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Substituting brown rice for white rice on diabetes risk factors in India: a randomised controlled trial.
Malik, VS, Sudha, V, Wedick, NM, RamyaBai, M, Vijayalakshmi, P, Lakshmipriya, N, Gayathri, R, Kokila, A, Jones, C, Hong, B, et al
The British journal of nutrition. 2019;(12):1389-1397
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Abstract
India has the second largest number of people with type 2 diabetes (T2D) globally. Epidemiological evidence indicates that consumption of white rice is positively associated with T2D risk, while intake of brown rice is inversely associated. Thus, we explored the effect of substituting brown rice for white rice on T2D risk factors among adults in urban South India. A total of 166 overweight (BMI ≥ 23 kg/m2) adults aged 25-65 years were enrolled in a randomised cross-over trial in Chennai, India. Interventions were a parboiled brown rice or white rice regimen providing two ad libitum meals/d, 6 d/week for 3 months with a 2-week washout period. Primary outcomes were blood glucose, insulin, glycosylated Hb (HbA1c), insulin resistance (homeostasis model assessment of insulin resistance) and lipids. High-sensitivity C-reactive protein (hs-CRP) was a secondary outcome. We did not observe significant between-group differences for primary outcomes among all participants. However, a significant reduction in HbA1c was observed in the brown rice group among participants with the metabolic syndrome (-0·18 (se 0·08) %) relative to those without the metabolic syndrome (0·05 (se 0·05) %) (P-for-heterogeneity = 0·02). Improvements in HbA1c, total and LDL-cholesterol were observed in the brown rice group among participants with a BMI ≥ 25 kg/m2 compared with those with a BMI < 25 kg/m2 (P-for-heterogeneity < 0·05). We observed a smaller increase in hs-CRP in the brown (0·03 (sd 2·12) mg/l) compared with white rice group (0·63 (sd 2·35) mg/l) (P = 0·04). In conclusion, substituting brown rice for white rice showed a potential benefit on HbA1c among participants with the metabolic syndrome and an elevated BMI. A small benefit on inflammation was also observed.
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Substituting white rice with brown rice for 16 weeks does not substantially affect metabolic risk factors in middle-aged Chinese men and women with diabetes or a high risk for diabetes.
Zhang, G, Pan, A, Zong, G, Yu, Z, Wu, H, Chen, X, Tang, L, Feng, Y, Zhou, H, Chen, X, et al
The Journal of nutrition. 2011;(9):1685-90
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Abstract
Epidemiologic studies have suggested that higher consumption of white rice (WR) is associated with increased risk for type 2 diabetes mellitus. However, it is unclear whether substituting brown rice (BR) for WR can improve metabolic risk factors. A total of 202 middle-aged adults with diabetes or a high risk for diabetes were randomly assigned to a WR (n = 101) or BR group (n = 101) and consumed the rice ad libitum for 16 wk. Metabolic risk markers, including BMI, waist circumference, blood pressure, glycated hemoglobin, and serum lipid, glucose, and insulin concentrations were measured before and after the intervention. Over the course of the intervention, no between-group differences were found for any markers except the serum LDL cholesterol concentration, which decreased more in the WR group compared to the BR group (P = 0.02). However, this effect was observed only among participants with diabetes (n = 47). The reversion rate of reduced serum HDL cholesterol was marginally higher in the BR group (14.9%) than in the WR group (6.9%) (P = 0.07). Among participants with diabetes, a greater reduction in diastolic blood pressure was observed in the BR group compared to the WR group (P = 0.02). Our study suggests that incorporating BR into the daily diet for 16 wk did not substantially improve metabolic risk factors. Further studies with larger sample sizes, longer durations of follow-up, and different varieties of rice are needed to carefully examine the role of BR in the prevention and management of diabetes.