TY - JOUR
T1 - White rice intake and incident diabetes
T2 - A study of 132,373 participants in 21 countries
AU - Bhavadharini, Balaji
AU - Mohan, Viswanathan
AU - Dehghan, Mahshid
AU - Rangarajan, Sumathy
AU - Swaminathan, Sumathi
AU - Rosengren, Annika
AU - Wielgosz, Andreas
AU - Avezum, Alvaro
AU - Lopez-Jaramillo, Patricio
AU - Lanas, Fernando
AU - Dans, Antonio L.
AU - Yeates, Karen
AU - Poirier, Paul
AU - Chifamba, Jephat
AU - Alhabib, Khalid F.
AU - Mohammadifard, Noushin
AU - Zatońska, Katarzyna
AU - Khatib, Rasha
AU - Keskinler, Mirac Vural
AU - Wei, Li
AU - Wang, Chuangshi
AU - Liu, Xiaoyun
AU - Iqbal, Romaina
AU - Yusuf, Rita
AU - Wentzel-Viljoen, Edelweiss
AU - Yusufali, Afzalhussein
AU - Diaz, Rafael
AU - Keat, Ng Kien
AU - Lakshmi, P. V.M.
AU - Ismail, Noorhassim
AU - Gupta, Rajeev
AU - Palileo-Villanueva, Lia M.
AU - Sheridan, Patrick
AU - Mente, Andrew
AU - Yusuf, Salim
N1 - Funding Information:
and Duality of Interest. S.Y. is supported by the Mary W. Burke endowed chair of theHeart and Stroke Foundationof Ontario. The PURE study is an investigator-initiated study that is funded by the Population Health Research Institute, Hamilton Health Sciences Research Institute, 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 Strategy for Patient-Oriented Research 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 (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 organizations in participating countries. These include the following: Argentina: Fundación 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 from Dairy Farmers of Canada and the NationalDairy Council(U.S.),PublicHealth 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 (6566-04-18062 and 6517-777-58228); India: Indian Council of Medical Research; V.M. is involved in the promotion of healthier varieties of rice; Malaysia: Ministry of Science, Technology and Innovation ofMalaysia (100-IRDC/BIOTEK16/ 6/21 [13/2007], and 07-05-IFN-BPH 010), Ministry of Higher Education of Malaysia (600-RMI/LRGS/ 5/3 [2/2011]), Universiti Teknologi MARA, Universiti Kebangsaan Malaysia (UKM-Hejim-Komuniti15-2010); Occupied Palestinian Territory: the United Nations Relief and Works Agency for Palestine Refugees in the Near East, Occupied Palestinian Territory, and International Development Research Centre, Canada; Philippines: Philippine CouncilforHealthResearchandDevelopment;Poland: Polish Ministry of Science and Higher Education (290/ W-PURE/2008/0), Wroclaw Medical University; Saudi Arabia: Saudi Heart Association, Dr. Mohammad Alfagih Hospital, The Deanship of Scientific Research at King Saud University, Riyadh (research group numberRG-1436-013),SalehHamza Sarafi Chair for Research of Coronary Heart Disease, Umm AlQura University, Makkah; South Africa: The North-West University, South AfricanNetherlands Programme on Alternatives in Development, National Research Foundation, Medical Research Council of South Africa, The South Africa Sugar Association, Faculty of Community and Health Sciences; Sweden: grants from the Swedish state under the agreement concerning research and education of doctors, the Swedish Heart and Lung Foundation,the Swedish Research Council, the Swedish Council for Health, Working Life and Welfare, King Gustaf V and Queen Victoria Freemasons’ Foundation, AFA Insurance; Turkey: Metabolic Syndrome Society, AstraZeneca, Sanofi Aventis; United Arab Emirates: Sheikh Hamdan Bin Rashid Al Maktoum Award For Medical Sciences and Dubai Health Authority, Dubai. No other potential conflicts of interest relevant to this article were reported. The external funders and sponsors of the study had no role in study design and conduct of the study; in the collection, analysis, and interpretation of the data; in the preparation, review, or approval of the manuscript; or in the decision to submit the manuscript for publication.
Publisher Copyright:
© 2020 by the American Diabetes Association.
PY - 2020/11
Y1 - 2020/11
N2 - OBJECTIVE Previous prospective studies on the 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 analyzed. White rice consumption (cooked) was categorized as <150, ≥150 to <300, ≥300 to <450, and ≥450 g/day, based on one cup of cooked rice 5 150 g. The primary outcome was incident diabetes. Hazard ratios (HRs) were calculated using a 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 (≥450 g/day compared with <150 g/day) was associated with increased risk of diabetes (HR 1.20; 95% CI 1.02–1.40; P for trend 5 0.003). However, the highest risk was seen in South Asia (HR 1.61; 95% CI 1.13–2.30; P for trend 5 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 1.08–1.86; P for trend 5 0.01), while in China there was no significant association (HR 1.04; 95% CI 0.77–1.40; P for trend 5 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, nonsignificant association was seen.
AB - OBJECTIVE Previous prospective studies on the 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 analyzed. White rice consumption (cooked) was categorized as <150, ≥150 to <300, ≥300 to <450, and ≥450 g/day, based on one cup of cooked rice 5 150 g. The primary outcome was incident diabetes. Hazard ratios (HRs) were calculated using a 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 (≥450 g/day compared with <150 g/day) was associated with increased risk of diabetes (HR 1.20; 95% CI 1.02–1.40; P for trend 5 0.003). However, the highest risk was seen in South Asia (HR 1.61; 95% CI 1.13–2.30; P for trend 5 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 1.08–1.86; P for trend 5 0.01), while in China there was no significant association (HR 1.04; 95% CI 0.77–1.40; P for trend 5 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, nonsignificant association was seen.
UR - http://www.scopus.com/inward/record.url?scp=85093657059&partnerID=8YFLogxK
U2 - 10.2337/dc19-2335
DO - 10.2337/dc19-2335
M3 - Article
C2 - 32873587
AN - SCOPUS:85093657059
SN - 0149-5992
VL - 43
SP - 2643
EP - 2650
JO - Diabetes Care
JF - Diabetes Care
IS - 11
ER -
