July 15, 2012

This Study Says - White Rice Joins White Bread

Normally I have respect for MedPage Today reports and read them with interest. Soon July 12, 2012 was no different when I received a special report titled Diabetes Risk: White Rice Joins White Bread.” Then after reading the report, I looked at the publication date and did a double take. The report was published on March 15, 2012, almost four months ago! How does this rate a special report?

So, I decided to reread the report to see what was so special four months ago. Yes, we have known that white rice increases the risk of diabetes, especially among Asian populations. Nothing new there. The only thing new is the discussion of the transition to more sedentary lifestyles, which may have become a factor. Then they launch into the more readily available food supply, which includes increased availability of refined carbohydrates, such as pastries, white bread, and sugar sweetened beverages.  So, is it the white rice or the white bread causing the diabetes?  Then they try to cover this up by stating that the glycemic index (GI) of white rice is higher than other whole grains - what about the white non-whole grain bread. They then say that the white rice GI is the result of processing and continue by stating that the primary contributor is the dietary glycemic load (GL) for populations that consume white rice as a staple food.

Now my curiosity is up and I wonder what other information they are going to try to blame on the white rice. No, they now start listing statistics about the size of the studies, as if this lends credence to the validity. Finally, we get to the fallacies. First, all the studies in the meta-analysis were observational studies and only one study included any information on brown rice. They also relied on food frequency questionnaires to assess dietary intake. Okay, the studies are faulty to begin with and should not lead to earlier statements. Then the authors really mute the value of this meta-analysis by stating, “even for Western populations with typically low intake levels, relatively high white rice consumption may still modestly increase risk of diabetes."

Then the last icing on the deathblow to the meta-analysis is in the editorial to the study by Bruce Neal, MD, of the University of Sydney in Australia. He cautioned that the "interpretation of the observed association, and, in particular, determination of the likelihood of causality, are problematic." He continued that there are "few immediate clinical implications," since "further research is needed to develop and substantiate the research hypothesis" -- even though funding is likely a challenge.

So much for a “special report.” No real science involved here. Now I would add a few thoughts of my own. First, this report is pure hype and means little. Second, is white rice like wheat that has been so genetically modified for increased production that it is causing the weight gain and increased incidence of diabetes? This is a question I doubt these hucksters will want to include in any true scientific research.

My last thoughts are mainly how I am going to be more cautious of what I read when something is included and hyped as a special report. The other concern is the increased availability of refined carbohydrates, such as pastries, white bread, and sugar sweetened beverages in Asian countries. Is this mentioned to make rice seem the culprit, when in fact it may be the adoption of a more western-style of living?

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