The truth concerning white rice and diabetes

My readers will know that I usually only write on this blog on days when I get annoyed with some growing untruth or virulent stupidity.

Today is one of those days.

Last week on 6 May, the Straits Times published a sensational headline Diabetes: The rice you eat is worse than sugary drinksfor a story by senior health correspondent Salma Khalik.

It kicked off by saying : “The health authorities have identified one of their top concerns as they wage war on diabetes: white rice. It is even more potent than sweet soda drinks in causing the disease. Sharing his battle plan to reduce the risk of diabetes, Health Promotion Board chief executive Zee Yoong Kang said that obesity and sugary drinks are the major causes of the condition in the West. But Asians are more predisposed to diabetes than Caucasians, so people do not have to be obese to be at risk. Starchy white rice can overload their bodies with blood sugar and heighten their risk of diabetes.”

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Straits Times, 6 May.

I thought the headline was over-the-top. ST has adopted more of The New Paper’s tabloid housestyle over the years but I read the story anyway.

After reading it through, I figured the article was pretty reasonable, since the ultimate recommendation was to mix 20% of brown rice with 80% of white rice (refined carbs) in a serving.

Why, that is what my wife has been recommending to me for years, though I politely decline (Dear, I really hate the taste and texture of brown rice). My kids don’t mind though.

And true, obesity and sugary drinks are a problem. Limpeh tells everyone to just drink water, plain tea or kopi-o-kosong (black coffee, no milk or sugar) if they want to lose weight.

And indeed, don’t eat so much rice, because everyone needs to control their refined carbs intake. I only eat one serving of rice at max for each meal.

Then I looked at the infographics and saw the glaring problem:

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The infographic tried to explain the issue in graphical terms : A bowl of rice has more than twice the carbohydrate content of a can of soft drink.

Then the infographic went into details of how carbs become sugar in the body, and how you get diabetes when you your body can no longer deal with the sugar spikes in your body. Which they conveniently link with white rice.

Nowhere on this infographic does it state how deadly sugary drinks are. It just goes literal with the headline, hand in hand, and whacks white rice to hell.

See the full length infographic here.

For most people who read the article, they are very likely to just focus on the colorful infographics and the really misleading headline. Which is a pity because the story does go into further detail about how not to just throw your rice bowl away.

The Public Furor

Of course, people got unhappy. And over the next few days, there were a slew of critical comments and articles.

From my friend Alfred on Facebook:

My friends, there’s a difference between rice and soda. One is a staple, the other isn’t. You need carbo if you run/swim but you certainly don’t need a Coke. Eat in moderation, as they say, and moderation is different things to different people so get to know yourself. Don’t just follow fads. I ate so much margarine in the past and now they say butter is good!

From Men’s Health Singapore, a U-turn from their previous article endorsing the HPB’s statement (which was the same ST story reprinted on their website)

Then I read this really interesting post from author Richard Seah, and I shared it on my Facebook page. It delves into a lot of scientific fact.

Richard commented on my post : I am not a qualified nutritionist either but has been reading and writing on food and health since 1980s. I also recently edited a book on the subject by Dr Poon Liat Ang. It does not take a qualified nutritionist to know common sense.

Ha! I thought that was so true and funny.

I’m not a qualified nutritionist either, but I wrote a common-sensical book on losing weight (and probably preventing diabetes), so there!

Unfortunately…

ST decided to run a commentary by Ms Khalik today to defend her original news piece. It’s titled “Fighting Diabetes: Why the target is white rice”

News that the Health Promotion Board (HPB) is targeting white rice in its fight against diabetes has created a storm of protest from rice lovers. Could the staple food of Asians for centuries truly be bad for health, they asked.

Many of those outraged by the report on the targeting (“Diabetes: the rice you eat is worse than sugary drinks“, May 6) were more than happy to make sweet drinks and junk food the real villains that cause diabetes, which, while enjoyable, are not part of Singapore’s heritage. But they were vehement that it could not be the traditional, steaming bowls of white rice that they consider essential.

Yes, sweet drinks and junk food are bad, and no one, least of all the HPB, is denying this. What it is saying, though, is that white rice is also a major culprit – largely because it is a staple, so more of it is eaten.

Sigh.

Again, nowhere does the commentary mention about the misleading title or infographics of the original piece. It’s not what you say, but how it’s said, and in this case I can tell you the issue lies with the original headline writer (who may not be the author of the story, but is usually a sub-editor or copy editor) and infographics illustrator.

Now I agree with just about everything Salma wrote (except asking NS guys to eat more brown rice – women should never, EVER recommend anything regarding National Service), it’s just that she did not address, or perhaps even realize the damage caused by the poor editing or presentation of her earlier piece.

What’s the damage, you ask?

Most people are ignorant when it comes to the matters of food nutrition. You tell them to stop eating eggs because of high cholesterol, and that’s exactly what they do FOR DECADES. Never mind that generations before them ate eggs with gusto.

Now that there is news or talk that rice is bad for you, many people will just go to the extreme and stop eating rice. Then when their health goes awry, they blame everything but their hysteria, ignorance and inability to think or research for themselves.

The general public ignorance is the most worrying bit – I have one reader of my book who is currently messaging me regularly about his progress on his weight loss regime. He told me he didn’t realize how deadly snacking on sugary snacks was, and he related how his previous paleo diet had failed him (of course it would).

People like him remind me daily that there is so much misinformation in the public and so much miscommunication of facts. I get so annoyed when I hear people say “Don’t believe in calorie counting! It doesn’t work!”

Yes, calorie-counting does not work for people who have some rare disease, physical ailment or something you probably do not have. It also does not work for people who do not know how to count calories properly, or truthfully.

For everyone else, it is only common sense that you should burn as much as you consume. But why do they brush off this simple logic?

Because it is easier to just believe whatever you choose to believe in.

Can I drink more soft drinks now if I eat less rice?

No.

In fact, you should cut out soft drinks almost completely.

They were first launched as a treat, but now people drink them as frequently as water.

Remember, rice is something man grows on a field. Soda is nothing more than heaps of sugar, coloring and other artificial chemicals added to water. And sold for a ridiculous profit margin.

You can stop drinking soft drinks for the rest of your life and become healthier and stronger. You cannot stop eating energy-giving staple food like rice, noodles, pasta, bread and so on without suffering adverse health effects.

Don’t even start considering such silly ideas like substituting soft drinks for rice, despite what a newspaper infographic may imply. You will just get fatter and dead faster than you’ve ever feared.

So can I still eat rice?

Yes, please!

You can eat one or two servings a day because you need it for energy. One serving refers to one rice bowl. And it’s true, eating too much rice will make you fat, and increase your chance of diabetes.

If you still feel hungry, eat more high-fibre vegetables, white meat (fish or chicken) and more high-fibre fruits like apples, pears and honey dew.

The same advice goes for noodles, but avoid the yellow-colored types because of the coloring. Go for white rice-based noodles like kuay-teow or mee tai mak which have less coloring.

You should avoid nasi lemak rice, chicken rice, or any other oily types of rice because they often have double the amount of calories of normal white rice.

I will also try to take more brown rice, even though I hate the bland taste and rough texture. But not because HPB and scientists said so, but because my wife is right.

But wait, is rice really a big cause of diabetes?

It’s not just rice. You should not bring up one particular risk factor and focus on it as part of a marketing or public education campaign where there are other far more pressing issues (like sugar).

And you have to be really careful when it comes to a staple food like rice. How do you do this gently without sending the masses into hysteria? Sensational headlines do not help.

But let’s get back to the real topic – diabetes.

Explaining diabetes is where the local articles and websites I have read don’t do such a great job. I’d suggest you read the New York State’s Department of Health diabetes website.

The cause of type 2 diabetes is largely unknown, but genetics and lifestyle clearly play roles. Type 2 diabetes has been linked to obesity, genetic risk factors, and inactivity. Some racial and ethnic groups are at higher risk for type 2 diabetes. These include American Indians, African Americans, Hispanics/Latinos, Asian Americans and Pacific Islanders. There is no known way to cure type 2 diabetes, but it can be controlled by keeping the level of glucose (sugar) in the blood within a normal range.

Risk factors for type 2 diabetes include:

  • Age (greater than age 45)
  • Overweight
  • Physical inactivity
  • Family background that is American Indian, African American, Hispanic/Latino, Asian American, or Pacific Islander
  • Parent or sibling with diabetes
  • High blood pressure
  • Abnormal cholesterol levels
  • Having had a baby that weighed more than 9 pounds or having had gestational diabetes
  • Pre-diabetes
  • History of polycystic ovary disease (PCOS)

So yeah, let’s not get rat-holed into a senseless discussion about rice, junk food, beverages and other types of food.

Diabetes, as well as other critical ailments like heart attacks, strokes and so on, are often triggered by our unhealthy lifestyles and other factors. There are some major risk factors that we have control of (food, exercise, lifestyle, sleep, stress) and others that we don’t (genetics).

What should we spend our time on? It’s just common sense.

If you ask me, it’s the fact that people do not know enough about food nutrition, or their lack of desire to find out more about food and healthy lifestyles, those are the real targets we need to attack in the war on diabetes.

8 Replies to “The truth concerning white rice and diabetes”

  1. I agree with your opinion that ST ought to be careful with their titles.

    And I think it’s fairly reasonable switch to 20% brown rice.

    I have to point out the correction that each person needs about 5 servings of Carbo which is around 2.5 – 3 bowls of rice per day.

  2. Consider this small scale Japanese study that shows significant HbA1c reduction with carbs limit of 120g/day. “In 69.4% of the Low Carb Diet (LCD) group, blood glucose was normalized at 12 months and the 2-hour plasma glucose level in the oral glucose tolerance test (OGTT) was reduced by 33 mg/dL. In addition, the incidence of diabetes was significantly lower in the LCD group than in the control group at 12 months (0% versus 13.9%, P=0.02).” http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4063858/

      1. Basically the study shows that by limiting to one bowl of rice per day with no specific limits on fats or protein, the participants shows significantly improved blood glucose and cholesterol (eg triglycerides/hdl) levels for those already showing early signs of diabetes…ie pre-diabetic levels.

        So what HPB is highlighting is for the general public to be more aware of the effects of excessive carbs intake in our high carb low physical activity culture. For many a simple reduction of daily carbs intake, not necessarily elimination, may be sufficient to reap huge benefit.

  3. While it is true some yellow noodles are dyed for manufacturers to save on eggs, not all yellow noodles are dyed.

    Given the nature of this article, might want to be clearer that people should check for eggs as genuine ingredient, instead of giving it the ST rice treatment and detracting from your efforts…

    1. Good callout, but it’s not that easy to find out which egg noodles are authentic or not. Better to err on the side of caution – any overly yellow noodle is probably coloured artificially.

  4. The key question is, what has changed in our diet to cause our diabetes rates to explode from a low of 1.9% in 1975 to 11.3% in 2010?

    The Straits Times articles are misleading and distracting. Not helpful in our “war on diabetes.” They need to do better.

    White rice is worse than sugary drinks in causing diabetes? I dug into some details and posted a defence of white rice, hope you find it of some interest:

    https://foodbethymedicine.org/

  5. So can I still eat rice?

    Yes, please!

    You can eat one or two servings a day because you need it for energy.

    Actually on average a normal person will have 20% or more body fat. assuming 70kg adult = 14kg of pure fats. = 30.8 pounds. since each pound of fat is 3500 cal. then our body is carrying 107800 calories of energy. from calorie expenditure websites we can see we burn about 100 calories from jogging 10mins. basically we carry enough energy in our bodies to run for 18 hours non stop before we run out of energy.

    tl:dr we dont need rice or any carb for that matter for energy. unless u going for 18hr ultramarathon.

    But wait, is rice really a big cause of diabetes?

    yes, rice like any other source of simple carbs is basically just sugar. chew on rice and hold it in your mouth for a few minutes together with saliva. it becomes sweet. (this sugar spikes insulin, and after constant spiking, insulin sensitivity gets screwed over which becomes diabetes)

    the only time rice doesnt spike your insulin is the eating window 1hour after exercise. (because glycogen is already depleted. so the sugar gets pumped into your muscles instead of flowing freely in your bloodstream)

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