Rice and Diabetes: What are the Risks?

Excessive consumption of white rice increases the risk for type 2 diabetes; and infant rice cereals have a checkered safety history.

Archeological evidence points to rice first being domesticated around 10,000 years ago, give or take. So, safe to say rice has been a staple throughout much of human history. But does that mean it’s healthy? As with so many things, the dose makes the poison. But the evidence points to white rice as something to be eaten rarely and in small portions, primarily because consumption of it has been linked to an increased risk of developing type 2 diabetes. Furthermore, if consumed in large quantities, frequently, and over many years, rice (white, brown and other types) may actually be unsafe because of the varying levels of toxic inorganic arsenic it could contain.

Rice and diabetes: Is white rice healthy?

The short answer: It’s not. White rice has gone through extensive processing to remove the hull (shell), bran (fiber), and germ (nutrients). What’s left behind: glistening white pellets of carbohydrates that, depending on preparation, have a glycemic index (GI) score in the 70s or 80s. To put that score in perspective, anything above 70 is considered “high” on the index. (Pure sugar is a 100.) High GI foods are more likely to cause blood glucose spikes, and could ultimately contribute to chronically high blood sugar levels and the development of type 2 diabetes. Learn more: The Link Between Diabetes and Blood Sugar.  

As with all things, there are tradeoffs. A high-GI food that is also high in nutrients isn’t all bad — especially when eaten with other foods that are high in fiber and low on the GI index. As stated above, however, white rice has had most of its nutrients stripped away.

Is brown rice a healthy alternative to white rice?

Because it still has its grainy bran and nutrient-dense germ, brown rice has been shown to be a much healthier alternative to white rice when it comes to glycemic response. Although it is more calorically dense than white rice, brown rice has a GI score of just 55. Other non-white rice varieties, such as wild rice, also produce a more favorable glycemic response than does white rice.

One word of caution, though: The bran in brown rice causes it to soak up arsenic more easily, which may result in some brown rice products having a higher arsenic level than white rice counterparts. However, consumed in moderation, arsenic risks are minimal in brown and most other rice types. (Read on to learn more about arsenic risks).

Is white rice safe? What about the arsenic scare? 

Arsenic occurs naturally in water, soil and rocks, but also gets into our food supply as a result of human pollution (pesticides/fertilizers, industrial waste, mining activities, coal burning). Inorganic arsenic is a known carcinogen that has been linked to, you guessed it, an increased risk of developing type 2 diabetes, especially in populations where it is central to traditional diets. Inorganic arsenic has also been shown to increase risks of lung and bladder cancer, ischemic heart disease, skin lesions, renal disease, hypertension, and stroke.

Since arsenic often drains into groundwater, paddy rice is particularly susceptible to arsenic contamination — and as a result, rice accumulates more arsenic than any other food crop. In fact, it is the single biggest food source of inorganic arsenic, which is the more toxic form. 

In its 2016 Risk Assessment Report on arsenic in rice and rice products, the FDA predicted that 157 lung and bladder cancers, annually, will result from dietary inorganic arsenic intake from rice alone. While the FDA notes that this is a small portion of an estimated 90,000 cases per million of lung and bladder cancer cases in the U.S., they cautioned that people who consume well over the average amounts used in the prediction modeling, and over long periods of life, face proportionally higher risks. Accordingly, the FDA stated the following:

“Decreasing the amount consumed per eating occasion and frequency of consumption could reduce cancer risk proportionally.”

Scientists who have studied the health impact of rice consumption in South Asia warn that increased prevalence of diabetes in that region may in large part be related to the consumption of arsenic contaminated rice. Similarly, there are concerns that Americans of Asian descent may also be consuming too much rice, placing them at increased risk both for diabetes and the arsenic-related cancer risks.

The majority of the total risk is attributed to white rice, due to the higher consumption of this product, compared with consumption of brown rice — even though brown rice actually contains somewhat more arsenic per serving. 

Infant rice cereal: The risks exposed

In August 2018, Consumer Reports published test results showing “worrisome levels” of arsenic, as well as other heavy metals, in many brands of infant rice cereals. Consumers Union then sent FDA a letter urging the agency to ensure that “companies implement strong, recognized best practices to prevent and reduce heavy metal contamination in foods.” When the FDA failed to respond quickly, CU chided the FDA, saying that “the agency has not done enough to limit the risks to consumers of arsenic in food. Infants and children are especially vulnerable to exposure to arsenic, a known carcinogen that has been linked to damage to the brain, cardiovascular system, and nervous system.” Finally, in August of 2020, the FDA took action to limit inorganic arsenic levels in infant rice cereals

However, uncertainty remains as to whether the new enforcement efforts have resulted in a complete eradication of questionably high levels of arsenic across all the many brands of infant rice cereal. Consequently, the Centers for Disease Control and Prevention (CDC) published — as recently as August 2021 — the American Academy of Pediatrics’ recommendation that parents offer a variety of fortified infant cereals such as oat, barley, and multi-grain instead of only rice cereal

“Only providing infant rice cereal is not recommended by the Food and Drug Administration because there is a risk for children to be exposed to arsenic.”

Should I just quit rice completely? 

You don’t have to be that extreme. Even white rice is OK in moderation. However, one cup of white rice has just over 53 grams of carbohydrates — with very little fiber. A healthy meal should have no more than 60 grams of carbohydrates, so a cup of white rice represents all the carbs you should let yourself consume in that meal. So, you’re better off avoiding it as much as possible. Instead, explore alternatives, including brown rice and grains.

What are some other alternatives to rice?

If you still want a granular, nutty side dish or base for meals, there are plenty of alternatives that are both healthier overall and far lower on the glycemic index. These include quinoa, farro, lentils, and the increasingly popular riced cauliflower. 

Key takeaways

White rice is a refined carbohydrate with a high GI score. Regular consumption has been tied to an increased risk of developing type 2 diabetes. As with all refined carbs, you’ll be better off finding alternatives, especially if you are concerned about glucose regulation. Try swapping in brown rice (but still in moderation) or experimenting with rice alternatives whenever possible. Filling your plate with a higher proportion of fiber-rich vegetables is an even healthier strategy. Keeping your rice intake to small portions, and less often, also reduces the remote, but not negligible, cancer, diabetes and other health risks associated with the arsenic levels in both white and brown rice.

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