If White Rice Is Linked to Diabetes, What About China?

If White Rice Is Linked to Diabetes, What About China?
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Protein consumption can exacerbate the insulin spike from high glycemic foods.

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Rice currently feeds almost half the human population making it the single most important staple food in the world, but a meta-analysis of seven cohort studies following 350,000 people for up to 20 years found that higher consumption of white rice was associated with a significantly increased risk of type 2 diabetes, especially in Asian populations. They estimated each serving per day of white rice was associated with an 11% increase in risk of diabetes, which may help explain why the association was even stronger in Asia, where they eat much more rice. This could explain why China has almost the same diabetes rates as we do. They’re at about 10%; we’re at about 11%, despite seven times less obesity in China. Japan has eight times less obesity than we do, yet may have a higher incidence of newly diagnosed diabetes cases than we do– nine per thousand, compared to our eight. They’re skinnier and still may have more diabetes. Maybe because of all the white rice they eat?

Just like eating whole fruit is associated with a lower risk of diabetes, whereas eating fruit processed into juice may not just be neutral but actually increase diabetes risk, eating whole grains–like whole wheat bread or brown rice–is associated with a lower risk of diabetes, whereas eating white rice, a processed grain, may not just be neutral but may actually increase diabetes risk.

White rice consumption does not appear to be associated with increased risk of heart attack or stroke, though, which is a relief after this earlier study in China suggested a connection with stroke. But do we want to eat a food that’s just neutral regarding some of our leading causes of death, when we can eat something associated with a lower risk of diabetes, heart attack, stroke, and weight gain?

For example, if you look at the Cornell-Oxford-China Project, rural plant-based diets centered around rice were associated with relatively low risk of the so-called diseases of affluence, which include diabetes. Maybe Asians just genetically don’t get the same blood sugar spike when they eat white rice? No, if anything, people of Chinese ethnicity get higher blood sugar spikes.

The rise in these diseases of affluence in China over the last half century has been blamed in part on the tripling of the consumption of animal source foods. The upsurge in diabetes has been most dramatic, and it’s mostly just happened over the last decade. That crazy 9.7% diabetes prevalence figure that rivals ours is new—they appeared to have had one of the lowest diabetes rates in the world in the year 2000.

So what happened to their diets in the last 20 years or so? Oil consumption went up about 20%, pork consumption alone went up 40%, and rice consumption dropped about 30%. So diabetes rates were skyrocketing, while rice consumption was going down; so maybe it’s the animal products and junk food that are the problem. Yes, brown rice is better than white rice, but to stop the mounting Asian epidemic, maybe we should focus on removing the cause–the toxic Western diet. That would be consistent with data showing animal protein and fat consumption associated with increased diabetes risk. But that doesn’t explain this.

If the rise in meat consumption is to blame, then why do the biggest recent studies in Japan and China associate white rice intake with diabetes? One possibility is that animal protein is making the rice worse. If you feed people mashed white potatoes, a high glycemic food like white rice, this is how much insulin your pancreas has to pump out to keep your blood sugars in check. But what if you added some tuna fish? Tuna’s got no carbs, no sugar, no starch. Wouldn’t make a difference, right? Or maybe it would even lower the mashed potato spike, by lowering the glycemic load of the whole meal, but instead you get this. Twice the insulin spike. Same with white flour spaghetti, and white flour spaghetti with meat. The addition of animal protein makes the pancreas work twice as hard.

You can do it with straight sugar water if you do a glucose challenge test to test for diabetes, where you drink a certain amount of sugar. This is the kind of spike in insulin you get, but if you take in the exact same amount of sugar, but with some meat added, you get this. And the more meat you add, the worse it gets. Just adding a little meat to carbs doesn’t seem to do much, but once you get up to a third of a chicken breast’s worth, you can elicit a significantly increased surge of insulin. This may help explain why those eating plant-based diets have such low diabetes rates, because animal protein can markedly potentiate the insulin secretion triggered by carbohydrate ingestion.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Images thanks to IRRI Photos via Flickr.

Rice currently feeds almost half the human population making it the single most important staple food in the world, but a meta-analysis of seven cohort studies following 350,000 people for up to 20 years found that higher consumption of white rice was associated with a significantly increased risk of type 2 diabetes, especially in Asian populations. They estimated each serving per day of white rice was associated with an 11% increase in risk of diabetes, which may help explain why the association was even stronger in Asia, where they eat much more rice. This could explain why China has almost the same diabetes rates as we do. They’re at about 10%; we’re at about 11%, despite seven times less obesity in China. Japan has eight times less obesity than we do, yet may have a higher incidence of newly diagnosed diabetes cases than we do– nine per thousand, compared to our eight. They’re skinnier and still may have more diabetes. Maybe because of all the white rice they eat?

Just like eating whole fruit is associated with a lower risk of diabetes, whereas eating fruit processed into juice may not just be neutral but actually increase diabetes risk, eating whole grains–like whole wheat bread or brown rice–is associated with a lower risk of diabetes, whereas eating white rice, a processed grain, may not just be neutral but may actually increase diabetes risk.

White rice consumption does not appear to be associated with increased risk of heart attack or stroke, though, which is a relief after this earlier study in China suggested a connection with stroke. But do we want to eat a food that’s just neutral regarding some of our leading causes of death, when we can eat something associated with a lower risk of diabetes, heart attack, stroke, and weight gain?

For example, if you look at the Cornell-Oxford-China Project, rural plant-based diets centered around rice were associated with relatively low risk of the so-called diseases of affluence, which include diabetes. Maybe Asians just genetically don’t get the same blood sugar spike when they eat white rice? No, if anything, people of Chinese ethnicity get higher blood sugar spikes.

The rise in these diseases of affluence in China over the last half century has been blamed in part on the tripling of the consumption of animal source foods. The upsurge in diabetes has been most dramatic, and it’s mostly just happened over the last decade. That crazy 9.7% diabetes prevalence figure that rivals ours is new—they appeared to have had one of the lowest diabetes rates in the world in the year 2000.

So what happened to their diets in the last 20 years or so? Oil consumption went up about 20%, pork consumption alone went up 40%, and rice consumption dropped about 30%. So diabetes rates were skyrocketing, while rice consumption was going down; so maybe it’s the animal products and junk food that are the problem. Yes, brown rice is better than white rice, but to stop the mounting Asian epidemic, maybe we should focus on removing the cause–the toxic Western diet. That would be consistent with data showing animal protein and fat consumption associated with increased diabetes risk. But that doesn’t explain this.

If the rise in meat consumption is to blame, then why do the biggest recent studies in Japan and China associate white rice intake with diabetes? One possibility is that animal protein is making the rice worse. If you feed people mashed white potatoes, a high glycemic food like white rice, this is how much insulin your pancreas has to pump out to keep your blood sugars in check. But what if you added some tuna fish? Tuna’s got no carbs, no sugar, no starch. Wouldn’t make a difference, right? Or maybe it would even lower the mashed potato spike, by lowering the glycemic load of the whole meal, but instead you get this. Twice the insulin spike. Same with white flour spaghetti, and white flour spaghetti with meat. The addition of animal protein makes the pancreas work twice as hard.

You can do it with straight sugar water if you do a glucose challenge test to test for diabetes, where you drink a certain amount of sugar. This is the kind of spike in insulin you get, but if you take in the exact same amount of sugar, but with some meat added, you get this. And the more meat you add, the worse it gets. Just adding a little meat to carbs doesn’t seem to do much, but once you get up to a third of a chicken breast’s worth, you can elicit a significantly increased surge of insulin. This may help explain why those eating plant-based diets have such low diabetes rates, because animal protein can markedly potentiate the insulin secretion triggered by carbohydrate ingestion.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Images thanks to IRRI Photos via Flickr.

Doctor's Note

This one is a little twisty and might require another watch or two. Instead of breaking this into multiple videos, I tried to pack it all into one. Basically, the question is if the modern diabetes epidemic in China and Japan has been linked to white rice consumption, how can we reconcile that with low diabetes rates just a few decades ago when they ate even more rice?

The protein exacerbation of the effect of refined carbs could help explain the remarkable results achieved by Dr. Kempner with a don’t-try-this-at-home diet composed of mostly white rice and sugar. See Kempner Rice Diet: Whipping Us Into Shape.

Refined grains may also not be good for our blood pressure (Whole Grains May Work As Well As Drugs).

 What should we be eating to best decrease our risk of diabetes? See:

Update: I did a deep-dive into the issue of arsenic in rice in summer 2017. Here are the 13 videos in that series:

If you haven’t yet, you can subscribe to my videos for free by clicking here.

237 responses to “If White Rice Is Linked to Diabetes, What About China?

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  1. Conventional wisdom about diabetics combining carbohydrates with protein or fat to control blood sugar had it all wrong then…

    1. Just to clarify, the conventional “wisdom” is more concerned with reducing immediate blood sugar levels than improving insulin function. Blood sugar is in fact reduced by addition of protein or fat through delayed gastric emptying and reduced intestinal motility. You can see the inverse relationship between blood glucose vs insulin response in the Gulliford paper (free access). Unfortunately the dietary recommendations (high fat/protein) resulting from this focus on glycemic response only serves to reduce insulin sensitivity in the long term and I agree is “all wrong”.

      1. Wrong B00mer just like your other posts. Improving insulin function is what we call improving insulin sensitivity. That is achieved by intermittent fasting (less insulin use), exercise (burning glycogen from the system so it wants carbs), and minimizing carb foods (insulin spikers).

        Improving insulin sensitivity is a long-term goal but can easily be attained in the short term with the right plan of attack, and that is the 3 things I mentioned above. The only way to maintain insulin sensitivity in the long-term is to not flood your body with insulin. Now if it’s a question of whether or not protein or carbs are a bigger contributer, then I ask you this:

        What has more sugar, steak or an apple. Common sense would dictate the apple, and knowing that sugar has the largest response on insulin, you can ascertain that steak (the protein/fat), produces a much smaller insulin response. Given that, you know to maintain insulin sensitivity for the long term, more protein/fats must be eaten instead of carbs.

        1. Weight for weight the insulin response to to protein is the same as carbs. A pound of steak produces the same insulin response as a pound of sugar. The only macro which doesn’t cause an insulin response is fat.

      2. Hi b00mer,
        I’m a newbie to these things and trying to make sense of your statement. Please help me understand.

        Eating protein with rice helps to lower the blood sugar but increases insulin response. The emphasis has always been on blood sugar but if I understand this video and your comment, the emphasis should be on insulin response/sensitivity.

        This is kind of murky to me. I still don’t get it, how can there be a difference between blood sugar and insulin sensitivity? Can you point me to a resource, book, video that makes this easier to understand. Pardon me if I’ve confused terms or sound naive. (I am). I’m trying to get this clear in my head.

    2. If it’s all wrong then, you have to ask yourself the question as to why it’s still prescribed to this day and works to the point it reverses the disease in many cases.

      Ever heard of the term “if it aint broke don’t fix it”?

      Insulin and Insulin resistance aren’t too hard to understand. Once a basic grasp of it is understood, then people know why proteins are combined with carbs.

  2. As this video illustrates, the more animal protein added to a carbohydrate meal, the more insulin required. I’ve also seen similar studies showing that adding butter to mashed potatoes increases insulin release. Since in 20 years the amount of fat in the Chinese diet increased from 23.6 to 35.9%, I would think fat as well as protein may have something to do with the rise in Type 2 diabetes.

    1. I agree Julie I think it has more to do with fat then protein. Should we be concerned with eating rice with beans if it’s really the protein. I doubt it

      1. Guys the protein involved here is animal derived so there’s no worry about combining rice & beans as beans have a significantly lower insulin spike than meat.

        1. are out there the same study but with rice and vegetable protein? for example rice + soy beans and insulin levels.
          does not seem to be an expensive or invasive test to do with patients.

          1. Good point. I can anticipate though that we could save this money.
            What this video fails to mention is that the net formation of protein is accelerated by insulin.
            This is why our body produces insulin after ingestion of proteins. This is not an accident of Nature, it is BY DESIGN!!!
            And insulin is needed and welcome.
            The more proteins (animal or vegetable IT DOES NOT MATTER) the more insulin, just like the carbs. And you need insulin if you want to make good use of those nutrients.

        2. I have better luck cutting vegetables and fruit and more meat, as my specialist recommended. I have major trouble with bloating and weight gain with rice and/or beans.
          Because I also have a muscle disease and cant continue with all of the exercise (yes, my body, or my legs, just shut down last fall. I needed steroids to get the moving again), and I am studying nutrition, I thought I would try less meat, so I have cut most of it out. Im not going to lie, I get really hungry sometimes without it.
          I started checking my blood sugars and they remained normal for a few days. I checked before and after waking, eating anf exercise. All good. Im perplexed at what might have me stalled with the weight Im at.
          It is true that I was bit by a tick while hiking in Colorado, and got “the rash”. Almost immediately, I began gaining weight. The legs not working came months later. I though about possible lyme, but Drs here don’t test for or treat it, they ignore it. Ideas?

          1. Becky,
            Have you seen the documentary; “Under Our Skin” about Lyme disease? Quite informative and crucial to get a doctor who specializes in Lyme. Please consider getting a second opinion as the disease will continue to progress.
            Best wishes.

          2. I don’t know why, but I used to not be able to eat beans without gas pain. Then I cut out all animal protein and can eat loads now with no problem. And I don’t feel bloated when I eat rice (which I usually don’t eat bc I prefer quinoa) any more either.

    2. Incorrect on all accounts Julie. Both protein and fat blunt the insulin response of carbohydrates (though you generally do not want to consume copious amounts of fats with carbs.

      The amount of insulin required depends on 2 things:

      1) Just how insulin resistant your insulin receptors are on your cells
      2) What type of carbohydrate your eating.

      Worst case scenario is your insulin resistant and eating something that requires a large release in insulin like carb ladened foods requiring a lot of insulin released suddenly to clear out the glucose. This is why proteins are added to carb meals to slow down the the glucose conversion, thus slowing down the insulin release. Proteins added to a meal do not require more insulin to be secreted.

    3. I can relate your comment to what Jonny Bowden mentioned on one of his presentation when he was in China. The meals composed of carbs and animal proteins are usually Western style, which is why we see many metabolic disease in Western countries. Now, we see it in Asian countries, too.

  3. This eduvideo is the bomb! This is going to be sent to all my colleagues so they can review this data. I can’t thank you enough keep up the great work.

    1. I have told you to stop surfing the internet for pictures of girls…… ;-)
      Just kidding!
      Why? I mean – land of the free…….

      1. Not funny, Plantstrongdoc, especially given the reality of girls (female children), being hustled and exploited for online porn. I’m sure that wasn’t your intention, but please don’t objectify girls or women in this safe-space for all of us to hang out and learn more about nutrition. Thanks.

        1. How did you make that connection? Please don’t allow anyone to joke about anything at anytime, anywhere. Humor is forbidden.
          John S

          1. John S: “surfing the internet for pictures of girls” is the obvious connection. Your response adds salt to the proverbial wound. When women, even politely (note my “I’m sure that wasn’t your intention” and “thanks”) request that men check their objectifying comments, they often receive a version of what you wrote: i.e. hey can’t you take a joke? I have a great sense of humor and love jokes but NOT ones that are hurtful to others or are based in sexism, racism, homophobia, etc.

            1. Interesting that you call yourself “Seedy Character” while criticism another for desiring the freedom on the internet to help make positive healthy contributions to the world of health. Preventing people from the freedom of expression, even while not perfect, could be considered a much worse problem then your concern for exploitation. Seedy Character, please don’t attack the people of good character for their silly off topic comments. And if you’re on a crusade, then at least say it using a better name! Maybe “Freedom Fighter”

              1. The Dude: You just demonstrated another common response men make when women politely request that they not objectify women and girls. It’s a version of blame-the-vicim. My gentle remonstration is now a “much worse problem” and is “preventing people from the freedom of expression.”

                The original quote “surfing the internet for pictures of girls” was seriously off-topic and hinted at child porn, even if unintentionally. Real Dudes might say: “Hey, Dudette, I agree that NF is no place to joke around about surfing the web for pictures of girls.”

                1. Seedy Character: you’re not being polite or gentle. You’re blowing it way out of context. You’re name speaks volumes “Seedy character”

                  1. Typical dude defensive response #3: “You’re blowing it way out of context.”

                    Why is it so hard for you to simply acknowledge that using a nutrition forum to joke about cruising the net for girls is inappropriate and objectifying of girls/women? If you want to have good relationships with women, you can start by believing them rather than challenging them when they tell you something is offensive to them.

                    Why the obsession with my username? “Seedy” as in flax, hemp, sesame, pumpkin, chia. I eat a lot of seeds and some friends consider me a “character” because I’m so crunchy-granola to them. A fun play on words. And perhaps a lighthearted way to counter the negative associations with the word “seedy.”

                    Dude, can you bury this bone please?

                    1. SeedyCharacter: I thought about out what your name meant when I first saw it. I think it is clever and fun. Sorry you are getting such flax (I mean flak).

                      My 2 cents: I think this whole conversation has played itself out.

                    2. Thea, I can handle the flax . . . it builds my moral . . . fiber. ;-)
                      I heartily agree with the “played out” aspect. Thanks for writing.

            2. Interesting that you call yourself “Seedy Character” while criticism another for desiring the freedom on the internet to help make positive healthy contributions to the world of health. Preventing people from the freedom of expression, even while not perfect, could be considered a much worse problem then your concern for exploitation. Seedy Character, please don’t attack the people of good character for their silly off topic comments. And if you’re on a crusade, then at least say it using a better name! Maybe “Freedom Fighter”

        2. Funny how so many people over reacted to what was once a fairly innocent jibe. Porn was not mentioned or implied, that was all in people’s minds.

      1. Pls stop all this nonsense on a serious site. this of us who read the comments to learn something about nutrition get offend d that u use the. Site to JOKE. Nutrition is more important than your jokes, all which are stupid and childish. PLEASE JUST STOP USING THIS FORUM FOR UR OWN PURPOSES!

    2. “By the way my corporation that I work for has now blocked all social media to everyone in the office.”

      Oh wow, shame on them. Back in the days when I toiled in law firms we felt lucky to even have access to word processors — .on which we were expected to crank out various documents, i.e. wills and other what-nots for the lawyers. No free time to speak of. But you kids today…..!!! *sigh*

      1. I’m glad you think I’m a kid since I’m 50 years old. And I don’t have free time but I try to make free time for the questions that are posted on this website.

  4. WOW! Great video! I go with brown rice most of the time, but for shorter cooking time I go with white rice. a few times a week of white rice should be okay right?

    1. You are correct as long as you don’t add any meat or oil to the rice that you’re eating. There is an old study that Dr. McDougall showed me about pre-diabetics and feeding them pure sugar and taking the oil and fat out of their diet and then there prediabetes went away. But when they added back the oil to the sugar prediabetes came back.

      1. Interesting! I know that we have much to learn..any grain, even whole causes me to gain weight quickly and belly fat seems to want to “grow”,. Jokingly, I say its like yeast! Even following myplates recommendations with more veggies makes me gain weight..
        Frustrated, trying, learning more

      2. It’s really a no brainer that it’s not the rice.i mean they have known this for many decade s why do they think it’s going to change all of sudden

          1. b00mer: I have been wanting to say for a while now how amazing and helpful your replies are. You do an incredible job of explaining things simply, logically, succinctly and with hard data to back up what you are saying. I so look forward to reading your posts.

            This particular post, with the link to Jeff’s comments is particularly helpful to me. It had cleared up a lot of confusion on my part. He makes so much sense! Smart guy.

            1. Thea, that’s so kind of you! Actually having a morning where I’m feeling a bit overwhelmed and inadequate and your comment brought a smile to my face.

              p.s. Happy 1st day of spring!

        1. Everything natural has some fat in it, I think. We tend to think that rice is a carb, like potatoes. But in reality, rice and potatoes are carbs, with protein and a little fat. Vegetables also have fat in them.

      3. What type of oil was used for this experiment? A processed vegetable oil is not the same as olive oil if you get my drift and could be important. The high omega 6 to omega 3 ratio in the s.a.d due to the use of cheap processed vegetable oils correlates with decline in health. All our processed carbs are produced with these processed veg oils to make the most unhealthy combination of fat and carbohydrate possible and that is what we mostly eat. Is it any wonder we are so sick

        1. The increased fat in the study came from animal sources. If you have any questions about the sources for videos you can look at the studies by clicking on the Sources Cited tab.

      4. First comment that included Dr McDougall. His research and success has come from concentrating on whole grains, legumes etc i.e. whole foods plant based! No animal food. No oil. Reverse prediabetes and then no diabetes.

    2. Hi Eddie, a couple more options for shorter cooking times: Uncle Ben’s makes a 10 minute parboiled brown rice. I haven’t tried it myself so I don’t know if the texture or flavor is comparable to regular rice or if there’s a significant price difference. Also I use a pressure cooker to cook rice (I happen to use an electric countertop model) and brown rice cooks in 12 minutes. It was about a hundred bucks so it’s a significant investment but I use it all the time. It made such a difference to be able to come home and have rice nearly immediately instead of 45 min on stovetop or 1 h 45 min in rice cooker. Stovetop pressure cookers would be quick too and can be less expensive than the electric ones.

      1. I got a programmable zojirushi rice cooker that allows you to set the time you want the rice to be ready. That lets me set it up before Ieaving for work in the morning and I have brown rice ready and waiting when I walk in the door. It is also great for making steel cut oats as well. Then I set it up before going to bed and wake up to hot oatmeal. I like to put a teaspoon of cinnamon and a bunch of raisins in mine and always comes out perfect. Some days it never makes it back in the cabinet as immediately after putting the left over brown rice in the frig, I set it back up with oatmeal for the next morning. But it is nice to have a pressure cooker as well for those times I forget to set up the rice cooker in the morning.

        1. Programmable rice cookers are great! I actually used to have one… the problem for me was realizing I was out of rice and/or remembering to set it up in the morning. I ended up getting rid of it when I got the pressure cooker to save on cupboard space. If one has the requisite brain power :P to operate one, yes a great option! Also that oatmeal sounds fantastic. I imagine the raisins end up with that fresh out of the oven cinnamon roll style gooiness? I’m off to find out if my pressure cooker has a delay function.

      2. Those short cooking time rice variants are often made by increasing the water content of the rice. Another possibility is to add a surfactant to get water in quicker. The former has a dramatic increase in risk of pathogens (nasty ones live on damp rice) and the latter wreaks havoc on your stomach. I used to drink decaffeinated instant coffee but found that the surfactants used to increase coffee extraction would give me a terrible stomach upset after 5 days of 3 cups a day. Now I only drink bean coffee and haven’t had a single problem.

      3. By the way, Basmati rice is a white long grain that is much lower GI. Also recently we bought red and black long grain which has a much stronger flavour while being low GI. Finally we can now by unrefined (brown) Basmati which is better still.

        1. LOVE the basmati rice…so very important in most Indian vegan dishes, I’ve found! My other go-to rice is just plain old brown rice…I think it’s 77 cents a pound at WalMart these days! But my preferred starch is potatoes..I cannot deny it. (“that’s me ‘Irish!”…my maternal grandma was 100% Irish)

    3. what about arsenic and cadmium in rice? It has been reported that arsenic levels are 10 times higher in brown rice — due its accumulation in the bran and husk — when compared to white rice

      1. At this last weekend’s Advanced Study Weekend, Dr. John McDougall said that the problem with arsenic in rice is not the rice per se, but in the water used to grow it and in some cases from soil affected by previous water sources; and that California rice is OK, but rice from the southeast U.S. is not.

        1. “…and that California rice is OK”

          Beg to differ. Lundberg rice of California was shown to have some of the highest arsenic levels of all.

          1. Was this true from the newer report? jj gave us some links, above. I believe California rice had lower levels, compared with rice grown in Texas and Arkansas.

            1. I was referring to the original brand-specific CU report regarding brown rice. Unsure if the follow-up retested as specifically as the original did.

              1. Hi Natalie. jj supplied us with a link, below, that looked at rice from different countries. I’ll post it, here. It is important to note that rice may not have as high levels of arsenic, compared with other foods. Dr. Greger has some great resources on food and arsenic. I find it valuable to know when reports like these are published that perhaps many other foods and arsenic sources are not identified. I am not saying arsenic in rice is not concerning, but perhaps other foods deserve awareness, as well.

      2. And generally Indian and Thai rices are also low in arsenic. I had heard that a lot of the arsenic in the rice in the SE US comes from the low dose arsenic deliberately feed to chickens to make them grow faster. Most of the arsenic ends up in the chicken manure which ends up on the fields or in the water. It isn’t that the water there is naturally high in arsenic. I wonder at the arsenic load of the people eating the chicken

        1. Jim they grew cotton there for many years and used arsenic laden pesticides up until the mid 80s and now it’s being absorbed by the rice

          1. Ah, good to know, thanks. Still who ever thought that feeding an incredibly toxic substance that accumulates in the animal’s tissue to animals used for human consumption was ever a good idea needs to be kept far far way from anything to do with food production! And the folks at the FDA who oversee food safety really need to be shown the door if this is the level of oversight they practice.

            Plus, what isn’t absorbed by the chickens eventually to be eaten winds up in the manure. So not only does all the tons of manure from the billions of chickens raised each year represent a huge ecological disaster just from the naturally occurring constituents, now it really should be treated as hazardous waste. Wonder if the future superfund sites will be centered around the huge broiler chicken factory farms.

      3. Hi Joe K. This was (is) a controversial topic. Dr. Greger’s video on rice and arsenic helps answer the question of “should we eat brown rice?” The answer is “Yes” – U.S. rice preferred, and there are ways to prepare (such as rinsing) to lower the arsenic.

        1. ” U.S. rice preferred” …… Where does he get this? That isn’t what the report says.

          All types of rice (except sushi and quick cooking) with a label indicating that it’s from Arkansas, Louisiana, or Texas or just from the U.S. had the highest levels of inorganic arsenic in our tests. For instance, white rices from California have 38 percent less inorganic arsenic than white rices from other parts of the country.

          Brown rice has 80 percent more inorganic arsenic on average than white rice of the same type. Arsenic accumulates in the grain’s outer layers, which are removed to make white rice. Brown has more nutrients, though, so you shouldn’t switch entirely to white. Brown basmati from California, India, or Pakistan is the best choice; it has about a third less inorganic arsenic than other brown rices.

          Rice that’s grown organically takes up arsenic the same way conventional rice does, so don’t rely on organic to have less arsenic. http://www.consumerreports.org/cro/magazine/2015/01/how-much-arsenic-is-in-your-rice/index.htm

          1. Thanks for catching that, jj! That video was from 2009, before both consumerreports articles. California rice was still found to be pretty low, from what I see, but you are right we cannot lump “U.S.” rices into one category. Sorry for my mistake and thanks for keeping an eye out. Please feel free to continue catching my goofs.

            Best,
            Joseph

    4. Do we know brown rice is better against diabetes? At 1:27 of the video the chart shows brown rice .5 servings per day .87 risk, white rice one serving per day 1.23 risk. That makes it kind of hard to compare. I keep some cooked Brown rice from TJ’s in the freezer in case I forget to start it in time.

    5. Eddie: b00mer listed some good ideas if you decide you want to cut down further on your white rice eating. I have another idea for super-quick brown rice – buy it already pre-cooked and frozen. I get pre-cooked, frozen brown rice from Trader Joes. It has nothing in it but brown rice. Period. Or you can get a box with a mix of brown rice, black barley and something else I think. Super quick and easy to fix – zap in microwave for 3 minutes. It’s perfect every time.

    1. It seems that animal protein was the main reason individuals had a spike in insulin. Good question though. Perhaps similar to the reason why carcinogens on plants do not form at high temperature like grilling, or nitrites in fresh vegetables do not create N-nitrosamine compounds like nitrites found in meat?

  5. But I love my basmati rice, Indian food just wouldn’t be the same with brown. I guess the idea here is to keep it fat free or very low fat. I eat paneer (high fat Indian cheese) once in a while with it.

    1. The cause of the increased insulin spike wasn’t the fat in the animal foods, it was the protein. Still keeping the fat low is still a really good idea, especially the amount of saturated fat. So just skip the paneer. I substitute tofu and find it an acceptable substitute for paneer since 99.9% of the flavor comes from the curry sauce.

      As for brown versus white rice, it is just a matter of giving your taste a chance to adapt. I used to hate brown rice and only liked white rice. But after eating almost exclusively brown rice for several years, I can’t stand to eat white rice. I consider it flavorless and the only way I can eat it is if it is thoroughly saturated by a highly flavored sauce like curry.

      1. Substituting tofu for paneer is a great idea, I’ll have to try that. I also want to find some brown basmati rice, as brad suggested, but my local stores don’t carry it. I’ll find some somewhere, sometime.

        1. You make a lot of sense. Forty percent of Americans will never eat a whole grain. Is this still true after General Mills and Kellogs’ switched to whole grain? The minimum suggested is 48 grams. If you ate 200 grams of labeled whole grain (four bowls of oatmeal) a day you could live the same amount extra as if you did twenty minutes of exercise a day, ate four more walnuts a day, or smoked five less cigarettes a day according to this site. Is that about five years? I can see it is about when you get started. How long does a 10 percent reduction in diabetes shorten your life according to this site? Maybe you could balance white rice with other whole grains. Eating less meat is also recommended. All in moderation.

            1. So to clarify,when the animal protein or animal fat is adds to the white rice, the insulin released is more than when white rice is consumed on its own? Does this mean that in the short run, if someone is checking their sugar, it will actually be lower when animal protein/fat is added to the rice? Does it act like an insulin secretagog, like a sulfonylurea?

        2. If you freeze the tofu first then let it thaw it really changes the texture. Freezing causes most of the water to form ice crystals throughout the block of tofu. When thawed the ice melts and leaves tiny pores in the tofu. The result is very much like a sponge. Also the tofu takes on a much chewer texture. When put in a marinade or sauce it almost instantly soaks it up and to a much greater degree than unfrozen tofu.

          I just take the tofu out of the packaging and water, wrap it in wax paper and then aluminum foil to make it vapor tight and pop it in the freezer. As soon as it is frozen, you can immediately let it thaw, but the tofu will keep for months in the freezer. I try to keep a few blocks in the freezer so I never run out. It is better to let it thaw in the refrigerator for at least a day, so the trick is remember to take it out of the freezer the day before you want to use it. If it is still a little frozen, just slice it up and then use the defrost setting on the microwave to defrost it the rest of the way. I have even completely defrosted it in the micro when I have forgotten to put it in the frig. Hope you like it.

      2. I’ve found that I greatly prefer the taste and feel of short-grain brown rice to long-grain brown. The grains are plump and nutty and incredibly tasty with a little shoyu sprinkled on them. Mmmmmm . . .

  6. Dr. Greger,

    The video showed us what was observed when animal protein was added with carbs, and the increased spike in insulin. But do we know why, i.e., the mechanism by which animal protein exacerbates the insulin spike?

    Neil

    1. There are likely multiple mechanism which causes insulin to spike (ie type of nutrient, effect on metabolism, energy reserves, etc). One of them probably is that higher levels of proteins and also fat interfere with the utilization of energy.

      1. Unsure why you felt the need to post what you did as it did not address my question. I was not asking about multiple mechanisms. The video was about animal protein spiking insulin, which is why I asked specifically about that subject. Then your conjecture about what one of these other “mechanisms” may be is equally irrelevant.

        1. I don’t quite understand your response to someone who sounded like they were trying to be helpful. Would it have addressed your question if it had been phrased:

          THE mechanism by which animal protein exacerbates the insulin spike depends on the type of nutrient.
          or
          THE mechanism by which animal protein exacerbates the insulin spike depends on metabolism.
          or
          THE mechanism by which animal protein exacerbates the insulin spike depends on energy reserves.
          or
          THE mechanism by which animal protein exacerbates the insulin spike depends on some combination or none of the above.
          ?

        2. > Unsure why you felt the need to post what you did as it did not address my question.
          Unsure why you felt the need to post a question that no one can answer to your foot-stomping satisfaction at our current level of understanding.

      2. proteins and fats don’t interfere with the utilization of energy, they blunt the insulin response carbs create to slow down the rise in blood sugar. This is what people generally want unless their high end athletes or cross fit gurus.

    2. I’m not sure what the biochemical mechanism is, but I’d put my money on an increase in insulin resistance as a causal factor. Insulin drives a number of processes, including ferrying glucose out of the blood stream and into cells. When blood sugar increases, the pancreas bumps up its secretion of insulin in order to bump up the movement of glucose out of the blood stream and into the cells. If the cells become resistant to to the influence of insulin (which the protein may cause), then the body responds by hitting it harder with more insulin.

      1. your about 95% correct with the exception of “protein may cause”

        Ask yourself this steve, what has more sugar in it? What is going to be converted into glucose quicker?

        Steak or an Apple?
        Chicken or Carrots?
        Fish or a Doughnut?
        Beef or a potato?

        From what you typed, you seem to have a good grasp on insulin and what it’s purpose is. So looking at the above 3 combos, hopefully you understand that the foods that get converted to glucose quicker and thus enter the bloodstream quicker, will cause a bigger insulin response to “ferry” glucose out. The slower the glucose conversion, the slower the insulin response.

        Now you have to ask yourself, how exactly does say Steak, Chicken, Fish, Beef cause a big insulin response when there is no sugar in it to convert to glucose? It’s all amino acids, so if you ask yourself what causes a bigger flood of glucose in the system; sugar or amino acids, hopefully you say “sugar”.

        Knowing that, you’d answer your own question, protein doesn’t cause it, carbs do.

        1. In isolation, you comment makes sense. But the interesting and surprising finding presented in the video is that, in the presence of animal protein, the insulin response from carbs is greatly increased (which may explain the recent increases in diabetes in China and Japan, two white rice-centered cultures). My comment was not to propose this. The video did that. My comment was to suggest a mechanism. Your comment seems to want to refute the findings in the video.

        2. Protein foods have an equal insulin response as carbohydrate. A kilo of beef has the same insulin response as a kilo of sugar. The only difference is the blood sugar level. What we have learned here is that the combination of carbs and proteins have an even higher insulin response than if the same quantity had been eaten separately.

      2. your about 95% correct with the exception of “protein may cause”

        Ask yourself this steve, what has more sugar in it? What is going to be converted into glucose quicker?

        Steak or an Apple?
        Chicken or Carrots?
        Fish or a Doughnut?
        Beef or a potato?

        From what you typed, you seem to have a good grasp on insulin and what it’s purpose is. So looking at the above 3 combos, hopefully you understand that the foods that get converted to glucose quicker and thus enter the bloodstream quicker, will cause a bigger insulin response to “ferry” glucose out. The slower the glucose conversion, the slower the insulin response.

        Now you have to ask yourself, how exactly does say Steak, Chicken, Fish, Beef cause a big insulin response when there is no sugar in it to convert to glucose? It’s all amino acids, so if you ask yourself what causes a bigger flood of glucose in the system; sugar or amino acids, hopefully you say “sugar”.

        Knowing that, you’d answer your own question, protein doesn’t cause it, carbs do.

    3. Hi Neil. Not sure. I’ll have to look at some of the mechanisms that may have been listed by the authors in that study. Unfortunately they do not do a great job (as far as I can tell) listing any mechanisms. I thought about it more and perhaps this paper on the over abundance of animo acids cold help? I used this in my review paper on cancer, as a reference for putative mechanisms. Interestingly, it was Dr. David Jenkins (co-inventor of the glycemic index) who brought this paper to my attention. See what you think, it’s a free article. I find it interesting that this paper discusses TOR (Target of Rapamycin) as Dr. Greger touches on this, explaining how reducing intake of leucine–rich animal products such as milk may reduce cancer risk. I hope this helps.

      Thanks,
      Joseph

    4. There is no answer Neil because adding protein to a carb meal doesn’t spike insulin.

      You first have to know why insulin is secreted, and that is in response to how much glucose is created from whatever food eaten. Carb foods are more ladended with sugar and thus cause a bigger insulin response. Proteins however have no sugar in them but amino acids. The aminos are what cause a release in insulin, but those have a much slower metabolizing rate than carbs.

      Knowing this, and putting 2 and 2 together and using common sense, obviously protein does not spike insulin when eating it by itself or adding it to carbs. There is a reason why diabetics today are prescribed diets based on combining vegetables with proteins while laying off simple and complex carbs, while eating a diet high in fat. They are prescribed this because it works and reverses the disease.

    1. If you were to breakdown the animal and plant proteins into constituent amino acids of the same proportions, YES.
      But in general, plant proteins are less available, have a different amino acid profile and are accompanied by numerous other factors that alter metabolism.

  7. confusing. I’d say eating white rice NOT every day is FINE. I eat in between – QUINOA, and BROWN rice. Or one week white rice, the other week quinoa, then brown rice…it should be fine.

    1. I don’t think the message from this video is to NEVER eat white rice. I think what you laid out sounds fine to me! A great variety of grains, snappir.

  8. In a way, this info seems to support the old theory of food combining / “natural hygiene”. Would like to see results with people who eschew the starches and sugars all together and eat, say, meat and non-starchy veggies.

    1. Yeah, I thought of the same thing. Just today I’ve watched very interesting and thought provoking interview with Ori Hofmekler, who among other things basically says that the way to increase health and longevity is to lower insulin as much as possible (beans immediately spanng to my mind after hearing this), which is done, in part, by correct food combining (or rather separation). I’m not sure about all of his ideas, but he has some very very intriguing points, https://youtu.be/0EOy0A2llVQ.

      As a minor note I quite often watch Jamie Oliver as a background while eating and such, so he almost every time pours like half a cup of olive oil in each of his dishes. It makes me wonder if it is indeed part of traditional (Mediterranean) way of cooking or it is just to look cool.. :))

  9. Where is the graph showing a high glycemic index carb combined with a plant based protein like soy? I expect it to be the same as the carb alone, or better but I was a bit surprised by the absence of that slide.

    1. I’m not sure they tested soy protein in that study, but yes it would be interesting to see. From what I gather the research overall doesn’t show any negative associations with soy intake and diabetes risk so it may be fair to say your expectations are valid. I too would not expect to see huge spikes in insulin from added soy.

    1. I’m confused, I’m just checking out your anabolicmen link and their site 100 ways to increase testosterone levels naturally where it states the following: “Vegetarian diets have been linked to very low testosterone levels.
      That’s not really hard to guess though, because for vegetarians it’s
      really hard to get those healthy saturated fats and cholesterol in their
      diet, and the fact that they consume a lot of soy won’t help either.
      One study showed that men who change from vegetarian diet to high fat
      carnivore diet increased their testosterone levels by 30%”. The only study link they cite in connection to this claim doesn’t work and if I remember correctly there was a video here at nutritionfacts stating exactly the opposite. It seems to me the whole thing sounds more like a smart marketing strategy which raises the question why post such a link?

      1. You won’t find THE truth and nothing but THE truth on this site either. It simply doesn’t exist, nor can it ever.
        What hold true to one needn’t necessarily be true for another.
        That doesn’t mean there aren’t some tasty tips for the information hungry on this subject to be found there :)

        Comment on the site, in general he promotes low protein, high carb, low BMI, avoid alcohol, pro nuts, boron (vegetables),
        the list of good things he recommends is pretty darn long.

        Nothing wrong with that site, just have your info filter on while you browse it just like you should with all websites you visit,
        and that is including nutritionfacts, the moment you stop being your own referee you are the one that loses out.

        1. Low testosterone/GHT can have a massive impact on how a man feels and his place in the world.
          So when I was experimenting away with licorice for a few days trying to trigger a change in my cortisol levels,
          and I read on that site I was destroying my testosterone levels I was very glad to have been handed that info.
          Rice being active in a similar way might be something to avoid as calorie mainstay for the testosterone challenged.

          There will be many a gentleman browsing nutritionfacts that will benefit greatly from a boost in testosterone,
          and will find some info on how to unlock it very helpful.

  10. I have been waiting for this video got a while! It delivered tenfold, but it did leave me with a question. Was soy or other plant protein tested against animal protein in terms of insulin spike? I’m wondering whether animal protein is specifically the cause or if total protein intake in general is the culprit. In this case, beans and rice would cause a higher insulin spike than just rice! But I like beans. I usually add either a few black beans, kidney beans, or edamame to rice.

    Personally I do not eat white rice or any rice very often. Occasionally I like to eat brown or forbidden black rice. I’ve never really cared for sticky rice so the natural chew of whole-grain rice lends itself to my palette.

    1. Hi Selena Darlim—you should check out Dr. Greger’s video ” Diabetics Should Take Their Pulses.” There’s a link to it in the Doctor’s notes under today’s video. Beans are good!

    2. Hi Selena. Good question! Others have asked about this, too. If interested, see my response a bit further down, or by clicking here.

  11. Thank you for this mind blowing information. The more I learn the more I’m amazed and pleased that I stumbled upon this WOE. Thank you for your continued inspiration and encouragement.

  12. What about these studies showing reversal of T2D on a macrobiotic diet?

    http://www.nutritionandmetabolism.com/content/11/1/39
    The effect of the macrobiotic Ma-Pi 2 diet vs. the recommended diet in the management of type 2 diabetes: the randomized controlled MADIAB trial

    http://onlinelibrary.wiley.com/doi/10.1002/dmrr.2519/pdf
    Ma-Pi 2 macrobiotic diet and type 2 diabetes mellitus: pooled analysis of short-term intervention studies

    http://www.hoajonline.com/internalmedicine/2052-6954/2/3
    Ma-Pi 2 macrobiotic diet intervention during 21 days in adults with type 2 diabetes mellitus, Ghana 2011

    http://www.hindawi.com/journals/jnme/2012/856342/
    Medium- and Short-Term Interventions with Ma-Pi 2 Macrobiotic Diet in Type 2 Diabetic Adults of Bauta, Havana

    https://hongkong.wyethnutritionsc.org/documents/28201/92730/Education+Column+Series+(Issue+3).pdf
    Gut microbiota and metabolic disorders: A focus on type 2 diabetes and dietary modulation

    http://carbsanity.blogspot.com/2014/01/carbohydrate-and-diabetes.html
    http://carbsanity.blogspot.com/2014/01/carbohydrates-and-diabetes-part-ii.html

    http://carbsanity.blogspot.com/2014/12/vegan-ma-pi-diet-bests-conventional.html
    Vegan Ma-Pi Diet Bests “Conventional Treatment” for Diabetes in Recent RCT

    1. Hi Charles. I am not sure what specifics you are asking, but I took a look at some links and it seems a macrobiotic diet can be helpful for diabetes. To my knowledge these diets are based on rice and vegetables, seaweed and soy. I would expect to see good results. Thanks for sharing.

      Joseph

  13. Just to be sure, is the good Dr saying vegetable protein and/or any kind of fat (read butter on your saffron rice) is A-ok as far as insulin spoke is concerned?

  14. Since animal protein and saturated fat or inexorably linked maybe it’s the saturated fat that causes the insulin spike by blocking the insulin receptor sites in the cells

    1. If you look at the plots in the Gulliford paper, you’ll see that from starch only to starch+tuna, there was a significant spike, and from there to starch+tuna+margarine there was not a significant increase (even a decrease at certain time points).

      Their meal descriptions are not quite clear to me in that when they state for example a meal description of “25 g of carbohydrate as potato”, I can’t tell if they mean 25 g of potato or 25 of carbohydrate from potato (= 35 g potato total). Regardless of which interpretation is correct, the addition of tuna or tuna+margarine does correspond fairly well to addition of protein or protein+fat, respectively.

      Given interpretation #1, each component contains:
      25 g potato = 18 g carb, 1.9 g protein, 0.25 g fat
      25 g tuna = 0 g carb, 6.8 g protein, 0.15 g fat
      25 g margarine = 0.03 g carb, 0.03 g protein, 20 g fat

      Given interpretation #2, different numbers but the trend remains the same:
      35 g potato = 25 g carb, 2.6 g protein, 0.35 g fat
      93 g tuna = 0 g carb, 25 g protein, 0.56 g fat
      31 g margarine = 0.03 g carb, 0.03 g protein, 25 g fat

      If the small amount of fat in the tuna were playing a significant role in the rise in insulin, I think we would see a much greater increase between starch+tuna and starch+tuna+margarine.

  15. Forgive me if I missed something obvious…

    What is the insulin response when a similar quantity of a plant-based protein, like tofu, is added to the insulin response tests? What about the added calorie load the digestive system is responding to with the additional calories a “comparable” protein source adds (albeit vegetable) …

    Slightly different twist, but add protein from seitan, tempeh or nutritional yeast, even though they all contain reasonable quantities of fiber. What is the new insulin response? Is the insulin spike related to animal protein or protein (and the additional calories) in general?

    1. Great questions. See if you can flip thru my comments and find any helpful answers? About the plant-based proteins, see here. Unsure about calorie load, but it is interesting to me that even in studies where kcals are not monitored (meaning diabetics could eat as many calories are they wanted from plant origin) markers for insulin resistance still improved.

      You may be onto something re: fiber. We know fiber slows blood sugar spikes. Not sure about what the new insulin response is?

      The insulin spike in these studies (where the graphs show insulin spike) were due to animal protein, not plant protein.

      Hope that helps
      Joseph

  16. I would be interested in finding out if it’s specifically animal protein or what we put into it that’s causing such a huge issue.. need a study with organic meat vs conventional meat vs no meat!

  17. This video nails it on meat and insulin. But I found out (the hard way) eating lots of nuts, and raising my saturated fat thereby, that my blood sugar went way up. I am vegan with only a minor ounce or two of meat every 2 weeks, so added lots of nuts to my diet. Nut oils have saturated fats and this loads up muscle cells with lipids that gum up the insulin works, resulting in insulin resistance. Carbs were already to the bone, so only by removing the excess nut consumption was I able to get my blood sugar down to normal over a couple of months. I eat half an ounce of walnuts now, instead of 8 ounces of nuts per day. There should be tests using nuts or oils as well as meat to give us wider knowledge of how this all works. It’s good news we know about meat, and probably dairy does the same thing. But nuts, and veg oils may be involved too due to their saturated fats.

    1. You should look at the videos on legumes and beans. They are a major part of my diet and they help balance my blood sugar. I eat beans at least 3 times a day, every day.

    2. Hi bobluhrs, when you say “carbs were already to the bone”, does that mean you are following a low carb diet? I ask because contrary to mainstream medical advice, a low fat very high carbohydrate diet is able to reverse type II diabetes in most cases. Some links exploring this dietary treatment are below if you are interested.

      Study published by Neal Barnard showing successful treatment of type II diabetes on low fat vegan diet: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2677007/
      “Neal Barnard’s Program for Reversing Diabetes”: http://www.nealbarnard.org/books/diabetes/

      Information from Dr. McDougall on diabetes:
      https://www.drmcdougall.com/health/education/health-science/common-health-problems/diabetes-adult-onset-and-juvenile/
      https://www.drmcdougall.com/health/education/videos/mcdougalls-moments/cure-type-2-diabetes/

  18. I would like to see the experiment performed again in another lab, to see if the results are replicable, and to be completely fair to animal products, with boiled grass-fed chicken tenders and steamed wild salmon fillets.

    Plant proteins might improve the insulin response, or it’s the high fiber content. See: http://nutritionfacts.org/video/beans-and-the-second-meal-effect/

    “… inclusion of whole grains or legumes at breakfast decreases postprandial glycemia at lunch and/or dinner on the same day … consumption of a whole grain or lentil dinner reduces glycemia at breakfast the following morning. This effect is lost upon milling, processing, and cooking at high temperatures. The subsequent meal effect has important implications for the control of day-long blood glucose, and may be partly responsible for the reduction in diabetes incidence associated with increased whole grain and legume intake. “

    1. Hi Shane, to perform such a test would require a cogent hypothesis. However the few differences in composition of grass-fed/wild animal tissue vs conventional/farmed animal tissue just don’t seem to warrant such a claim. If you have one or have heard a well-formed and substantiated hypothesis as to why it would make a significant difference, please share. Personally I have only seen pseudoscience that disagrees with established real-world observations and claims based on the logical fallacy of argument from ignorance (i.e. we don’t know for sure so it could be true). Below is a link with general information about the grass-fed trend and diseases in ancient civilizations, as well as an excerpt from a Plant Positive video which is generally more philosophical but does contain a couple points on health implications of grass-fed meat.

      From Healthy Longevity: “Cardiovascular Disease in Ancient Civilizations”
      (also briefly touches on blood sugar and diabetes)
      http://healthylongevity.blogspot.com.au/2013/10/Cardiovascular-Disease-in-Ancient-Civilizations.html?m=1

      From Plant Positive: “Humanity Past & Future”
      http://plantpositive.com/44-humanity-past-and-future/
      Excerpt: “The health claims for grass fed also seem to me to be totally speculative. Tiny changes in the amounts of certain fatty acids or vitamin E are supposed to compensate for the other disease-causing properties of beef. If this were true, why when I look at the countries that rely on pastured beef the most do I still see evidence of an association between beef consumption and disease? In Uruguay and Argentina, the land of the gaucho, we see some of the highest rates of breast and colon cancer in the world. Why do Japanese immigrants to Brazil have an increased risk of stomach cancer when they eat more beef, which is typically grass-fed there? […] Why in Australia is fresh red meat associated with an increased risk of rectal cancer? Aren’t they mostly grazing their cattle?”

      1. You cleverly failed to take notice of the words “boiled & “steamed”. Lower temperatures reduce the carcinogenicity by 5-10 times, it’s like eating a tablespoon of burger versus a cup of burger. So that’s huge, and…

        “the few differences in composition of grass-fed/wild animal tissue ”
        FEW differences?

        you can find multiple agencies verifying these MANY facts:

        five times the vitamin a
        four times the vitamin e
        triple the omega 3s
        half the saturated fat
        double the b vitamins
        1% the e. coli

        https://m1.behance.net/rendition/modules/51783461/disp/0cc4e2332f16bed8975c99d0c325736d.jpg

        put that in your pipe and smoke it

        1. and until the results are replicated with even fried burgers, you can’t say one study is conclusive. it’s suggestive sure, but to say it’s conclusive, that’s jumping the gun.

      2. http://grist.org/sustainable-food/in-argentina-factory-farms-replacing-grass-fed-beef/

        It says they eat 219lbs per capita per year, compared to the USA’s 89lbs. So nearly three times as gluttonous.
        It also says they export and import lots of beef, suggesting they import grain-fed
        And obviously it says the trend is its way out, so you can’t rely on statistics since 2010 about cardiovascular mortality stats there. So no, they aren’t mostly grazing their cattle, and your quotation proves nothing.

  19. So if I understand this video and the comments combined, then it is not a good idea to add animal protein to rice because the insulin goes too high and increases the chances for future insulin resistance. But if you do not have the animal protein with the rice, then your sugar level will go higher than if you did have the animal protein– isn’t higher sugar level also bad? (And what happens to sugar and insulin levels when the rice is mixed with a plant protein source like beans?)

    1. Hi Gnut, I am having a hard time following your question. Let me know if my response helps? From what i understand the carbohydrates alone spike insulin levels (this is normal as we need insulin to usher glucose into cells) When animal protein was increased, even greater spikes in insulin was seen. So yes, you are right, in this study adding animal protein to rice or potatoes increased insulin levels more than what would happen if you ate the carbohydrate alone. The study did not look at plant-based proteins, however, Dr. Greger has tons of videos and information within the Doctor’s Note section pointing to studies that track plant-based diets and diabetes.

    1. Hi thankyou (cute username!),

      Your guess is correct – addition of protein and fat does blunt the immediate sugar spike, but exacerbates the spike in insulin. These phenomena are inversely proportional. You can see plots of both in the Gulliford paper (free access: http://www.ncbi.nlm.nih.gov/pubmed/2679037). It seems conventional medical advice has been relying on the reduction in blood sugar response as the best way to treat diabetes, however we know that this conventional treatment results in type II diabetes being categorized as an incurable chronic disease. Whereas an approach focusing on minimizing the insulin response (i.e. low fat vegan diet) is shown to reverse the disease.

  20. Can we assume then that a non-dairy ice cream would cause less of a sugar “crash” than a dairy ice cream with the same amount of sugar?

    1. Interesting question. Not sure at all :) Maybe not. Perhaps it is something in the fiber of plant that helps slow blood sugar spikes.

  21. Thank you for this great presentation Dr Greger! The figures on the 03:55-04:08 and the Glucose challenge with the added meat at the 04:24 mark had such relevance personally, as these sugar spikes are exactly what I had daily when I was consuming animal protein as well as rice a few years ago. Since I’ve switched to the Plant based whole food diet no animal protein , dairy or sugar I am able to consume white rice without the sugar-spikes but I limit it to one serving per day.
    The best part of all of this is the quality of life that I have now without the 11:00am/2:00pm sugar spike and mood swings, which also came with the sense of lethargy . Now my energy level is consistent throughout the day. It took about 4 -5 months to see the positive effects but it is truly worth it.

    1. Hi vegank, so can you speak to what so many people are curious about on this thread regarding starch plus meat vs starch plus beans? Do you have any numbers you could share? Apologies if too intrusive. Also congrats on your improved quality of life. Comments like these are always my favorite.

      1. Hi b00mer, unfortunately I don’t have any numbers. I was consuming meat /fish/chicken I usually had white rice as an accompaniment until about 2 years ago when I decided to go on a vegan diet.
        How I discovered that I felt much better without the animal protein/white-rice combination was by chance, i.e. when I went through an elimination process by switching first to a traditional vegan diet, followed by Plant based whole food when I discovered this website 5-6 months ago.
        I began to replace white rice/bread/pasta with whole food eg. sweet potatoes. By this time I had a glucose meter and was able to see the positive effects in numbers. The sugar spikes accompanied by lethargy and irritability has recently disappeared almost completely. As I previously mentioned it took about 4-5 months, mainly because I was going through a learning curb but I also wonder if there is a scientific reason behind the length of time it takes. I figured that I was eating the wrong way for decades so it stands to reason that the body needs time to adjust before it can improve.
        The tunnel vision / slight nausea I used to feel when I became hungry also lessened down to about 1 in a scale of 10. I think I was edging towards Type 2 diabetes before I switched to the plant based whole food diet even without sugary drinks and junk food .
        Seeing this video (white rice & diabetes) was not only an Ah-ha ! moment but helped me to make sense of the science behind my “before & after” experience.
        Having access to really good recipe books also helps to stick with it. My favorite is ” the Oh she glows cook book” and her Blog , and also what is known as the Shojin style cooking developed over the centuries by monks in Japan who eat vegan. They use the natural taste and textures of plant based food to create appetizing yet clean food.

        I don’t usually post a lengthy comment but just thought I’d mention my experience so that anyone finding it difficult to get used to or see the benefit of going plant based whole food will find the motivation to persevere for a few months, until the positive changes begin to show. I had the Type-2 diabetes like symptoms for 10-15 years but now I am able to manage it and have a lot of energy.

  22. Can any 1 help, i have hade my cholestrol checked. They said the total value was, 4,3 and it was good. But i saw some videos of the dr saying that it should be 150 MG, maybe the wrong cholestrol cheked??

  23. What about eating tofu with white rice? Would tofu, as a protein and fat, increase the insulin response and increase the risk for diabetes?

  24. Does the same thing happen with non-animal proteins, such as tempeh or tofu? Also, someone below talked about oils/fats and rice. I know that many stir fry recipes use oils (coconut, sesame etc), so I wonder about that too. Can anyone clarify? Thanks!

  25. Interesting, but I would like to see a study confirming that this is truly an anti-synergistic effect and not merely an additional effect (i.e. could protein raise insulin on its own without any glucose involved?).

    1. Sorry, Treacle234. All of the citations can be found in “Sources Cited” it may be best to find them there. Dr. Greger compacted much information into one video, as he mentioned in the “Doctor’s Note” under the video. I suggest reading and watching those videos as well.

  26. God. This makes everything so confusing. If we eat a straight carbohydrate then our blood glucose levels spike. When blood glucose levels spike, a resulting spike of insulin pursues. If we mix the carbs with fats and protein then our blood glucose levels don’t spike. You would think that our blood insulin levels would not spike because our blood glucose levels didn’t, but this is saying that even though our sugar levels might not spike with the addition of fat and protein, out insulin levels still spike, and they actually spike even greater than if the carbs were eating alone! This makes my head spin :(

  27. I posted this on my Facebook…I knew of protein and starches back in my 20’s…let see now knew that 45 yrs ago…OMG 65…must be the good living and yes I do prepare my own meals…thanks again for this information I read years ago in “Prevention” a monthly magazine I do believe is still in circulation….old articles are new information to the youth of today…NutritionFact keep telling people…Let food be your medicine and your medicine be your food….

  28. Does the combination at a specific meal matter…at the time of consumption (rather than diet overall)? IE for friends w a diet including meat, is it better to eat the meat alone & carbs alone? I’m also curious about the “is it protein or animal protein” question posed above

  29. What about the incidence of radiation exposure in the last 50 years……especially in…..Japan for instance??? How sensitive is the pancreas to radiation exposure?

  30. Hope you’re all sitting down….Can’t the whole problem can be avoided by simply not eating the carbohydrate? Eat the clean protein and good fat instead with lots of non starchy vegetables. Much more satisfying, blood sugar stays more even.

    1. Eating meat (beef, salmon) induces a larger insulin spike than carbohydrates (oatmeal, pasta, apple):

      http://nutritionfacts.org/video/paleo-diets-may-negate-benefits-of-exercise/

      A low fat high carbohydrate diet actually reverses diabetes, meaning that a person can eat plenty of carbohydrate and process it efficiently and properly due to improvement in insulin function.

      Whereas simply preventing the introduction of carbohydrates into the bloodstream, as in low carbohydrate diets, is externally managing a symptom of the disease itself – insulin malfunction – instead of addressing and fixing the problem and allowing the body to heal and regain function. In eating a very low carbohydrate diet, one remains in a diseased state, with the body incapable of processing carbohydrate.

  31. I have read many places that brown rice, even organic brown rice, has high levels of arsenic. This is why I’ve switched to white rice, even given the knowledge that whole grains are better. In this case, might it be more healthful overall to consume white rice? I’m trying to weigh the risk/benefits. I would appreciate your input.

    Thanks,
    Caroline Kahn

  32. i love videos like this! But what i don’t understand is why is data from India not used? Esp south India where I grew up has the largest vegetarian almost vegan (no cheese or paneer consumed here, ghee , yogurt n milk are the animal products consumed here) populations (millions!). But all my grandparents have DM2. I lost my grandma who had to use insulin everyday to complications of DM2 and she never touched meat or was any where near it her whole life (its a very religious thing). i am on this diet n i avoid all forms of animal products but i am always puzzled by this esp after i watch vids like the recent flexi tarians (sorry exact name escapes me) where it discusses DM2 risk lowered even if they yo-yo between eating and avoiding meat??

  33. Very surprising and interesting research! I was diagnosed as being pre-diabetic 20 years ago and was told to eat protein every couple hours to avoid sugar spikes. The hospital registered dietician suggested that i eat lots of peanut butter and cheese!!! To say that i never consulted that RD again is an understatement. I have been researching lately switching from an animal to a plant based diet but was concerned about my sugar levels not staying level during the day due to reduced amount of protein from legumes and nuts. Could you please addres my concern? Thanks

  34. Is it the fat (from animal products) or the animal protein that is causing the spike?

    If i remember correctly i have seen a previous vid illustrating that adding fats does that!

    confused.

  35. Makes total since. What I remeber studying a few years ago (I believe in guyton and hall-physiology textbook) amino acids stimulate insulin secretion once absorbed or entering the small intestine because insulin is required for protein synthesis and delivery into cells. So carbs plus protein double whammy on the insulin spike. Now the question is…which amino acid may cause a higher spike? Since we’re talking about animal protein and not plant proteins, aspartate, alanine, lysine, Leucine, carnitine? Let’s not forget growth hormone being stimulated along with insulin when we eat these proteins as well. Food for thought :)

  36. So another interesting angle would be to show the insulin spike pattern of eating meat alone, compared to the meat and carb shown in this video.

  37. We know that the addition of fat can cause a rise in blood sugar from the ingestion of glucose. Is it clear from this study that it’s really the protein itself and not the fat that is making the difference? Couldn’t it be the fat in the animal products instead of the protein? How do we know it’s the protein?

  38. This would be for the Doctor…or anyone who knows how to research this piece from the ‘Blamestream Media’ ;)
    A friend recently sent me this link – an article on cutting edge science at work. It talks about cooking rice in coconut oil to cut the calories in half! I’m baffled by even the suggestion that this is possible, but the article reports that…’Science says!’ Feedback on this much appreciated: http://www.washingtonpost.com/blogs/wonkblog/wp/2015/03/25/scientists-have-figured-out-a-simple-way-to-cook-rice-that-dramatically-cuts-the-calories/?tid=sm_tw

  39. So whole grain pasta or brown rice are okay with some oil, right? We’re just talking about the processed white stuff being bad with oil?

    1. White rice is still okay, but brown has more nutrients and is considered a whole gain. Oil is not needed, but if you insist on using a bit a little can go a long way.

  40. so what about “eating meat alone and insulin secretion levels” ? you have to add it there before.
    and you just seperate them in the moring eat meat – on midday eat rice ?

  41. https://www.youtube.com/watch?feature=player_embedded&v=coUlGtAqmNg
    100 gr carb vs ( 50 gr car + 50 gr protein) vs (50 gr carb )vs (5 gr carb )

    food combin. | ins spike ( apprx ) (max is 100)
    100 gr carb | 88
    ( 50 gr carb + 50 gr protein) | 87

    say , you got a bowl rice ( 100 gr) . if you add 50 gr meat( 10 gr prot).
    plate before = 100 gr rice
    plate after = 100 gr rice + 50 gr meat = 150 gram food.
    wow what happened. you increased total gram of what you eat. you better expect this.

    the point is if you add meat you gotta remove same amount of carb.

    if total grams in the plate stayed 100 gr . that wouldnt have happened to chinese
    its give and take.

    1. Probably. I have tried red rice before, but I am unsure it’s nutritional content. I suppose it’s more like brown rice, very fibrous! Black rice, brown, red, all great choices.

  42. That was great loved it. Too much shaming about CHO caused hyperinsuleamia when protein based foods can be a main contributor to a greater insulin spike.

  43. Coles Notes:

    White Rice is a simple carb – Large insulin response
    Brown Rice is a complex carb- Moderate insulin response
    Protein foods like beef, chicken, fish – Low insulin response (no sugar to quickly convert to glucose)

    Combine rice with protein to slow down the insulin response.

    Don’t combine rice with fats like olive oil or coconut oil or butter, even though fats blunt the insulin response. Fact is, insulin still secrets and the fat has to go somewhere. Insulin promotes storage so fat can and will be stored.

    Proteins and rice (or carbs in general) is the golden rule to follow.

  44. The instance of diabetes has increased in asian over the past 2 decades and that’s because of the western diet being introduced there… mcdonalds, sugary drinks like starbucks, and pasta places.

    A typical asian diet only consumes small amounts of rice, very very small. Small amounts of white rice will not harm a healthy person. A westernized asian diet still consumes small amounts of rice, but not may include crap from mcdonalds that’s inundated with carbs then washes it down with a sugar ladened vanilla latte from starbucks.

    Many of the studies that revolved around comparing asian cultures.. compared them to ones living in asia vs the ones living in the west. Turns out (big surprise) the ones living in the west had a much high instance of diabetes.

  45. How do we know that it is the protein consumption and not the fat? (The animal fat and the increased use of vegetable oils?) Dr. Douglas Graham talks a lot about the link between fat consumption and insulin regulation in The 80-10-10 Diet. Or perhaps it is both? Thanks for any help.

  46. This video is not really contradictory to Kempner’s Rice Diet, as long as one sticks to eating veggies and not adding protein. Some recent modifications to the Rice Diet (“to make it more palatable”) may find application here. Oh, yes…..no olive oil on those veggies now, either.

  47. Are we totally sure the animal protein was to blame? Was the experiment with insulin spikes done with plant protein as well? This would have been great in order to determine what to blame.

  48. Hello Dr.Greger

    I wanted to know if Brown rice was still healthier compared to white rice with the arsenic. I want to know if it’s ok for my 22 mth old son to have Brown rice although it has more arsenic?

    1. Levels of arsenic in rice may not be as high when compared with other foods. Dr. Greger has some great resources on food and arsenic. ​He also compared arsenic levels of wild rice to brown rice in this Ask the Doctor Q&A.​ In short, I think it’s okay to still eat rice but mixing up whole grains is key and taking steps to reduce arsenic seems appropriate. For example, by rinsing the rice and cooking with excess water can help lower arsenic levels.

  49. This is really fascinating.
    I’d like to know more because the data seems to be framed in a certain way to lead us to foregone conclusions … and that is …

    You show us the graph of insulin over time with high sugar and carb.
    Then you show the graph with meat added and the spike is higher.
    What about just the meat alone?
    If the meat alone is less than it would be with added sugar, it changes the nature of the data.

    Why is it that kids naturally seem to like to eat things alone?
    That is what we used to do in the primitive times … we did not add everything together and put a cherry on top, we went over to the apple tree and ate an apple, then over to the lettuce patch and had some lettuce. Then the men came back with the meat and we ate that.

    Why is that not just as good of an interpretation of the data or challenge to the data as the explanation given here?

  50. omg :( I always try to combine some protin with my carbs to supposedly try to make the insulin spike less severe.But wait.. COmbining lowers blood sugar but raises the insulin spike? Is that a problem? I dont get it. Does combining DO reduce blood sugar spikes as I’ve been egularly told?

  51. Augh Nutrition information is all over the place. Im going to have to experiment on my own and spend a year reading nutrition papers and textbooks. Sigh. I LOVE white rice with some salt and a little olive oil. I generally use brown but a week ago I tried white.. and I went culinarily NUTS. I love it and crave it. Im going to be the anti-christ here but I love eating it with bean & tuber stew and stewed chicken.. omg its amazing XD Its basically the traditional food eaten in my country.

    I dislike vegetables a lot, I wonder if there is any real, hard evidence of its supposed benefits. Are vegetables proven to be this big of a deal healthwise? Im looking at the vegetable filled heart illustration to the right of this website and I cant help but think I dont want to eat any of it! Vegetables are these things I force myself to eat. I only like very tender greens that are recently harvested, or the ones used for flavoring like rosemary, mint, oregano, etc. I hate brussel sprouts and lettuce the most. Yuck!

  52. Has any clinical study compared a wholefoods diet WITHOUT vegetables with a whole foods diets with vegetables? Or at least a diet pattern high in wholefoods without vegetables with one with vegetables? Its the only way to know for sure if these unsavory green things give helath benefits or not. Because if they dont, or the benefit is marginal.. why would I make myself eat them!

  53. “The fact the cohorts used to determine this study’s conclusions (BMJ published meta analysis) failed to consider incredibly relevant diabetes confounders like family history of diabetes, socioeconomic status, and dietary consumption patterns, including the dietary consumption of other categories of refined grains, makes quantifying the effect on diabetes development due to white rice consumption from this data set impossible.

    And yet it was published in the BMJ?”

    At the end of the press release it says this: “In an accompanying editorial, Dr Bruce Neal from the University of Sydney suggests that more, bigger studies are needed to substantiate the research hypothesis that white rice increases the chances of getting type 2 diabetes.”

    But then the title says: “White Rice Increases Risk of Type 2 Diabetes”

    Im understandably upset at this.

  54. Does that mean that diabetics should cut down on all carbohydrate intake? I recently brought my grandmother to a diabetes dietician in a local hospital in Singapore and that is what they recommended. That being said, the dietician didn’t seem to be very credible, she didn’t even know that strawberries and cassia cinnamon act as sugar regulators.

    1. I don’t think diabetes need to cut down on all carbohydrates. From the research I was a part of with Dr. Barnard, study participants received either a low-fat vegan diet or a typical diet for diabetes and found significant changes in weight loss and insulin levels. Dr. Greger presents the study in this video and it’s a higher carb diet, but the difference is we used unrefined carbs (beans, brown rice, oats, veggies, fruits, etc). Also, I suggest watching the first two videos from this link to explain better. Let me know if that helps?

    2. I don’t think diabetes need to cut down on all carbohydrates. From the research I was a part of with Dr. Barnard, study participants received either a low-fat vegan diet or a typical diet for diabetes and found significant changes in weight loss and insulin levels. Dr. Greger presents the study in this video and it’s a higher carb diet, but the difference is we used unrefined carbs (beans, brown rice, oats, veggies, fruits, etc). Also, I suggest watching the first two videos from this link to explain better. Let me know if that helps?

  55. Informative video. In India there is a common practice of consuming curd rice, so even curd (animal protein) will have same effect on insulin???

  56. seems to me the increase in type 1 (the more interesting stat) and type 2 is due to the increase in western processed foods, rice has nothing to do with it. brown rice has shorter shelf life and higher arsenic.

  57. I’m just wondering, is there any study out there that would test this observation with Non-GMO Rice + Non-GMO meat versus a GMO pair?

    1. Hi Jef, Many people are under the false impression that protein (in particular animal protein) doesn’t raise insulin levels but in fact the amino acid alanine (which is found in animal protein) stimulates insulin production. I read this several years ago and I just did a search to see if I could find the article where i read it but I couldn’t find it. In any case if we presume it’s true that supports the findings discussed in this video.

  58. In the video called “What causes diabetes?” Dr. Greger says that it is saturated fat impairing beta cell function and insulin sensitivity that causes diabetes. In another video, he says the intramyocellular lipid and lipid toxicity. Dr. McDougall claims that he has been reversing diabetes with his starch based diet, not to mention the results of Kempner diet… So is it also continually spiking insulin what can cause diabetes, as some of the keto / paleo proponents say? Doesn’t this speak in favor of limiting one’s (high gi) carb intake? Thanks for any answers and clarifications!

    1. Miroslav Kovar: It seems to me that all of your first sentences are saying the same thing in different ways. Insulin *in*sensitivity *is* T2 diabetes, which is caused by too much fat, especially saturated fat, getting into the cell–ie: intramyocellular lipid (meaning fat getting into the cells). Both Dr. McDougall’s starch diet and Kempner’s diet (a severely limited form of the starch diet) are low fat diets. All of these statements and claims are part of a consistent explanation of what causes T2 diabetes.
      .
      The keto/paleo people are confusing a symptom of T2 diabetes with the cause. It’s not a bad idea to stay away from sugar and other foods high in refined carbohydrates, which are unhealthy for a number of reasons, including that they spike insulin levels in unnatural ways. But that doesn’t mean that those foods *cause* diabetes. Did you know that Kempner’s diet included sugar when people needed more calories?
      .
      Does that help?

      1. Thank you Thea, this does help. My question really was: does chronic rapid insulin spiking contribute to the development of T2 diabetes? From what I understand, it does, at least because body reacts to these rapid spikes by dumping fat into the bloodstream, as Dr. Greger put it in one of his videos. I wonder however if there is some truth to the analogy that “beta cells can become “tired” from working overtime” (as I heard from some rather untrustworthy sources)?

  59. Grains also make conditions like sibo and ibs worse, as they feed the good and the bacteria. What can someone with sibo do to consume grains.

  60. Did I miss where they compared adding tofu to rice and the insulin surge it produces? I just saw rice (or potatoes) alone and then with added animal protein.

  61. Hi

    Just a quick question. At around 1:30 there is a table showing the risk of Type 2 Diabetes with different subtypes of grain. White rice is highest at 1.23. But that’s at one serving per day. Brown rice is 0.87, but at 0.5 servings per day. So I’m guessing at one serving per day brown rice would be 1.74. Significantly higher! I’m sure I’m missing something obvious, but not sure what… Can anyone explain?

    Many thanks

  62. Doesn’t seem as if people are writing in these comments any more, so I don’t think either of us are likely to get a response Michelle; which is a shame :(

    In fact, the same goes for the couple of comments before mine…

  63. Hi Lola, Dr Greger indicates ,Yes, brown rice is better than white rice, but to stop the mounting Asian epidemic, maybe we should focus on removing the cause–the toxic Western diet. That would be consistent with data showing animal protein and fat consumption associated with increased diabetes risk.

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