Whiterice consumption and risk oftype 2 diabetes: meta-analysis and systematic review.
Hu EA, Pan A, Malik V, Sun Q. BMJ. 2012 Mar 15;344:e1454. doi: 10.1136/bmj.e1454.
Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA.
To summarise evidence on the association between whiterice consumption and risk oftype 2 diabetes and to quantify the potential dose-response relation.
Meta-analysis of prospective cohort studies.
Searches of Medline and Embase databases for articles published up to January 2012 using keywords that included both rice intake and diabetes; further searches of references of included original studies.
Included studies were prospective cohort studies that reported risk estimates for type 2 diabetes by rice intake levels.
Relative risks were pooled using a random effects model; dose-response relations were evaluated using data from all rice intake categories in each study.
Four articles were identified that included seven distinct prospective cohort analyses in Asian and Western populations for this study. A total of 13,284 incident cases of type 2 diabetes were ascertained among 352,384 participants with follow-up periods ranging from 4 to 22 years.
Asian (Chinese and Japanese) populations had much higher whiterice consumption levels than did Western populations (average intake levels were three to four servings/day versus one to two servings/week).
The pooled relative risk was 1.55 (95% confidence interval 1.20 to 2.01) comparing the highest with the lowest category of whiterice intake in Asian populations, whereas the corresponding relative risk was 1.12 (0.94 to 1.33) in Western populations (P for interaction=0.038).
In the total population, the dose-response meta-analysis indicated that for each serving per day increment of whiterice intake, the relative risk oftype 2 diabetes was 1.11 (1.08 to 1.14) (P for linear trend<0.001).
Higher consumption of whiterice is associated with a significantly increased risk oftype 2 diabetes, especially in Asian (Chinese and Japanese) populations.
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