Is White Rice Consumption Associated with an Increased Risk of Type 2 Diabetes? A Systematic Literature Review and Meta-Analysis

Background: Evidence from cohort studies investigating the relationship between white rice consumption and the incidence of type 2 diabetes is inconsistent. This review aimed to explore the association between white rice consumption and the risk of type 2 diabetes in Western and Asian/Middle Eastern populations. Method: Seven electronic databases were searched for prospective cohort studies published in English and Chinese up to October 2017, which analysed the association between dietary intake of white rice and the development of type 2 diabetes. Eligible studies were assessed for methodological quality and subjected to qualitative and quantitative synthesis using a random effects model meta-analyses. Results: Eight high-quality cohort studies involving 570,225 participants were included in the review. When the highest and lowest categories of rice intake were compared, no association was found between white rice consumption and the risk of type 2 diabetes in Western (relative risk (RR) = 1.05; 95% confidence interval (CI): 0.84, 1.31) or Asian/Middle Eastern (1.33; 1.00, 1.79) populations. The pooled relative risk for both populations combined was 1.18 (0.98, 1.42), with significant between-study heterogeneity (I = 76%, p < 0.001). Conclusion: White rice consumption was not associated with an increased risk of type 2 diabetes in either Western or Asian/Middle Eastern populations. Multiple modifiable and non-modifiable factors contribute to type 2 diabetes risk, and there is insufficient evidence linking the consumption of a single food item such as white rice with type 2 diabetes.