Estimated effects of white rice consumption and rice variety selection on incidence of type 2 diabetes in Cambodia

Abstract

Objective: Rice consumption patterns are considered an important risk factor for diabetes in many countries. The present study aimed to model the impact of a shift in consumption of white rice from current to appropriately reduced levels and a shift in rice variety from one with a high glycaemic index to one with a low glycaemic index, on the burden of type 2 diabetes in Cambodia. Design: Prevent Plus software was used to model the impact of selected changes to white rice consumption on the burden of type 2 diabetes. Data used for modelling included: demographic projections, relative risk estimates for white rice consumption and diabetes, diabetes incidence, rice type and quantities consumed. The 10-year projections were based on different scenarios of changes in risk factors. Results: With no intervention, 10-year projections showed that total new diabetes cases will increase from 11 315 (9·1 per 10 000 person-years) for the year 2011 to 14 852 new cases (12·4 per 10 000 person-years) in 2020. However, this increase will be reduced by 27 % (average across 10 years) with a change in rice variety from Phka Rumdual to IR66 and by 26 % (average across 10 years) with a 25 % reduction in quantity from current consumption levels. Conclusions: Changing rice consumption patterns has potential for an important impact on diabetes risk, with a change of rice variety having a similar impact on the burden of diabetes in communities consuming rice with a high glycaemic index as a 25 % reduction in the quantity of rice consumed. Similar effects are likely for other countries with rice as a staple food, diversity in rice varieties and high incidence of diabetes. Keywords Rice Diabetes Epidemiological modelling CambodiaThe glycaemic index (GI) of white rice ranges from 64 (SD 9) to 93 (SD 11) using an in vivo method (1) . The associations between dietary GI and glycaemic load (GL) and the risk of developing type 2 diabetes have been examined in several large-scale human observational studies. A positive association between dietary GL and risk of diabetes was supported by a recent meta-analysis that included twentyfour prospective cohort studies (2) . Significant positive associations have most consistently been reported in Asian populations (Chinese and Japanese) although the association was not significant in Japanese men (3,4) ; however, mixed results were reported from cohort studies in Western populations where the levels of rice consumed were much lower than those in Asian populations (5,6) . The specific relationship between white rice consumption and risk of developing diabetes was supported by a meta-analysis of seven prospective cohort studies where the association was significant in Asian but not in Western populations (7) . This might be explained by a greater glycaemic response to rice in regular rice-eating populations (Asian) than seldom rice-eating Western populations (8) .Rice is a staple food in Cambodia. It contributes at least 65 % of the energy intake in the diet of most Cambodians (9) who consume on ...

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“…With the substantial focus of nutrition research among maternal and child health on malnutrition and anaemia, an obvious gap exists, with only three studies focusing on NCD 48,86,96 . As Cambodia continues to show strong economic improvement, the concern of rising NCD prevalence needs to be addressed.…”

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“…A study posted on the US National Library of Medicine of the National Institute of Health on the type and quantity of rice consumed by Cambodians showed how the incidence of diabetes could be reduced. Specifically, with a change in rice with a lower glycemic index along with a reduction in quantity, the projected incidence of type 2 diabetes over a 10-year period would be reduced by 27 percent due to the rice type change and by 26 percent due to a 25 percent reduction in quantity from current consumption levels [17]. At the Rice Traders World Rice Conference held in Hong Kong in 2013, the Cambodian rice variety, Phka Rumdul, was chosen as the World's Best Rice; this same variety of Cambodian rice was also awarded this designation in 2012.…”