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Effectiveness of Locally Grown Red Pigmented Rice on Cardiometabolic Health in Type 2 Diabetes Patients: Findings from The RICH Study
Jun-Hao Lim’, Catriona Kar-Yuen Ong2, Yu-Qiong Chin3, Cordelia Kheng-May Lim1,’ Imliya Ibrahim’, Hui-Ching Low4, Yong-Ling Sou4, Mohd Naeem Mohd Nawi2,5, Sreelakshmi Sankara Narayanan2, Sameeha Jamil6, Elise Mognard3, Fazliana Mansors5, Mohd Fairulnizal Md Noh5, Yuh-Fen Pung4, Faiz Daud7, Wickneswari Ratnam8, Zulfitri Azuan Mat Daud1,9, Tilakavati Karupaiah2, and RICH Investigators
- Department of Dietetics, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor’s University, Selangor, Malaysia
- School of Food Studies & Gastronomy, Faculty of Social Sciences, Taylor’s University, Selangor, Malaysia
- Biomedical Science, Faculty of Science & Engineering, University of Nottingham Malaysia, Selangor, Malaysia
- Nutrition, Metabolism & Cardiovascular Research Centre, Institute for Medical Research, NIH, Selangor, Malaysia
- Nutritional Sciences Programme, Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Department of Biological Sciences, Faculty of Science & Technology, UKM, Selangor, Malaysia
- Department of Dietetics, Hospital Sultan Abdul Aziz Shah, Universiti Putra Malaysia, Serdang, Malaysia.
Background: Cardiovascular diseases (CVD) remain the leading cause of death among Type 2 Diabetes (T2D) patients. High glycemic index (GI) white rice is known to increase CVD risk, whereas pigmented rice, with its low GI and antioxidant properties, holds therapeutic potential.
Objective: This study evaluates the effects of substituting white rice with anthocyanin-rich, red pigmented rice (UKMRC9) on cardiometabolic parameters in T2D patients.
Methods: The Rice Intervention in Chronic Health (RICH) study was a 24-week, multi-center, open- label, parallel-group, randomized controlled trial involving 101 Malaysian adult T2D patients. Eligible participants, who were habitual white rice consumers with poorly controlled T2D, were randomly assigned to either UKMRC9 (treatment) or white rice (control) group. Assessments were conducted at baseline, 12th and 24th weeks. Generalized estimating equations were employed to compare changes in study parameters: adiposity, glycaemic, insulin, and inflammatory markers, lipid profiles, blood pressure, and 10-year CVD risk, over time between treatment and control groups. Intention- to-treat analysis was utilized to evaluate the effectiveness of UKMRC9 under real-world condition. Path analysis was conducted to explore the putative mechanism while dose-response analysis and linear-programming were performed to determine the minimum UKMRC9 intake for optimal cardiometabolic health.
Results and Conclusion: Significant and progressive reductions in adiposity indices, glycaemic markers, insulin resistance, and the 10-year CVD risk (al p<0.05) were observed in the treatment group from baseline to the 12th and 24th weeks of intervention. Conversely, no significant changes were noted in these parameters in the control group (p>0.05). The effect of UKMRC9 on 10-year CVD risk reduction was significantly mediated by glycemic markers (SIE=-2.978, p=0.024). At least 40g/d (raw weight) of UKMRC9 was required for its optimal cardiometabolic effects. Substituting white rice with UKMRC9 significantly improves key cardiometabolic parameters in T2D patients, suggesting its potential as an effective staple food for diabetes management.
