Switch to whole-grain varieties, not just eat less white rice

The Singapore Nutrition and Dietetics Association (SNDA) has been following, with interest, the different views on white rice consumption triggered by recent articles in The Straits Times. Our association members have also received queries to clarify the content of the articles.

The SNDA's position is that the articles may have been misinterpreted as advocating that Singaporeans cut back on rice intake and that it is acceptable to consume sugared drinks without restrictions.

This is not the right thinking.

The SNDA is aligned with the Health Promotion Board (HPB) in terms of our assessment of the current evidence and the dietary advisory on refined carbohydrates such as white rice.

Management of carbohydrate quantity and quality in clinical settings reliably reduces elevated blood glucose. The effects of carbohydrate portioning and substitution from refined to whole-grain sources are immediate and well documented.

Given that Singaporeans consume a lot more refined carbohydrates from starchy staples, and given the effectiveness of carbohydrate management as part of diabetes care, we support HPB's approach of taking such intervention to the population level as a first approach to diabetes prevention. There is a need to cultivate carbohydrate literacy and encourage an adoption of whole-grain varieties.

Singapore's 2010 National Nutrition Survey showed that dietary energy from carbohydrate is well within the recommended allowance.

However, much of the refined carbohydrate in the local diet comes from starchy staples such as white rice, noodles and refined breads.

A highly refined carbohydrate diet, coupled with Asians' predisposition to higher blood glucose and insulin responses to carbohydrate intake, is a contributing factor to rising diabetes prevalence in Asia.

Singaporeans in modern living should focus on switching to whole-grain varieties instead of just cutting down on white rice intake.

Cutting down carbohydrate intake may have the effect of increasing fat intake as a proportion of dietary energy. This would lead to calorific excesses and obesity, which is another risk factor for Type 2 diabetes.

As part of clinical management of people with diabetes, dietitians are already advising patients to avoid sugar-sweetened beverages and gradually replace refined staples with whole-grain varieties.

This same advice should be given at the population level, as part of diabetes preventive intervention.

At the same time, we urge the Government to keep a focus on obesity and the consumption of sugar-sweetened beverages, especially among school-age children, and explore practical ways to curb this empty-calorie food source.

Chow Pek Yee (Ms)

President

Singapore Nutrition and Dietetics Association

A version of this article appeared in the print edition of The Straits Times on June 15, 2016, with the headline 'Switch to whole-grain varieties, not just eat less white rice'. Print Edition | Subscribe