White rice intake and incidence of type-2 diabetes: analysis of two prospective cohort studies from Iran
Open Access
- 31 January 2017
- journal article
- research article
- Published by Springer Science and Business Media LLC in BMC Public Health
- Vol. 17 (1), 1-11
- https://doi.org/10.1186/s12889-016-3999-4
Abstract
Refined grains and white rice have been associated with elevated risk of type 2 diabetes mellitus (T2DM). In this study, we sought to quantify the effect of white rice intake on incident T2DM in two prospective population-based cohort studies from Iran, where white rice is one of the main staple. We used follow-up data from 9,182 participants from Golestan Cohort Study (GCS, 2004–2007, conducted mainly in rural areas) and 2,173 from Tehran Lipid and Glucose Study (TLGS, 2004–2006) who did not have T2DM and other chronic diseases at baseline. Diet was assessed using validated food frequency questionnaires. Multivariable logistic regression models were used to estimate adjusted odds ratios (ORs) for incident T2DM. We documented 902 new cases of T2DM in GCS and 81 in TLGS. Age-standardized cumulative incidence of T2DM was 9.9% in Golestan and 8.0% in Tehran. Daily white rice intake was significantly higher among residents of Tehran compared to Golestan (median daily intake: 250 vs. 120 grams; P-value < 0.001). After adjustment for potential confounders, there was no significant association between daily white rice intake and incident T2DM in GCS. In TLGS, the adjusted OR (95% confidence interval (CI)) was 2.1 (1.1, 3.9) comparing participants with daily white rice intake of >250 grams/day to those with <250. We observed an increased lieklihood of T2DM associated with high white rice intake among residents of Tehran and no association in Golestan. Our findings, if further supported by other studies, have important public health implications especially for countries where white rice is a major staple and diabetes is increasing rapidly incidence is high. Further research is needed to investigate lack of an association between lower levels of white rice intake and T2DM.Funding Information
- National Institute of Diabetes and Digestive and Kidney Diseases (DK090435)
- Division of Intramural Grant, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health
- Digestive Disease Research Institute of Tehran University of Medical Sciences (82-603)
- International Agency for Research on Cancer
- National Research Council of Iran (121)
This publication has 32 references indexed in Scilit:
- Dietary glycemic index, glycemic load and incidence of type 2 diabetes in Japanese men and women: the Japan public health center-based prospective studyNutrition Journal, 2013
- National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2·7 million participantsThe Lancet, 2011
- National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9·1 million participantsThe Lancet, 2011
- White Rice, Brown Rice, and Risk of Type 2 Diabetes in US Men and WomenJAMA Internal Medicine, 2010
- Population-based incidence of Type 2 diabetes and its associated risk factors: results from a six-year cohort study in IranBMC Public Health, 2009
- Third national surveillance of risk factors of non-communicable diseases (SuRFNCD-2007) in Iran: methods and results on prevalence of diabetes, hypertension, obesity, central obesity, and dyslipidemiaBMC Public Health, 2009
- Socio-economic status and oesophageal cancer: results from a population-based case–control study in a high-risk areaInternational Journal of Epidemiology, 2009
- Cohort Profile: The Golestan Cohort Study--a prospective study of oesophageal cancer in northern IranInternational Journal of Epidemiology, 2009
- Prevention of non-communicable disease in a population in nutrition transition: Tehran Lipid and Glucose Study phase IITrials, 2009
- Constructing Inverse Probability Weights for Marginal Structural ModelsAmerican Journal of Epidemiology, 2008