Can Brown Rice Slow the Spread of Type 2 Diabetes?
Can Brown Rice Slow the Spread of Type 2 Diabetes?
The worldwide spike in type 2 diabetes in recent decades has paralleled a shift in diets away from staple foods rich in whole grains to highly refined carbohydrates, such as white rice and refined flours. Now, a group of researchers at Harvard School of Public Health (HSPH) aims to stem the tide by changing the color of the world’s rice bowl from white to more-nutritious brown.
To tackle the issue, the researchers launched the Global Nutritional and Epidemiologic Transition (GNET) Working Group, a collaborative initiative between researchers from the Departments of Epidemiology and Nutrition at HSPH and their colleagues in Asia, Latin America, and Africa. The aim of the group is to prevent the global diabetes epidemic by improving the carbohydrate quality of staple foods in the diets of people from around the world.
Refined carbohydrates like white rice have a high glycemic index, which causes rapid spikes in blood sugar that increase diabetes risk. Foods with a lower glycemic index, like brown rice, are digested more slowly, causing a lower and gentler change in blood sugar. But eating white rice and other refined carbohydrates such as white bread is now firmly embedded in many cultures around the world. In China, for example, highly polished white rice has come to be seen as a symbol of affluence and brown rice of poverty.
The GNET group began a study in Shanghai, China, in 2008 to see if participants could switch from white rice to brown. The preliminary results of that study, led by Frank Hu, professor of nutrition and epidemiology, were promising. This focus group study assessed the awareness and acceptability of brown rice in 32 Chinese adults, and examined the feasibility of introducing brown rice into the diet. Most participants consumed white rice daily and only a few had tried brown rice previously. Before tasting, most participants considered brown rice inferior to white rice in terms of taste and quality. However, after tasting brown rice and learning about its nutritional value, the majority indicated greater willingness to consume brown rice. In addition, most participants expressed willingness to participate in a future long-term brown rice intervention study.
In a subsequent pilot study, a total of 202 middle-aged adults were randomly assigned to white rice or brown rice groups and consumed the rice for 16 weeks. The study found a reasonably good compliance with the brown rice intervention. Although no overall differences in metabolic factors were found between the two groups, the brown rice intervention showed some benefits in improving HDL cholesterol and blood pressure in diabetic patients. The study demonstrated the feasibility of conducting long-term brown rice intervention trials in a Chinese population.
GNET pilot studies are now underway in eight additional countries—Costa Rica, India, Kenya, Kuwait, Mexico, Nigeria, Puerto Rico, and Tanzania—to assess the effect of substituting whole grains, including brown rice, for refined carbohydrate staples on blood pressure and blood sugar levels in populations at risk for diabetes, and to evaluate the acceptability of such interventions in local communities. The results of these studies will form the basis of longer-term interventions, which are likely to start in two years.
“Our hope is that this project will shift world trends in staple food consumption,” said Hannia Campos, senior lecturer on nutrition. “We expect that the project will impact food policy, production, and processing so that whole foods and legumes become the norm.” Campos has been encouraged by “the willingness of academics, government officials and even industry to recognize the importance of this initiative and to participate in the best way they can,” she said. “And, it’s been inspiring to see how willing middle-aged adults at high risk for the development of diabetes are to make these sorts of changes to improve their health.”
A conference organized by GNET at HSPH on November 14, 2011, drew scientists from around the world.
>>> View videos and slides from the presentations. <<<
By Amy Roeder
Assistant Editor/Web Communications Specialist
Harvard School of Public Health
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Department of Epidemiology
NET Working Group
The Nutritional and Epidemiologic Transition (NET) Working Group is a collaborative initiative launched by researchers from the Departments of Epidemiology and Nutrition at HSPH, led by Drs. Donna Spiegelman, Frank Hu, and Walter Willett, with the overarching mission of preventing the global diabetes epidemic by improving the carbohydrate quality of staple foods in the diets of people from around the world.
As global free trade continues to fuel rapid economic and nutritional transitions, Type 2 diabetes has reached epidemic proportions in many countries around the world. Traditional staple foods, once rich in whole grains and dietary fiber, have been replaced by highly refined carbohydrates such as polished white rice, thus reducing the overall carbohydrate quality of the diet. Research has shown that consumption of higher quality carbohydrates such as whole grains can reduce diabetes risk by improving glycemic control. Therefore, adopting a diet that is rich in whole grains represents a cost-effective, feasible and sustainable approach to diabetes prevention, particularly in low and middle- income countries, which must manage co-existing infectious disease and malnutrition.
Pilot projects are ongoing in a number of countries, including China, India, Tanzania, Nigeria, Costa Rica and Puerto Rico. These studies aim to assess the effect of substituting culturally-specific whole grain alternatives for refined carbohydrate staples on intermediate markers of diabetes risk in high-risk populations, and to assess the acceptability and taste preferences of such interventions in local communities using focus group discussions. Findings from these pilot studies will form the basis of larger-scale trials that will test whether dietary modifications of this nature can have a long-lasting measurable impact on reducing diabetes risk.
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About Harvard Medical School (HMS)
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About Harvard School of Public Health (HSPH)
Harvard School of Public Health is dedicated to advancing the public’s health through learning, discovery and communication. More than 400 faculty members are engaged in teaching and training the 1,000-plus student body in a broad spectrum of disciplines crucial to the health and well being of individuals and populations around the world. Programs and projects range from the molecular biology of AIDS vaccines to the epidemiology of cancer; from risk analysis to violence prevention; from maternal and children’s health to quality of care measurement; from health care management to international health and human rights.
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About Harvard University.
Established in 1636, Harvard is the oldest institution of higher education in the United States. The University, which is based in Cambridge and Boston, Massachusetts, has an enrollment of over 20,000 degree candidates, including undergraduate, graduate, and professional students. Harvard has more than 360,000 alumni around the world.
Harvard University is devoted to excellence in teaching, learning, and research, and to developing leaders in many disciplines who make a difference globally. Harvard faculty are engaged with teaching and research to push the boundaries of human knowledge. For students who are excited to investigate the biggest issues of the 21st century, Harvard offers an unparalleled student experience and a generous financial aid program, with over $160 million awarded to more than 60% of our undergraduate students. The University has twelve degree-granting Schools in addition to the Radcliffe Institute for Advanced Study, offering a truly global education.
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* The above story is adapted from materials provided by Harvard University
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