Effect of brown rice, white rice, and brown rice with legumes on blood glucose and insulin responses in overweight Asian Indians: a randomized controlled trial

The role of continuous glucose monitoring in physical activity and nutrition management: perspectives on present and possible uses

PURPOSE

Continuous glucose monitoring (CGM) is on the rise as the prevalence of obesity and diabetes increases. This review aimed to explore the use of CGM and its potential novel applications in physical activity and nutrition management.

METHODS

We searched PubMed, Web of Science, and Wiley Online Library databases using the keywords 'continuous glucose monitor,' 'nutrition,' 'physical activity,' and 'numerical modeling.'

RESULTS

Continuous blood glucose measurement is useful for individuals with obesity and diabetes. Long-term blood glucose data allow for personalized planning of nutritional composition, meal timing, and physical activity type and intensity, as well as help prevent hypoglycemia and hyperglycemia. Thus, understanding the limitations of CGM is important for its effective use.

CONCLUSION

CGM systems are being increasingly used to monitor and identify appropriate blood glucose controlling interventions. Blood glucose level is influenced by various factors such as nutrient composition, meal timing, physical activity, circadian rhythm, and cortisol levels. Numerical modeling can be used to analyze the complex relationship between stress, sleep, nutrition, and physical activity, which affect blood glucose levels. In future, blood glucose, sleep, and stress data will be integrated to predict appropriate lifestyle levels for blood glucose management. This integrated approach improves glucose control and overall wellbeing, potentially reducing societal costs.

Are Unhealthy Diets Contributing to the Rapid Rise of Type 2 Diabetes in India?

The prevalence of diabetes is increasing at an alarming rate globally, particularly in India. In the urban areas, the prevalence of diabetes among adults aged ≥20 y, which was around 2% in the early 1970's, has increased by >20% in 50 y. The rapid nutrition transition due to high economic growth rates increased urbanization and globalization has resulted in higher intakes of processed refined grain staples, mainly white rice in Southern and Eastern India and refined wheat in Northern and Western India. This coupled with inadequate quantity and quality of protein; unhealthy fats; lower intake of vegetables, fruits, and fiber; and a sedentary lifestyle are the main drivers of the diabetes epidemic in India. This review attempts to discuss both the quality and quantity of Indian diets with specific reference to macronutrients. This review also outlines some of the strategies that can be employed to slow down the diabetes epidemic in this region. We believe that the lessons learned from India would be applicable to other developing nations as well, particularly to the South East Asian region. J Nutr 2023;xx:xxx.

Nutrigenomic Effects of White Rice and Brown Rice on the Pathogenesis of Metabolic Disorders in a Fruit Fly Model

Consumption of white rice (WR) has been shown to predispose individuals to metabolic disorders. However, brown rice (BR), which is relatively richer in bioactive compounds, possesses anti-glycaemic and antioxidant effects. In this study, fifteen cultivars of paddy rice that are predominantly consumed in North West Nigeria were analysed for their nutritional composition, bioactive contents and effects on metabolic outcomes in a fruit fly model. Gene expression analyses were conducted on the whole fly, targeting dPEPCK, dIRS, and dACC. The protein, carbohydrate, and fibre contents and bioactives of all BR cultivars were significantly different (p < 0.05) from the WR cultivars. Moreover, it was demonstrated that the glucose and trehalose levels were significantly higher (p < 0.05), while glycogen was significantly lower (p < 0.05) in the WR groups compared to the BR groups. Similarly, the expression of dACC and dPEPCK was upregulated, while that of dIRS was downregulated in the WR groups compared to the BR groups. Sex differences (p < 0.05) were observed in the WR groups in relation to the nutrigenomic effects. Our findings confirm metabolic perturbations in fruit flies following consumption of WR via distortion of insulin signalling and activation of glycogenolysis and gluconeogenesis. BR prevented these metabolic changes possibly due to its richer nutritional composition.

Dietary carbohydrates: Pathogenesis and potential therapeutic targets to obesity-associated metabolic syndrome

Metabolic syndrome (MetS) is a common feature in obesity, comprising a cluster of abnormalities including abdominal fat accumulation, hyperglycemia, hyperinsulinemia, dyslipidemia, and hypertension, leading to diabetes and cardiovascular diseases (CVD). Intake of carbohydrates (CHO), particularly a sugary diet that rapidly increases blood glucose, triglycerides, and blood pressure levels is the predominant determining factor of MetS. Complex CHO, on the other hand, are a stable source of energy taking a longer time to digest. In particular, resistant starch (RS) or soluble fiber is an excellent source of prebiotics, which alter the gut microbial composition, which in turn improves metabolic control. Altering maternal CHO intake during pregnancy may result in the child developing MetS. Furthermore, lifestyle factors such as physical inactivity in combination with dietary habits may synergistically influence gene expression by modulating genetic and epigenetic regulators transforming childhood obesity into adolescent metabolic disorders. This review summarizes the common pathophysiology of MetS in connection with the nature of CHO, intrauterine nutrition, genetic predisposition, lifestyle factors, and advanced treatment approaches; it also emphasizes how dietary CHO may act as a key element in the pathogenesis and future therapeutic targets of obesity and MetS.

Whole grain rice: Updated understanding of starch digestibility and the regulation of glucose and lipid metabolism

Nowadays, resulting from disordered glucose and lipid metabolism, metabolic diseases (e.g., hyperglycemia, type 2 diabetes, and obesity) are among the most serious health issues facing humans worldwide. Increasing evidence has confirmed that dietary intervention (with healthy foods) is effective at regulating the metabolic syndrome. Whole grain rice (WGR) rich in dietary fiber and many bioactive compounds (e.g., γ-amino butyric acid, γ-oryzanol, and polyphenols) can not only inhibit starch digestion and prevent rapid increase in the blood glucose level, but also reduce oxidative stress and damage to the liver, thereby regulating glucose and lipid metabolism. The rate of starch digestion is directly related to the blood glucose level in the organism after WGR intake. Therefore, the effects of different factors (e.g., additives, cooking, germination, and physical treatments) on WGR starch digestibility are examined in this review. In addition, the mechanisms from human and animal experiments regarding the correlation between the intake of WGR or its products and the lowered blood glucose and lipid levels and the reduced incidence of diabetes and obesity are discussed. Moreover, information on developing WGR products with the health benefits is provided.

Consumer acceptance and preference for brown rice-A mixed-method qualitative study from Nepal

Background

Brown rice consumption reduces the risk of diabetes. The prevalence of diabetes is increasing in Nepal; however, dietary preference remains for white rice. This study aimed to understand the perception, enablers, barriers, and facilitators of acceptance brown rice at a worksite cafeteria.

Methods

We conducted a mixed-method qualitative research among 42 employees of a hospital in central Nepal. The participants tasted and rated the qualities of five different combinations of brown and white rice on a hedonic scale. We conducted eight focus group discussions (FGDs)-four before and four after tasting rice combinations. FGDs were recorded, transcribed, and coded verbatim and analyzed manually using inductive-deductive thematic method.

Results

Before tasting, the participants perceived brown rice as poor in quality. After tasting, the participants found that brown rice had better quality and were willing to switch gradually starting with a 25B ratio. Eighty-three percent of participants liked a combination of 25B. Major barriers were poor perception of its quality, tradition, unavailability, lack of awareness of health benefits, and high price. Major facilitators were availability, self and family awareness about the health benefits, knowledge, the brown rice cooking process, serving with side dishes, prior tasting, and gradual substitution of brown rice.

Conclusion

We found that brown rice should be promoted stepwise, first as a mixture with white rice and gradually increasing the proportion of brown rice. Brown rice acceptance can be increased by improved knowledge of its nutrition and health benefits, increasing availability, and affordability.

Differential Associations of Intakes of Whole Grains and Coarse Grains with Risks of Cardiometabolic Factors among Adults in China

There is a lack of studies on the association between whole grain intake and cardiometabolic risk factors in China and the current definition of whole grains is inconsistent. This study defined whole grains in two ways, Western versus traditional, and examined their associations with the risks of major cardiometabolic factors (CMFs) among 4706 Chinese adults aged ≥18 years, who participated in surveys both in 2011 and in 2015. Diet data were collected by consecutive 3 d 24 h recalls, together with household seasoning weighing. Whole grains were defined as grains with a ratio of fiber to carbohydrate of ≥0.1, while coarse grains were defined as grains except for rice and its products, and wheat and its products. Multivariable logistic regressions were modeled to analyze the associations of intakes of whole grains and coarse grains, respectively, with risks of major CMFs including obesity-, blood pressure-, blood glucose- and lipid-related factors, which were defined by International Diabetes Federation and AHA/NHLBI criteria. After adjusting for potential confounders, the odds of elevated LDL-C decreased with the increasing intake levels of whole grains (OR 0.64, 95% CI 0.46−0.88, p-trend < 0.05). Moreover, adults with the whole grain intake of 50.00 to 150.00 g/day had 27% lower odds of overweight and obesity (OR 0.73, 95% CI 0.54−0.99) and 31% lower odds of elevated LDL-C (OR 0.69, 95% CI 0.49−0.96), as compared with non-consumers. In conclusion, given the significant nutrient profiles of whole grains and coarse grains, the adults with higher intakes of whole grains only may have a lower risk of LDL-C and overweight and obesity.

Stachydrine derived from fermented rice prevents diet-induced obesity by regulating adipsin and endoplasmic reticulum homeostasis

Makgeolli, a widely consumed traditional alcoholic beverage in Korea, is brewed mainly from rice using Nuruk as a fermentation starter, which contains fungi, yeast, and lactic acid bacteria. Among 58 Makgeolli samples brewed using various Nuruks, we found that one exhibited anti-obesity properties, with stachydrine shown to be responsible for these properties. Stachydrine promotes lipolysis and inhibits lipid accumulation in 3T3-L1 adipocytes; it also reduces weight gain and improves glucose tolerance and insulin resistance in a mouse model. Stachydrine dramatically suppresses adipsin mRNA levels in liver and adipose tissue, whereas serum adipsin levels were elevated in stachydrine-treated mice compared to mice fed a high-fat diet alone. Moreover, stachydrine recovers endoplasmic reticulum homeostasis and regulates adipsin expression. We highlight the potential use of stachydrine as a therapeutic agent for the treatment of obesity and insulin resistance and the use of Makgeolli fermented by Nuruk as a source of novel bioactive compounds.

Role and importance of high fiber in diabetes management in India

BACKGROUND & AIMS

India is facing a triple burden of pre-diabetes, diabetes, and obesity. Unhealthy eating habits and physical inactivity have been linked to the onset and progression of type 2 diabetes mellitus (T2DM). Despite dietary recommendations, individuals consume inadequate amounts or unsuitable type of dietary fiber (DF) which needs correction. An Expert group attempted to review and report on the role and importance of high DF in the management of T2DM and offer practical guidance on high fiber use in daily diet.

METHODOLOGY

Twelve diabetologists and two expert dietitians from India were chosen to ensure diversity of the members both in professional interest and cultural background. The authors convened virtually for one group meeting and actively participated in a detailed discussion. Multiple reviews of the draft document followed by focused teleconference calls & email helped to reach consensus on final recommendations between Aug 2021 and Dec 2021.

RESULTS

Evidence has shown that medical nutrition therapy (MNT) is a valuable approach and an essential component of T2DM prevention and management. Studies have shown that fiber rich diabetes nutrition (FDN) has multi-systemic health benefits, including, improvement in glycemic control, reduction in glucose spikes, decrease in hyperinsulinemia, improvement in plasma lipid concentrations and weight management in T2DM patients.

CONCLUSION

A high fiber diet is vital for people with diabetes and associated conditions. Increasing fiber intake, preferably through food or through dietary supplement, may help. Fiber rich diabetes nutrition (FDN) is recommended in order to prevent and manage T2DM.

Effects of whole grain intake on glycemic traits: A systematic review and meta-analysis of randomized controlled trials

Whole grains (WGs) may have various health benefits, including lowering blood glucose and improving insulin sensitivity. To conduct a meta-analysis of the effects of WGs compared with non-WGs on changes in fasting glucose, fasting insulin, glycated hemoglobin (HbA1c), and homeostasis model assessment of insulin resistance (HOMA-IR). A systematic literature search was performed for all published randomized controlled trials on the effects of WG intake on fasting glucose, fasting insulin, HbA1c and HOMA-IR response up to February 2021. Weighted mean differences (WMD) were calculated. Pre-specified subgroup and univariate meta-regression analyses were explored to identify the sources of heterogeneity. Sensitivity analysis and bias analysis were conducted to appraise study quality. Among 12,435 articles screened for eligibility, data were extracted from 48 articles. Meta-analysis of 4,118 participants showed that WG consumption resulted in a significant reduction in fasting glucose by -0.15 mmol/L, fasting insulin by -2.71 pmol/L, HbA1c by -0.44%, and HOMA-IR by -0.28, respectively. Compared with mixed grains, brown rice, and wheat, oats were significantly lower on marker of glycemic. Besides, multiple interventions per day consolidated effectiveness of WGs. WG consumption decreased the levels of fasting glucose, fasting insulin, HbA1c, and HOMA-IR compared with non-WG consumption.

Black rice anthocyanins alleviate hyperlipidemia, liver steatosis and insulin resistance by regulating lipid metabolism and gut microbiota in obese mice

Hyperlipidemia, liver steatosis and insulin resistance are common metabolic diseases associated with obesity. The present study was designed to investigate the in vivo protective value of black rice anthocyanins (BRAN) on hyperlipidemia, liver steatosis and insulin resistance in mice with high-fat-diet (HFD)-induced obesity and elucidate the underlying mechanism. Specific pathogen-free male C57BL/6J mice (four weeks old, weighing 17.6-20.9 g) were randomly divided into three groups and fed with low-fat diet (LFD, 10% fat energy), HFD (45% fat energy), or HFD supplemented with BRAN by intragastric administration for 14 weeks. The obesity-related biochemical indices and hepatic gene expression levels were determined. 16S rRNA sequencing was used to determine the gut microbial changes induced by BRAN treatment. The results showed that the body weight gain, triglycerides, total cholesterol, steatosis scores and insulin resistance index in the BRAN group decreased by 24.69%, 29.83%, 28.08%, 46.67% and 40.42%, respectively, compared to the HFD group. Gene expression analysis indicated that BRAN treatment improved the gene expression profiles involved in lipid metabolism compared with the mice fed HFD alone. Moreover, BRAN treatment significantly altered the composition of the gut microbiota, which was closely correlated with the obesity-related biomarkers. In conclusion, this study demonstrated that dietary supplementation of BRAN protected from obesity-associated hyperlipidemia, hepatic steatosis and insulin resistance by influencing the gut microbiota and lipid metabolism.

Toward Integrated Multi-Omics Intervention: Rice Trait Improvement and Stress Management

Rice (Oryza sativa) is an imperative staple crop for nearly half of the world's population. Challenging environmental conditions encompassing abiotic and biotic stresses negatively impact the quality and yield of rice. To assure food supply for the unprecedented ever-growing world population, the improvement of rice as a crop is of utmost importance. In this era, "omics" techniques have been comprehensively utilized to decipher the regulatory mechanisms and cellular intricacies in rice. Advancements in omics technologies have provided a strong platform for the reliable exploration of genetic resources involved in rice trait development. Omics disciplines like genomics, transcriptomics, proteomics, and metabolomics have significantly contributed toward the achievement of desired improvements in rice under optimal and stressful environments. The present review recapitulates the basic and applied multi-omics technologies in providing new orchestration toward the improvement of rice desirable traits. The article also provides a catalog of current scenario of omics applications in comprehending this imperative crop in relation to yield enhancement and various environmental stresses. Further, the appropriate databases in the field of data science to analyze big data, and retrieve relevant information vis-à-vis rice trait improvement and stress management are described.

Rice Compounds with Impact on Diabetes Control

Rice is one of the most cultivated and consumed cereals worldwide. It is composed of starch, which is an important source of diet energy, hypoallergenic proteins, and other bioactive compounds with known nutritional functionalities. Noteworthy is that the rice bran (outer layer of rice grains), a side-stream product of the rice milling process, has a higher content of bioactive compounds than white rice (polished rice grains). Bran functional ingredients such as γ-oryzanol, phytic acid, ferulic acid, γ-aminobutyric acid, tocopherols, and tocotrienols (vitamin E) have been linked to several health benefits. In this study, we reviewed the effects of rice glycemic index, macronutrients, and bioactive compounds on the pathological mechanisms associated with diabetes, identifying the rice compounds potentially exerting protective activities towards disease control. The effects of starch, proteins, and bran bioactive compounds for diabetic control were reviewed and provide important insights about the nutritional quality of rice-based foods.

Combination effects of rice extract and five aromatic compounds against α-glucosidase, α-amylase and tyrosinase

Rice is a source of bioactive compounds related to human health and has been used for both consumption and traditional medicine. The authors investigated the synergistic and additive effect of rice extract (RE) combined with five aromatic compounds against three enzymes: α-glucosidase, α-amylase and tyrosinase. RE was purified by thin-layer chromatography (TLC) and preparative TLC (PTLC) with different solvent systems. RE had higher α-glucosidase and α-amylase inhibitory activity than the five aromatic compounds, while the five aromatic compounds had higher tyrosinase inhibitory activity than RE. The combination of RE/acarbose produced synergic inhibition of α-glucosidase and α-amylase, whereas RE showed additive inhibition of both enzymes when combined with aromatic compounds. The five aromatic compounds showed additive inhibition of tyrosinase when combined with RE. The combination of 2-methoxy-4-vinylphenol/vanillin/guaiacol produced synergistic inhibition of α-amylase while showing antagonism of α-glucosidase and tyrosinase. Interestingly, the RE produced additive inhibition of α-glucosidase, α-amylase and tyrosinase when combined with the 2-methoxy-4-vinylphenol/vanillin/guaiacol combination. RE had rich bioactive compounds related to α-glucosidase, α-amylase and tyrosinase inhibitory activity. Volatile compounds, including 2-methoxy-4-vinylphenol, vanillin and guaiacol, enhanced the inhibitory activity of RE against α-glucosidase, α-amylase and tyrosinase activities.

The effect of brown rice compared to white rice on adiposity indices, lipid profile, and glycemic markers: a systematic review and meta-analysis of randomized controlled trials

A few randomized controlled trials (RCTs) have assessed the effect of brown rice consumption on metabolic parameters compared to white rice, with inconsistent findings. Therefore, the present systematic review and meta-analysis was designed to evaluate the effect of brown rice on adiposity indices, lipid profile, and glycemic markers in adult subjects compared to white rice. In this study, PubMed/Medline, Scopus, Web of Sciences, and Embase databases were comprehensively searched until March 2021. Thirteen RCTs were selected and then included in the meta-analysis. As reported, brown rice significantly reduced weight by -1.63 kg (95% CI: -2.15 to -1.11, I²=97%, n = 6), body mass index (BMI) by -0.58 kg/m² (95% CI: -0.78 to -0.37, I²=96%, n = 6), and waist circumference by -2.56 cm (95% CI: -4.86 to -0.26, I²=88%, n = 5) compared with white rice. Moreover, it had no significant effect on lipid profile and glycemic markers. Besides, pre-germinated brown rice significantly declined weight (-1.75 kg, 95% CI: -2.70 to -0.81, I²=99%, n = 4), total cholesterol (-24.22 mg/dl, 95% CI: -33.03 to -15.41, I²=78%, n = 5), triglyceride (TG) (-43.28 mg/dl, 95% CI: -74.05 to -12.50, I²=90%, n = 5), low-density lipoprotein (LDL) (-20.05 mg/dl, 95% CI: -29.57 to -10.52, I²=71%, n = 5), and fasting blood glucose (FBG) (-15.83 mg/dl, 95% CI: -25.20 to -6.46, I²=91%, n = 5). In accordance with Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, the certainly of the included evidence was low and very low. The results of the present study indicate that, brown rice has anti-obesity effects in comparison with white rice; however, it has no beneficial effects on lipid profile and glycemic markers. Contrary to brown rice, it was shown that, pre-germinated brown rice significantly decreases body weight and improves lipid profile and FBG levels compared to white rice. Accordingly, our results indicate that, pre-germinated brown rice has better functional effects on promoting lipid profile and FBG compared to brown rice.

The relationship between rice consumption and glioma: a case-control study in adults

Previous studies have shown the effect of refined grains on various cancers; however, data on the link between rice consumption and brain cancer are scarce. We aimed to investigate the relationship between rice consumption and glioma in Iranian adults. Current hospital-based case–control study was done in Tehran between 2009 and 2011. Cases were individuals with pathologically confirmed glioma in a maximally 1 month of the disease diagnosis (n = 128). Controls were individuals, aged between 20 and 75 years, who were hospitalized or were outpatients referred to other wards of the same hospital (n = 256). Cases and controls were frequently matched in terms of age and gender. Usual dietary intakes of participants, including rice consumption, during the preceding year were examined using a Block-format validated semi-quantitative 126-item food frequency questionnaire. Compared with participants in the lowest tertile of rice consumption (< 181 g/day), those in the highest tertile (≥ 279 g/day) had 2.47 times greater chance for having glioma (OR: 2.47, 95% CI 1.44–4.23). This relationship was also seen when potential confounders including demographic variables, energy and dietary intakes as well as body mass index were taking into account; such that individuals in the top tertile of rice consumption had 2.46 times greater odds of glioma compared with those in the bottom tertile (OR: 2.46, 95% CI 1.01–5.97). We found that rice consumption was positively associated with risk of glioma in adults. Further prospective studies are required to confirm this finding.

Substituting white rice with brown and black rice as an alternative to prevent diabetes mellitus type 2: a case-study among young adults in Yogyakarta, Indonesia

Purpose

The purpose of this study is to explore the preference and acceptance of white rice substitution with brown and black rice among young adults in Indonesia to prevent diabetes.

Methods

This study used a qualitative design. Rice preference deeply explored using focus group discussion as a case-study. 85 informants with an average of ages 20 years old were divided into several groups. Several topics to discuss include the reasons to accept or reject brown and black rice, knowledge, attitude, motivation, and potency to substitute white rice.

Results

Price was the main barrier to substitute white rice to brown and black rice. The participants have known brown rice from parents, mass media, and friends. Most of them were still unfamiliar with black rice. Culture also affected the preferences of the participants. To motivate people to change their white rice diet, creative packaging and segmentation of the sale were recommended.

Conclusion

Substituting white to brown and black rice is still a challenge for young adults in Indonesia. Several barriers such as culture, accessibility, and affordability need to be considered. Further efforts are important to manage a program to increase brown and black rice consumption.

Impact of processing techniques on the glycemic index of rice

Rice is an important starchy staple food and generally, rice varieties are known to have a higher glycemic index (GI). Over the years, the significance of GI on human health is being better understood and is known to be associated with several lifestyle disorders. Apart from the intrinsic characteristics of rice, different food processing techniques are known to have implications on the GI of rice. This work details the effect of domestic and industrial-level processing techniques on the GI of rice by providing an understanding of the resulting physicochemical changes. An attempt has been made to relate the process-dependent digestion behavior, which in turn reflects on the GI. The role of food constituents is elaborated and the various in vitro and in vivo approaches that have been used to determine the GI of foods are summarized. Considering the broader perspective, the effect of cooking methods and additives is explained. Given the significance of the cereal grain, this work concludes with the challenges and key thrust areas for future research.

White Rice Intake and Incident Diabetes: A Study of 132,373 Participants in 21 Countries

OBJECTIVE

Previous prospective studies on the association of white rice intake with incident diabetes have shown contradictory results but were conducted in single countries and predominantly in Asia. We report on the association of white rice with risk of diabetes in the multinational Prospective Urban Rural Epidemiology (PURE) study.

RESEARCH DESIGN AND METHODS

Data on 132,373 individuals aged 35-70 years from 21 countries were analyzed. White rice consumption (cooked) was categorized as <150, ≥150 to <300, ≥300 to <450, and ≥450 g/day, based on one cup of cooked rice = 150 g. The primary outcome was incident diabetes. Hazard ratios (HRs) were calculated using a multivariable Cox frailty model.

RESULTS

During a mean follow-up period of 9.5 years, 6,129 individuals without baseline diabetes developed incident diabetes. In the overall cohort, higher intake of white rice (≥450 g/day compared with <150 g/day) was associated with increased risk of diabetes (HR 1.20; 95% CI 1.02-1.40; P for trend = 0.003). However, the highest risk was seen in South Asia (HR 1.61; 95% CI 1.13-2.30; P for trend = 0.02), followed by other regions of the world (which included South East Asia, Middle East, South America, North America, Europe, and Africa) (HR 1.41; 95% CI 1.08-1.86; P for trend = 0.01), while in China there was no significant association (HR 1.04; 95% CI 0.77-1.40; P for trend = 0.38).

CONCLUSIONS

Higher consumption of white rice is associated with an increased risk of incident diabetes with the strongest association being observed in South Asia, while in other regions, a modest, nonsignificant association was seen.

Assessment of quality of minor millets available in the south Indian market & glycaemic index of cooked unpolished little & foxtail millet

BACKGROUND & OBJECTIVES

: Millets are widely marketed as healthier alternatives to white rice (WR). This study was conducted with two aims: firstly, to look at the nature and quality of minor millets available in the Chennai market and secondly, to estimate the glycaemic index (GI) of unpolished forms of the two most widely available minor millets, i.e. little (LM) and foxtail millet (FXM).

METHODS

: A market survey was conducted of 100 food stores in four zones of Chennai, south India. Morphological features of market millet samples were compared with that of unpolished millets under stereo-zoom microscope, and the claims declared on the pack were evaluated. A consumer perception survey was conducted among 20 minor millet-consuming female homemakers. Finally, the GI of unpolished LM and FXM was evaluated using a validated protocol in 12 healthy volunteers.

RESULTS

: Forty eight brands of minor millets were available, with LM and FXM being the most common. Most of the millet samples were identified as highly polished grains using stereo-zoom microscope. The product labels were misleading and showed no scientific backing for claims mentioned on the label. Most participants (12 of 20) were unaware of the fact that millets can also be polished like rice. Both LM and FXM exhibited high GI (88.6±5.7 and 88.6±8.7, respectively).

INTERPRETATION & CONCLUSIONS

The availability and knowledge regarding unpolished millets was low. Both LM and FXM exhibited high GI. Hence, substituting millets for WR might be of limited benefit considering the glycaemic property in the prevention and management of chronic non-communicable diseases such as T2DM.

The cultural practices of Bamar diabetic patients: An ethnographic study

Background

Many qualitative studies on the feelings and lived experiences of diabetic patients have already been conducted in European and Asian countries. However, little is known about the cultural practices of diabetic patients among the Bamar population of Myanmar.

Aim

The aim of this study was to explore the cultural practices of Bamar diabetic patients in Myanmar.

Methods

The conceptual framework of this ethnographic study was based on Spradley's ethnographic theory and Leininger's cultural care theory. Seven participants who met the preset criteria were purposively selected from Anawmar quarter, Tharkayta Township, Yangon. Their cultural practices were studied through participant observations, ethnographic interviews and writing field notes. Collected data were analyzed step-by-step using Creswell's data analysis method.

Findings

The nine main themes that emerged were: reasons for late awareness of diabetes, misconceptions, cultural beliefs and practices, non-adherence, cultural influences on controlling diet, limitations in physical activities, suffering of living with diabetes, emotional reactions and coping by way of religious or spiritual beliefs. Fourty-six subthemes support the main themes.

Discussion

It was found that Bamar diabetics in this study were being strongly influenced by cultural beliefs and practices on treatment choice and controlling diet. They believed that diabetes is a curable disease, and its cause is due to cultural factors such as karma from either a previous or their current life. Bamar diabetic patients in this study used a variety of medicinal plants and traditional medicines due to availability at affordable prices.

Conclusion

Although some cultural beliefs are not harmful, some have detrimental effects on these patients' health. Hopefully, this study may provide information which can reduce cultural influences on Bamar diabetic patients. The results of this study highlight patients' needs for nursing personnel when it comes to providing effective culturally-tailored care.

Method validation and dissipation kinetics of the new HPPD inhibitor QYR301 in rice, paddy water and paddy soil using a QuEChERS-based method and LC-MS/MS

A rapid and simple method based on liquid chromatography-tandem mass spectrometry (LC-MS/MS) of sample preparation using QuEChERS was developed for detecting residues of QYR301, a new HPPD-inhibiting herbicide, in rice plant (straw), water, soil, rice hull and brown rice (BR). To eliminate matrix interference, matrix-matched calibrations with satisfactory linearity (R² > 0.99) were used for accurate quantification. The method showed recoveries of 90.3-108.1% and relative standard deviations (RSDs) < 11%. The limits of quantification (LOQ) for QYR301 were 0.005 mg kg^-1 in all five matrixes. Furthermore, the dissipation kinetics and terminal residues of QYR301 were determined at two sites in 2018. The days for 50% dissipation (DT₅₀) of QYR301 in rice plants, water and soil were 3.6-4.4, 0.7-3.0 and 4.3-8.0 d, respectively, which indicated that QYR301 is a short-persistence herbicide. Moreover, no QYR301 residues were detected in BR, rice hull and straw collected at harvest following its application at 1.0 or 1.5 × of the recommended high rate. These results will help organizations and governments establish related principles/laws regarding the use of QYR301 in terms of environmental protection, food safety and other potential aspects.

Glycemic Index and Microstructure Evaluation of Four Cereal Grain Foods

To determine the glycemic index (GI) of selected cereals and association with their microstructure. The GI of whole grain pilaf (WGP), instant brown rice (IBR), whole maize ugali (MWU), and refined maize ugali (RMU) was assessed in a randomized trial. Fourteen healthy participants with mean age of 25 years were administered 50 g portions of available carbohydrates from glucose and various test foods after an overnight fast on separate occasions. Capillary blood samples of participants were used to measure blood glucose over 2 hr. The GI was calculated as per standard protocol. The microstructure of test foods, determined by scanning electron microscopy was evaluated to understand the measured GI values. The GI (mean ± standard error) of IBR was the highest (87.8 ± 6.8) followed by RMU (74.7 ± 6.5) and WMU (71.4 ± 5.1). WGP had medium GI (58.9 ± 5.1; P < 0.01 vs. IBR). Microstructure examination of IBR revealed disruption of bran layer and presence of fissures indicating loss of intactness of bran. Stereozoom images for WGP revealed intact bran and germ. For RMU and WMU, the grain was milled leading to loss of integrity. IBR, RMU, and WMU have high GI values, which is likely due to disruption of bran layer, endosperm modification (IBR), and loss of grain matrix (WMU, RMU). WGP has medium GI probably due to fairly intact bran and germ. PRACTICAL APPLICATION: Wholegrain or whole meal flour may not necessarily be low in glycemic index (GI; low GI < 55; medium 55 to 69 and high GI ≥70). "Ugali" a commonly consumed cereal staple food in Tanzania made from either refined or whole meal maize flour was found to be a high GI food. Intact whole grain foods, such as whole grain pilaf (mixed intact whole grains) is a healthier alternative to milled whole grains such as whole meal maize flour. Instant quick cooking brown rice exhibited a high GI, due to the processing method, suggesting that regular brown rice may be a healthier option.

Legume Consumption and Cardiometabolic Health

Legumes are key components of several plant-based diets and are recognized as having a wide range of potential health benefits. Previous systematic reviews and meta-analyses have summarized the evidence regarding different cardiometabolic outcomes, such as cardiovascular disease (CVD) and type 2 diabetes (T2D), and legume consumption. However, those studies did not differentiate between nonsoy and soy legumes, which have different nutritional profiles. The aim of the present updated review, therefore, was to summarize and meta-analyze the published evidence regarding legume consumption (making a distinction between nonsoy and soy legumes) and cardiometabolic diseases. In addition, we reviewed randomized clinical trials assessing the effect of legume consumption on CVD risk factors in order to understand their associations. The results revealed a prospective, significant inverse association between total legume consumption and CVD and coronary heart disease risk, whereas a nonsignificant association was observed with T2D and stroke. In the stratified analysis by legume subtypes, only nonsoy legumes were associated with lower risk of T2D. Unfortunately, owing to the paucity of studies analyzing legumes and CVD, it was not possible to stratify the analysis for these outcomes. Because of the high degree of heterogeneity observed for most of the outcomes and the few studies included in some analyses, further prospective studies are warranted to determine the potential role of legume consumption on CVD and T2D.

Evidence for the association between FTO gene variants and vitamin B12 concentrations in an Asian Indian population

BACKGROUND

Low vitamin B12 concentrations have been associated with major clinical outcomes, including adiposity, in Indian populations. The Fat mass and obesity-associated gene (FTO) is an established obesity-susceptibility locus; however, it remains unknown whether it influences vitamin B12 status. Hence, we investigated the association of two previously studied FTO polymorphisms with vitamin B12 concentrations and metabolic disease-related outcomes and examined whether these associations were modified by dietary factors and physical activity.

METHODS

A total of 176 individuals with type 2 diabetes, 152 with pre-diabetes, and 220 normal glucose-tolerant individuals were randomly selected from the Chennai Urban Rural Epidemiology Study. Anthropometric, clinical, and biochemical investigations, which included body mass index (BMI), waist circumference, vitamin B12, homocysteine, and folic acid were measured. A validated food frequency questionnaire was used for dietary assessment and self-reported physical activity measures were collected. An unweighted genetic risk score (GRS) was calculated for two FTO single-nucleotide polymorphisms (rs8050136 and rs2388405) by summation of the number of risk alleles for obesity. Interaction analyses were performed by including the interaction terms in the regression model.

RESULTS

The GRS was significantly associated with increased BMI (P = 0.009) and risk of obesity (P = 0.023). Individuals carrying more than one risk allele for the GRS had 13.13% lower vitamin B12 concentrations, compared to individuals carrying zero risk alleles (P = 0.018). No associations between the GRS and folic acid and homocysteine concentrations were observed. Furthermore, no statistically significant GRS-diet or GRS-physical activity interactions with vitamin B12, folic acid, homocysteine or metabolic-disease outcomes were observed.

CONCLUSION

The study shows for the first time that a genetic risk score using two FTO SNPs is associated with lower vitamin B12 concentrations; however, we did not identify any evidence for the influence of lifestyle factors on this association. Further replication studies in larger cohorts are warranted to investigate the association between the GRS and vitamin B12 concentrations.

The Effect of Two Types of Pasta Versus White Rice on Postprandial Blood Glucose Levels in Adults with Type 1 Diabetes: A Randomized Crossover Trial

Background: Food choices are essential to successful glycemic control for people with diabetes. We compared the impact of three carbohydrate-rich meals on the postprandial glycemic response in adults with type 1 diabetes (T1D). Methods: We performed a randomized crossover study in 12 adults with T1D (age 58.7 ± 14.2 years, baseline hemoglobin A1c 7.5% ± 1.3%) comparing the postprandial glycemic response to three meals using continuous glucose monitoring: (1) "higher protein" pasta containing 10 g protein/serving, (2) regular pasta with 7 g protein/serving, and (3) extra-long grain white rice. All meals contained 42 g carbohydrate; were served with homemade tomato sauce, green salad, and balsamic dressing; and were repeated twice in random order. After their insulin bolus, subjects were observed in clinic for 5 h. Linear mixed effects models were used to assess the glycemic response. Results: Compared with white rice, peak glucose levels were significantly lower for higher protein pasta (-32.6 mg/dL; 95% CI -48.4 to -17.2; P < 0.001) and regular pasta (-43.2 mg/dL, 95% CI -58.7 to -27.7; P < 0.001). The difference between the two types of pastas did not reach statistical significance (-11 mg/dL; 95% CI -24.1 to 3.4; P = 0.17). Total glucose area under the curve was also significantly higher for white rice compared with both pastas (P < 0.001 for both comparisons). Conclusions: This exploratory study concluded that different food types of similar macronutrient content (e.g., rice and pasta) generate significantly different postprandial glycemic responses in persons with T1D. These results provide useful insights into the impact of food choices on and optimization of glucose control. Clinical Trial Registry: clinicaltrials.gov NCT03362151.

Traditional Medicine and Its Role in the Management of Diabetes Mellitus: "Patients' and Herbalists' Perspectives"

BACKGROUND

Diabetes mellitus is a complicated health condition with multiple causes and many treatment options. Various myths may influence diabetics' health-seeking behavior, and they may use traditional medicines, which include normal foods and herbs, for primary health care. The aim of this study was to determine patients' and herbalists' practices and perspectives regarding the use of traditional medicines and the role of traditional medicines in the management of diabetes.

METHODS AND FINDINGS

We conducted a cross-sectional study with a mixed-methods design. We interviewed 140 patients attending diabetic clinics using a structured questionnaire, conducted focus group discussions with an additional 20 diabetic patients, and conducted in-depth interviews with 8 local herbalists. The majority of the diabetic participants believed that diabetes is caused by a high-carbohydrate diet. Of the 140 participants who answered the questionnaire, 67.2% reported using traditional medicines to manage their diabetes, including 58.6% who reported using both conventional medicines and traditional medicines. Some participants believed that combining conventional and traditional medicines improved the effectiveness of treatment. Reasons given for using traditional medicines included the high cost of conventional treatment and the availability and accessibility of the traditional medicines. The most commonly used traditional medicines were indigenous vegetables and medicinal plant products including amalanth leaves, hare lettuce leaves, nightshade leaves, spider plant leaves, okra pods, moringa leaves and seeds, soursop leaves, black plum back, avocado seed, and lemongrass.

CONCLUSION

Patients and herbalists provided a range of perspectives regarding the use of traditional medicines to treat diabetes. Further research is needed to identify bioactive compounds present in commonly used traditional medicines and their efficacy.

The relationships between macronutrient and micronutrient intakes and type 2 diabetes mellitus in South Asians: A review

BACKGROUND

South Asians (SA) have increased prevalence of type 2 diabetes mellitus (T2DM). The role of nutrient intakes in T2DM in SA is not well understood, however.

OBJECTIVE

The paper reviewed the relationship between macronutrient and micronutrients intakes and T2DM in SA.

METHODS

The MEDLINE database was searched for relevant papers on this topic in SA.

RESULTS

There was some evidence that dietary fiber and linoleic acid intake may reduce but carbohydrates may increase the risk of T2DM. Some studies found higher energy from protein and fat in subjects with T2DM versus controls. Other studies, however, found lower carbohydrate intake among those with T2DM or no relationship between diet composition and T2DM. Several vitamins and minerals were also inversely related to T2DM.

CONCLUSIONS

The data were limited to a few epidemiological studies. Most studies did not distinguish between undiagnosed and known T2DM. Subjects with known T2DM are more likely to have changed their diet. Prospective cohort or randomized controlled studies examining the role of diet composition, using precise image-assisted dietary assessment method and blood biomarkers, in the development of T2DM among migrant and native SA are needed. Lastly, a more complete nutrient database for foods consumed by SA is needed.

Substituting brown rice for white rice on diabetes risk factors in India: a randomised controlled trial

India has the second largest number of people with type 2 diabetes (T2D) globally. Epidemiological evidence indicates that consumption of white rice is positively associated with T2D risk, while intake of brown rice is inversely associated. Thus, we explored the effect of substituting brown rice for white rice on T2D risk factors among adults in urban South India. A total of 166 overweight (BMI ≥ 23 kg/m2) adults aged 25-65 years were enrolled in a randomised cross-over trial in Chennai, India. Interventions were a parboiled brown rice or white rice regimen providing two ad libitum meals/d, 6 d/week for 3 months with a 2-week washout period. Primary outcomes were blood glucose, insulin, glycosylated Hb (HbA1c), insulin resistance (homeostasis model assessment of insulin resistance) and lipids. High-sensitivity C-reactive protein (hs-CRP) was a secondary outcome. We did not observe significant between-group differences for primary outcomes among all participants. However, a significant reduction in HbA1c was observed in the brown rice group among participants with the metabolic syndrome (-0·18 (se 0·08) %) relative to those without the metabolic syndrome (0·05 (se 0·05) %) (P-for-heterogeneity = 0·02). Improvements in HbA1c, total and LDL-cholesterol were observed in the brown rice group among participants with a BMI ≥ 25 kg/m2 compared with those with a BMI &lt; 25 kg/m2 (P-for-heterogeneity &lt; 0·05). We observed a smaller increase in hs-CRP in the brown (0·03 (sd 2·12) mg/l) compared with white rice group (0·63 (sd 2·35) mg/l) (P = 0·04). In conclusion, substituting brown rice for white rice showed a potential benefit on HbA1c among participants with the metabolic syndrome and an elevated BMI. A small benefit on inflammation was also observed.

The glycaemic index and insulinaemic index of commercially available breakfast and snack foods in an Asian population

A low-glycaemic-index (GI) breakfast has been shown to lower blood glucose levels throughout the day. A wide variety of breakfast foods are consumed, but their GI values are largely unknown, hence limiting consumers' ability to select healthier options. This study investigated the GI values of ten common breakfast (five Asian and five Western) foods in this region using a randomised, cross-over study design. Participants arrived after an overnight fast, and fasting blood sample was taken before participants consumed test foods. Next, blood samples were taken at fixed intervals for 180 min. Glycaemic and insulinaemic responses to test foods were calculated as incremental AUC over 120 min, which were subsequently reported as glycaemic and insulinaemic indices. In all, nineteen healthy men (nine Chinese and ten Indians) aged 24·7 (sem 0·4) years with a BMI of 21·7 (sem 0·4) kg/m2 completed the study. Asian breakfast foods were of medium (white bun filled with red bean paste=58 (sem 4); Chinese steamed white bun=58 (sem 3)) to high GI (rice idli=85 (sem 4); rice dosa=76 (sem 5); upma=71 (sem 6)), whereas Western breakfast foods were all of low GI (whole-grain biscuit=54 (sem 5); whole-grain biscuit filled with peanut butter=44 (sem 3); whole-grain oat muesli=55 (sem 4); whole-grain oat protein granola=51 (sem 4); whole-grain protein cereal=49 (sem 3)). The GI of test foods negatively correlated with protein (r s -0·366), fat (r s -0·268) and dietary fibre (r s -0·422) (all P<0·001). GI values from this study contribute to the worldwide GI database, and may assist healthcare professionals in recommending low-GI breakfast to assist in lower daily glycaemia among Asians who are susceptible to type 2 diabetes mellitus.

Effect of a Novel High Fiber Rice Diet on 24-Hour Glycemic Responses in Asian Indians Using Continuous Glucose Monitoring: A Randomized Clinical Trial

BACKGROUND

We have recently demonstrated a medium glycemic index for novel high fiber white rice (HFWR) variety compared to regular white rice (RWR). However, substituting HFWR for RWR during the whole day's diet may provide extended benefits. The current study aims to assess the 24 h glycemic responses of a HFWR diet compared to a RWR diet.

METHODS

Continuous glucose monitoring (CGM) was used to assess the glycemic profile in 18 overweight, non-diabetic Asian Indians aged 25 to 50 in a randomized cross-over design. The volunteers were provided with iso-caloric (≈2100 kcal/day) HFWR or RWR based diets for four continuous days and switched diets after appropriate washout. Fasting blood samples for insulin assessments were collected at baseline and at the end of 4 day feeding. The glucose response in terms of incremental area under the curve (IAUC) was recorded. General linear model was used to assess the adjusted mean change of fasting insulin level of HFWR compared to RWR. Age and sex were adjusted as confounders in the model.

RESULTS

The average 24 h glucose response for HFWR was significantly lower (IAUC 66.3 ± 3.1 mg-5 min/dL) than RWR (IAUC 79.8 ± 5.7 mg-5 min/dL). The adjusted mean change in fasting insulin levels from baseline was also lower for HFWR compared to RWR. HFWR elicited a 34% and 30% lower 24 h glycemic and insulin response respectively, compared to RWR.

CONCLUSION

Replacing RWR with HFWR may be a healthier alternative for Asian Indians who are at a higher risk of developing type 2 diabetes.

Regional Disparities in the Association between Cereal Consumption and Metabolic Syndrome: Results from the China Health and Nutrition Survey

This study examines regional disparities in the association between cereal consumption and metabolic syndrome (MetS) among Chinese adults. We used data from the longitudinal China Health and Nutrition Survey (CHNS) for 2892 healthy adults aged 18⁻75 years (1088 in northern China, 1804 in southern China) who had no non-communicable chronic diseases or MetS at the initial visit in 2009 and the follow-up in 2015. We used a 74-item food frequency questionnaire (FFQ) to assess the dietary intake. We defined MetS according to the International Diabetes Federation (IDF) criteria. Multiple logistic regressions stratified by region were performed to estimate the association between cereal consumption and the risk of MetS, and the quantile regression analyzed the relationship between cereal consumption and individual components of MetS in 2015. The rice consumption in southern China (9.00 kg/month) was more than twice that in northern China (3.60 kg/month). Consumption of wheat and wheat products in northern China (4.20 kg/month) was more than twice that in southern China (1.50 kg/month). After we adjusted for potential confounders, rice consumption was inversely associated with a risk of MetS 0.709 (95% CI: 0.458⁻1.003), the intake of wheat and wheat products was positively associated with a risk of MetS 1.925 (95% CI: 1.292⁻2.867) in southern China. We found no association between the intake of cereal and the prevalence of MetS in northern China. The quantile regression showed that various cereals were differentially associated with the components of MetS. The association between cereal consumption and the risk of MetS, and the components of MetS varied across these two regions of China.

Acute Effects of Three Cooked Non-Cereal Starchy Foods on Postprandial Glycemic Responses and in Vitro Carbohydrate Digestion in Comparison with Whole Grains: A Randomized Trial

Plant origin, processing, and domestic preparation may affect the postprandial glycemic response (PGR) of starchy foods. The objective of this study was to examine the possibility of integrating domestically cooked non-cereal starchy foods commonly consumed in Northeast Asia into glycemic management diet, and compare their glycemic characteristics with those of waxy and non-waxy whole grains and starchy beans. In a randomized crossover trial, ten healthy subjects consumed dried lily bulb (LB), lotus seed (LS), adlay (AD), waxy black rice (BR), millet (MI), and adzuki bean (AB), pre-soaked and each cooked for two time durations. Acute PGR tests and in vitro carbohydrate digestion were carried out for each test food. Both the LS and AB meals achieved low glycemic index (GI 21⁻51), while the other starchy foods failed to show significant difference with rice (GI 83⁻109). The hydrolysis indexes of LS and AB were 37.7%⁻61.1%, significantly lower than other test foods. The in vitro tests indicated that pre-soaking resulted in high rapidly digestible starch (RDS) and low resistant starch (RS). Careful choice of whole grain materials, minimized pre-soaking, and moderate cooking may be critical factors for successful postprandial glycemic management for diabetic and pre-diabetic.

Epidemiology and determinants of type 2 diabetes in south Asia

Type 2 diabetes has rapidly developed into a major public health problem in south Asia (defined here as Bangladesh, Bhutan, India, Nepal, Pakistan, and Sri Lanka) in recent decades. During this period, major lifestyle changes associated with economic transition, industrialisation, urbanisation, and globalisation have been key determinants in the increasing burden of non-communicable diseases. A decline in nutrition quality, reduced physical activity, and increased sedentary behaviours are reflected in the increasing prevalence of type 2 diabetes and related risk factors in the region. The International Diabetes Federation 2017 estimates of the prevalence of diabetes in adults in the region range from 4·0% in Nepal to 8·8% in India. The prevalence of overweight ranges from 16·7% in Nepal to 26·1% in Sri Lanka, and the prevalence of obesity ranges from 2·9% in Nepal to 6·8% in Sri Lanka. An increasing proportion of children, adolescents, and women are overweight or obese, leading to a heightened risk of type 2 diabetes. Ethnic south Asians present with greater metabolic risk at lower levels of BMI compared with other ethnic groups (referred to as the south Asian phenotype), with type 2 diabetes often developing at a younger age, and with rapid progression of diabetic complications. Because of the presence of multiple risk factors and a body composition conducive to the development of type 2 diabetes, south Asians should be aggressively targeted for prevention. In this Series paper, we detail trends in the prevalence of diabetes in the region and address major determinants of the disease in the context of nutrition and physical activity transitions and the south Asian phenotype.

Clinical management of type 2 diabetes in south Asia

Compared with other ethnic groups, south Asian people with type 2 diabetes tend to develop the disease at a younger age and manifest with higher glycaemia, dyslipidaemia, nephropathy, and cardiovascular diseases. Additionally, specific issues that can affect treatment of type 2 diabetes in south Asia include poor awareness of the disease, delay in diagnosis, inadequate treatment, the use of ineffective and often harmful alternative medicines, and frequent non-compliance with lifestyle recommendations and drug treatment. Disease development at younger ages, delayed diagnosis, and inadequate management result in early development of severe complications and premature mortality. In this Series paper, we describe the challenges associated with the increasing burden of type 2 diabetes in south Asia and discuss ways to improve clinical care of people with the disorder in the region (defined to include Bangladesh, Bhutan, India, Nepal, Pakistan, and Sri Lanka). Treatment of diabetes in south Asia needs to be individualised on the basis of diverse and heterogeneous lifestyle, phenotype, environmental, social, cultural, and economic factors. Aggressive management of risk factors from diagnosis is necessary to reduce the risk of microvascular and macrovascular complications, focusing on provision of basic treatments (eg, metformin, low-cost statins, and blood pressure-lowering drugs) and other interventions such as smoking cessation. Strengthening of the primary care model of care, better referral linkages, and implementation of rehabilitation services to care for patients with chronic complications will be important. Finally, improvement of physicians' skills, provision of relevant training to non-physician health-care workers, and the development and regular updating of national clinical management guidelines will also be crucial to improve diabetes care in the region.

Phytochemical Profile of Brown Rice and Its Nutrigenomic Implications

Whole grain foods have been promoted to be included as one of the important components of a healthy diet because of the relationship between the regular consumption of whole-grain foods and reduced risk of chronic diseases. Rice is a staple food, which has been widely consumed for centuries by many Asian countries. Studies have suggested that brown rice is associated with a wide spectrum of nutrigenomic implications such as anti-diabetic, anti-cholesterol, cardioprotective and antioxidant. This is because of the presence of various phytochemicals that are mainly located in bran layers of brown rice. Therefore, this paper is a review of publications that focuses on the bioactive compounds and nutrigenomic implications of brown rice. Although current evidence supports the fact that the consumption of brown rice is beneficial for health, these studies are heterogeneous in terms of their brown rice samples used and population groups, which cause the evaluation to be difficult. Future clinical studies should focus on the screening of individual bioactive compounds in brown rice with reference to their nutrigenomic implications.

Glycemic Response to Black Beans and Chickpeas as Part of a Rice Meal: A Randomized Cross-Over Trial

Legumes, such as black beans (Phaseolus vulgaris L.) and chickpeas (Cicer arietinum L.), have a low glycemic index, and may reduce the glycemic load of meals in which they are included. Although the low glycemic response of beans consumed alone has been documented, few studies have examined the glycemic response to traditional food combinations such as black beans and rice or chickpeas and rice. This randomized cross-over study examined the glycemic and insulinemic impact of 50 grams of available carbohydrate from three test meals: plain white rice (control), black beans with rice, and chickpeas with rice among healthy adult women (n = 12, 18-65 years). Treatments were consumed on different mornings, a minimum of 7 days apart. Blood samples were collected at time 0 (fasting), and at 30, 60, 90, and 120 min postprandial, and were subsequently analyzed for glucose and insulin concentrations. Glucose response based on the incremental area under the curve showed a significant difference by treatment (p = 0.027). Changes in blood glucose concentrations were significantly different for the black bean meal and the chickpea meal in comparison to rice alone at 60 min (p = 0.026 and p = 0.024), 90 min (p = 0.001 and p = 0.012) and 120 min post prandial (p = 0.024; black bean meal). Findings indicate that combinations of black beans and chickpeas with white rice improve glycemic response, providing evidence that has promising implications for dietary guidance to reduce postprandial glucose and related health risks through traditional food patterns.