FOR Malaysians, rice is not just a meal, it is a way of life, a comfort and a constant.
Yet while nasi lemak and steaming plates of white rice bring joy to millions of tables daily, science has been quietly raising the alarm about what all that polished grain may be doing to the nation's blood sugar.
Among the dietary culprits under the microscope is the humble plate of white rice.
Could your daily "nasi putih" actually be nudging you closer to diabetes?
Verdict:
TRUE
Almost 3.6 million Malaysians, or one in six adults, were diabetic according to the National Health and Morbidity Survey 2023, and two in five did not know they had the disease.
According to Health Minister Datuk Seri Dr Dzulkefly Ahmad, Malaysia holds the title of the country with the highest prevalence of diabetes in South-East Asia.
Diabetes cases have continued to rise, with about 21% of the population, or one in every five people, recorded as diabetics in 2024, up from 12.1% in 2011.
Multiple large-scale peer-reviewed studies have established a clear link between high white rice consumption and elevated risk of Type 2 diabetes, particularly among Asian populations.
White rice, produced through a series of mechanised processes including hulling and milling, primarily consists of starch.
The glycaemic index of white rice averaged 64, higher than brown rice at 55, whole wheat at 41 and barley at 25.
Excess rice consumption led to postprandial glucose spikes that, in turn, led to compensatory hyperinsulinemia to maintain normal blood sugar levels.
Over time, beta-cells became exhausted, leading to beta-cell failure and diabetes.
A meta-analysis published in the BMJ found that for each additional serving per day of white rice, the relative risk of Type 2 diabetes rose by 11%.
Asian populations consuming an average of three to four servings per day faced a pooled relative risk of 1.55, compared to 1.12 in Western populations, who typically consumed one to two servings per week.
A major multinational study involving 132,373 participants across 21 countries, including Malaysia, tracked dietary habits and diabetes incidence over a mean period of 9.5 years.
It found that consuming 450g or more of white rice per day, compared to less than 150g per day, was associated with a 20% increased risk of diabetes overall.
The highest risk was seen in South Asia at 61%, followed by South-East Asia, which included Malaysia and the Philippines, at 41%.
South-East Asia recorded a median white rice consumption of 239g per day, the second highest of any region studied.
A 2022 systematic review and meta-analysis drawing on 15 cohort studies involving 577,426 participants reinforced the findings.
At intakes above approximately 300g per day of cooked white rice, each additional serving of 158g was associated with a 13% higher risk of Type 2 diabetes.
The review also concluded that intake of brown rice was associated with lower risk of Type 2 diabetes.
Researchers pointed to the refining process as a key culprit, noting that the shift to industrially milled white rice stripped grains of dietary fibre, vitamins and minerals present in the bran layer.
They advised replacing highly polished white rice with other cereals or healthier grain varieties, adding legumes and pulses to reduce the glycaemic index of meals and reducing overall white rice consumption.
The Malaysian Health Ministry adopted various approaches to address the crisis, including the "War on Sugar" initiative and the Strategic Plan to Reduce Sugar among Malaysians 2024–2030, which encompassed six main strategies, 38 initiatives and 65 activities.
It is important to note that white rice consumption is one of several contributing factors, and that physical inactivity, obesity, genetics, overall diet and even your stress levels play significant roles in increasing your diabetes risk.
Sources:
1. https://pubmed.ncbi.nlm.nih.
2. https://pmc.ncbi.nlm.nih.gov/
3. https://pmc.ncbi.nlm.nih.gov/
4. https://pmc.ncbi.nlm.nih.gov/
5. https://pmc.ncbi.nlm.nih.gov/
6. https://pubmed.ncbi.nlm.nih.
8. https://bernama.com/en/news.
