The Association of Bread and Rice with Metabolic Factors in Type 2 Diabetic Patients

PLoS One. 2016 Dec 22;11(12):e0167921. doi: 10.1371/journal.pone.0167921. eCollection 2016.


Purpose: Carbohydrates are shown to have an important role in blood glucose control, type 2 diabetes and cardiovascular diseases risk. This is even more challenging when considering populations consuming refined grains diets. Bread and rice are staple foods which supply main proportion of Iranian calorie intake. This study was designed to investigate the effect of bread and rice intake on blood glucose control, lipid profile and anthropometric measurements in Iranian type 2 diabetic patients.

Methods: 426 patients with type 2 diabetes were included in this study. Anthropometric measurements were done using standard methods. Dietary information was assessed by a valid and reliable food frequency questionnaire (FFQ). Fasting blood glucose (FBG), glycated hemoglobin (HbA1c), serum triglycride (TG), total cholesterol (TC), low density lipoprotein (LDL) and high density lipoprotein (HDL) cholesterol were examined after 12-hour fasting.

Results: The results represented that people in the highest tertile compared to the lowest tertile of calorie adjusted total bread intake have higher FBG. FBG in the highest tertile of calorie adjusted total bread-rice intake was also significantly higher than the lowest. The association remained significant after adjusting for potential confounders. Rice intake showed no association with cardio-metabolic risk factors.

Conclusion: We founded that higher total bread intake and total bread-rice intake were associated with FBG in type 2 diabetic patients whereas rice intake was not associated with glucose and lipid profile. This result should be confirmed in prospective studies, considering varieties, glycemic index (GI), glycemic load (GL) and cooking method of bread and rice.

MeSH terms

  • Adult
  • Biomarkers / analysis*
  • Blood Glucose / analysis
  • Bread*
  • Cholesterol / blood
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / physiopathology*
  • Diet*
  • Fasting
  • Female
  • Follow-Up Studies
  • Glycated Hemoglobin A / analysis
  • Glycemic Index
  • Humans
  • Lipids / analysis
  • Male
  • Middle Aged
  • Oryza / chemistry*
  • Prognosis
  • Risk Factors


  • Biomarkers
  • Blood Glucose
  • Glycated Hemoglobin A
  • Lipids
  • hemoglobin A1c protein, human
  • Cholesterol

Grant support

The study was conducted on type 2 diabetic patients referring to diabetes and metabolic diseases clinic of Tehran University of Medical Sciences with code of ethics E00192.