Substituting Brown Rice for White Rice: Effect on Diabetes Risk Factors in India

用糙米代替白米：对印度糖尿病危险因素的影响

• 批准号: 7944856
• 负责人: Frank B Hu
• 金额: $ 6.05万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-01 至 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7944856
• 关键词: Adult; Advocate; Africa; Agriculture; Animals; Award; Behavioral; Biological Markers; C-reactive protein; Candidate Disease Gene; Carbohydrates; Cardiovascular Diseases; China; Cholesterol; Cohort Studies; Collaborations; Consumption; Coronary heart disease; Country; Data; Development; Diabetes Mellitus; Diabetes prevention; Diet; Dietary Fiber; Dietary Intervention; Dietary Practices; Dyslipidemias; Eating; Economics; Education; Effectiveness; Environment; Epidemiology; Equation; Factor Analysis; Fasting; Fatty acid glycerol esters; Follow-Up Studies; Food; Functional disorder; Future; Glucose; Glycemic Index; Glycosylated hemoglobin A; Goals; Habits; Haplotypes; Health; Health Benefit; Health Professional; High Density Lipoprotein Cholesterol; Homeostasis; Hypertension; Incidence; India; Individual; Inflammation; Insulin; Insulin Resistance; International; Intervention; Intervention Studies; Intervention Trial; LDL Cholesterol Lipoproteins; Latin America; Lipids; Local Government; Measurement; Mediating; Mexico; Modeling; Nigeria; Non-Insulin-Dependent Diabetes Mellitus; Nurses' Health Study; Obesity; Observational Study; Outcome; Pathway interactions; Pattern; Plasma; Policies; Polishes; Preparation; Prevention strategy; Price; Production; Public Health; Puerto Rico; Randomized; Recommendation; Research; Rice; Risk; Risk Factors; Role; Schools; Statistical Methods; Tanzania; Taste Perception; Testing; Time; Translating; Triglycerides; United States; Work; cardiovascular disorder risk; cost; design; diabetes risk; experience; glucose metabolism; glycemic control; group intervention; high risk; improved; mortality; novel; nutrition; parent grant; policy implication; programs; public health relevance; randomized trial

DESCRIPTION (provided by applicant): Currently, India has the largest absolute number of people with diabetes in the world and the escalation in diabetes incidence is occurring as global free trade continues to fuel rapid economic and nutrition transitions, especially in urban settings. These transitions are accompanied by a shift in dietary consumption towards more highly refined carbohydrates, fats, and animal products. Evidence indicates that consumption of whole-grains can decrease diabetes by improving glycemic control. The proposed proof-of-concept trial herein will evaluate the efficacy of substituting brown rice, a whole-grain, for white rice in Chennai, India, on biomarkers of diabetes risk and also will obtain glycemic index values of local rice and other staples. The long-term goal is to develop a multi-center nutritional-intervention in India, China, Africa and Latin America to create sustainable diabetes prevention strategies through improving carbohydrate quality. We propose to conduct a 4-month randomized parallel-group intervention trial to evaluate the effects of substitution of brown rice for white rice in two meals per day six days per week on biomarkers for diabetes risk among adults in Chennai, India who are at high risk for the development of diabetes. The first aim of this research is to determine the glycemic index of different local rice varieties (brown, red, and fully polished white) and preparations (regular or parboiled). The second aim is to determine the effects of brown rice substitution on fasting biomarker measurements of glucose metabolism (i.e., glucose, insulin, hemoglobin A1c, homeostasis model assessment for insulin resistance), dyslipidemia (i.e., triglycerides, total cholesterol, LDL- cholesterol, and HDL-cholesterol), and inflammation (i.e., C-reactive protein). This trial will also demonstrate the feasibility and cultural appropriateness of this type of intervention in the local environment to which results may be translated in the future. This study will have important implications for policy and help local governments develop national nutrition strategies for diabetes prevention such as wide- spread education campaigns about the health benefits of whole-grains, and school lunch programs which serve whole-grains. Such policies could also encourage ministries of agriculture to support production of whole grains, thereby improving accessibility and regulate costs. This work is intended to be part of a larger global initiative to identify local, feasible and sustainable dietary interventions to reduce diabetes risk in countries experiencing epidemiologic transition by improving the carbohydrate quality of staple foods. Initiatives have already been launched by our group in China, and are planned for Tanzania, Nigeria, Puerto Rico and Mexico. PUBLIC HEALTH RELEVANCE: Currently, India has the largest absolute number of people with diabetes in the world, and evidence indicates that consumption of whole-grains can decrease diabetes by improving glycemic control. Our study will evaluate the efficacy of substituting brown rice, a whole-grain, for white rice in Chennai, India, on biomarkers of diabetes risk. The ultimate goal of this research is to provide data for use in designing a global dietary intervention study aimed at reducing diabetes risk through simple, culturally appropriate, feasible and sustainable dietary changes.

描述（由申请人提供）：目前，随着全球自由贸易继续推动快速的经济和营养过渡，尤其是在城市环境中，印度的糖尿病患者的绝对人数最多，并且糖尿病发病率的升级正在发生。这些过渡伴随着饮食中消费量的转变，向更精致的碳水化合物，脂肪和动物产品转移。证据表明，全粒的消费可以通过改善血糖控制来降低糖尿病。本文提出的概念验证试验将评估印度钦奈的糙米（全谷物，全谷物）对糖尿病风险的生物标志物的有效性，并将获得当地大米和其他主食的血糖指数。长期目标是在印度，中国，非洲和拉丁美洲开发多中心的营养干预，以通过提高碳水化合物质量来创建可持续的糖尿病预防策略。我们建议进行为期4个月的随机平行组干预试验，以评估少糙米替代白米在每天六天的两餐中对印度钦奈成年人的糖尿病风险的生物标志物的影响，这些糖尿病风险很高，这些风险对糖尿病的发展有很高的风险。这项研究的第一个目的是确定不同局部水稻品种（棕色，红色和完全抛光的白色）的血糖指数和制剂（常规或煮沸）。 The second aim is to determine the effects of brown rice substitution on fasting biomarker measurements of glucose metabolism (i.e., glucose, insulin, hemoglobin A1c, homeostasis model assessment for insulin resistance), dyslipidemia (i.e., triglycerides, total cholesterol, LDL- cholesterol, and HDL-cholesterol), and inflammation （即C反应蛋白）。该试验还将证明这种类型的干预措施在当地环境中的可行性和文化适用性，未来可能会转化结果。这项研究将对政策产生重要影响，并帮助地方政府制定预防糖尿病的国家营养策略，例如有关全麦的健康益处的广泛传播教育运动，以及为全麦提供服务的学校午餐计划。这种政策还可以鼓励农业部支持全谷物的生产，从而提高可及性和规范成本。这项工作旨在成为一项更大的全球倡议的一部分，以确定本地，可行和可持续的饮食干预措施，以减少经历流行病学过渡的国家的糖尿病风险，通过提高主食的碳水化合物质量。我们的团队已经在中国发起了倡议，并计划在坦桑尼亚，尼日利亚，波多黎各和墨西哥启动。 公共卫生相关性：目前，印度拥有世界上糖尿病的绝对人数最多，并且证据表明，全麦的消费可以通过改善血糖控制来降低糖尿病。我们的研究将评估印度钦奈的全麦牛米对糖尿病风险生物标志物的含有糙米的疗效。这项研究的最终目标是提供用于设计全球饮食干预研究的数据，该研究旨在通过简单，适当，可行和可持续的饮食变化来降低糖尿病风险。