diet, served with multiple meals a day. Did you know that India is the second largest producer of rice in the world, second to China and rice has been a staple food for thousands of years. White rice is thought to contribute to nearly half of the daily calorie intake in India. White rice is milled resulting in the husk, bran, and germ (nutrient dense portions) being removed while brown rice has only the husk removed (considered the inedible part). I am focusing on white rice consumption in South Asians because a recently published paper by Bhavadharini et al based on a large prospective cohort, demonstrated that a higher intake of white rice (2–3 cups per day) was associated with increased risk of diabetes. The highest risk was seen in South Asians.

So what happens if you swap out white rice with brown rice? A small, but interesting randomized crossover study by Mohan et al (2014) enrolled 15 Asian Indians (seven males and eight females) with overweight (as defined by ethnic specific criteria with BMI >23 kg/m2) who were randomized to a diet of white rice, brown rice or brown rice with legumes for breakfast and lunch. Each participant at some point in the study was on each diet with a wash out period of nine days in between. The study authors found while in the brown rice and brown rice with legume group of the study, the percentage difference in 5 day average glycemic response (as determined by the IAUC) was 19.8% lower in the brown rice group than white rice group. The brown rice with legume group further decreased the glycemic response by 22.9% compared to white rice. They also found that the 5 day percentage change in fasting insulin was 57% lower for the brown rice group and 54% lower for the brown rice with legume group versus white rice. The authors concluded that consumption of brown rice in place of white rice can help reduce 24 hour glucose and fasting insulin response among overweight Asian Indians. This small study suggest that replacing refined grains (i.e white rice) with whole grains (i.e brown rice), has a favorable effect on blood glucose and insulin release which could in turn could decrease the risk of developing type 2 diabetes in South Asians who are at risk.

Obviously, white rice is just one part of a traditional South Asian diet, but as an at risk South Asian and a physician, I recognize the importance of making sustainable dietary changes for prevention of type 2 diabetes and cardiovascular disease. Even small dietary changes (i.e replacing white rice with brown rice or another whole grain for some of your meals) can be helpful if it is available to you. Small changes add big.

Sources:

Mohan et al. “Effect of brown rice, white rice and brown rice with legumes on blood glucose and insulin responses in overweight Asian Indians: A randomized controlled trial. Diabetes Technology and Therapeutics. Nov 2014

Bhavadharini et al. “White rice intake and incident diabetes. A study of 132,373 participants in 21 countries.” Diabetes Care. Sept 2020