Rice consumption, incidence of chronic diseases and risk of mortality: meta-analysis of cohort studies

Abstract

Objective: Findings from cohort studies investigating the association between rice consumption and risk of chronic diseases or mortality have been inconsistent. We performed a comprehensive systematic review and meta-analysis on all published cohort studies examining white rice consumption in relation to incidence of chronic diseases or risk of mortality. Design: A systematic literature search of MEDLINE, Embase, Cochrane review, Google Scholar and Scopus databases for relevant cohort studies published until July 2014. For systematic review, we found nineteen studies examining the association between rice intake and risk of chronic diseases (obesity, hypertension, metabolic syndrome, diabetes, CVD and cancers) or mortality. Cohort studies which reported relative risk (RR) or odds ratio for highest v. lowest intake of rice and chronic diseases or mortality were included in the meta-analysis. Results: In a meta-analysis on seventeen risk estimates for highest v. lowest category of rice intake, provided from twelve studies, we found a trend towards a positive association (RR; 95 % CI) between rice consumption and risk of all chronic diseases (1·11; 0·96, 1·29); however, significant between-study heterogeneity was found (I 2 = 70·3 %, P < 0·001). Stratified analysis by gender showed a significant positive association between rice consumption and risk of chronic diseases in women (1·40; 1·13, 1·73), but not in men (0·95; 0·72, 1·24). Combining ten effect sizes from five studies showed that high consumption of rice was not significantly associated with mortality (0·97; 0·88, 1·06). Subgroup analysis by gender indicated an inverse association between rice consumption and mortality in men (0·87; 0·81, 0·94), but a trend towards a positive association in women (1·08; 0·97, 1·19). Conclusions: Although white rice consumption was not found to be associated with individual chronic conditions, we observed a positive association between white rice intake and risk of all overall chronic diseases in women. High rice consumption was related to a modest reduction in risk of mortality in men but not in women. Further studies of these relationships, in different populations, are needed. Keywords Rice consumptionChronic disease Mortality Meta-analysis Worldwide, chronic diseases such as CVD, stroke, diabetes and cancer account for 60 % of all deaths (1) . The rising prevalence of chronic diseases and the projected public health and economic consequences imply the need for identification of modifiable risk factors, including habitual diet, as a priority (2) .White rice is the major staple food for more than half of the world's population, in particular for those living in Asian countries (3) . As white rice consumption affects insulin secretion and postprandial glycaemia (4) , it is implicated in the aetiology of many chronic diseases. As a major refined carbohydrate source, it may increase the risk

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