Understanding rice preferences and awareness of brown rice among persons with diabetes: A mixed methods study from South India

Polished white rice (WR), high in refined carbohydrates, the main staple in South India is associated with enhanced risk of diabetes. Brown Rice (BR), with lower glycemic load, high fibre content and micronutrients, is a healthier choice. Two hundred and twelve Persons with Diabetes (PwD) attending a tertiary diabetes care centre in a city in South India responded to a questionnaire documenting types, frequency and reasons for rice consumption, awareness and beliefs about BR. A sub-set of 10, participated in qualitative interviews, which additionally, explored the influence of traditional beliefs on and consumption patterns of rice, barriers to BR consumption and willingness to accept it in their diet. Ninety-three percent reported consuming WR with traditional usage (97 %) being the main reason for its preference. Brand image, grain size, texture and taste, of rice were other decisional considerations. Awareness about health benefits of BR was limited, with 69 % and 51 % believing it to be nutritious and helping to reduce blood sugar respectively. Appearance, texture, taste and cost were deterrents to its use. Over half agreed to switch to BR if they believed it would improve their health. Participants with a shorter duration of diabetes were more willing to change to BR. The study highlights the need to promote greater literacy regarding health benefits of BR and other forms of less polished rice. Larger trials examining the effectiveness of BR viz-a viz other types of less polished rice on blood glucose levels, metabolic factors and nutritional content among PwD are needed.