Lifescience Promoting Association, Daikyo-cho 25-3-1004, Shinjuku-ku, Tokyo 160-0015, Japan; Asia Pacific Clinical Nutrition Society (APCNS), Department of Food Science and Nutrition, Zhejiang University, 866 Yu-Hang-Tang Road, Hangzhou 310058, ChinaChina
Also available as PDF (figures and tables appear in the PDF).
When I visited Bangkok in Thailand about five years ago, I saw the label “medical rice” on a package of ‘diabetes and health promotion’ rice, and I was hopeful that the concept could be widened beyond Thailand. On December 10-12, 2014, the “East Asia Functional Standardization of Rice Conference” was held at Kyoto Research Park to promote the idea among related countries. Since then, I am considering what is “medical rice”.1 To say ‘medical rice’ we need evidence from human studies. We have learned of the health effects of unpolished brown rice, genmai in Japanese, from Japanese history. Sagen Ishizuka (1850-1909) was a pioneer doctor in the Imperial Japanese Army who proposed the concepts of shokuiku (eating education) and the macrobiotic diet. He was one of the first to investigate the nutritional value of whole grains as well as kelp, radish, and kudzu.2 In Kenji Miyazawa’s famous poem “Unbeaten by rain, Unbeaten by wind”, his daily intake “With a handful brown rice a day, miso and a small amount of vegetable suffice” was confirmed to contain all necessary daily nutrients by our recalculation.
OpenJournal PUBLISHERS Editorial Rice Function for Disease Prevention and Establishment of Medical Rice Association 1,2* Shaw Watanabe, MD, PhD1,2* 1Lifescience Promoting Association, Daikyo-cho 25-3-1004, Shinjuku-ku, Tokyo 160-0015, Japan 2Asia Pacific Clinical Nutrition Society (APCNS), Department of Food Science and Nutrition, Zhejiang University, 866 Yu-Hang-Tang Road, Hangzhou 310058, China * *Corresponding author Shaw Watanabe, MD, PhD Lifescience Promoting Association, Daikyo-cho 25-3-1004, Shinjuku-ku, Tokyo 160-0015, Japan; Fax: +81-3-5379-7786; E-mail: watashaw@lifescience.or.jp Article information th th rd Received: March 26 , 2019; Accepted: March 27 , 2019; Published: April 3 , 2019 Cite this article Watanabe S. Rice function for disease prevention and establishment of medical rice association. Diabetes Res Open J. 2019; 5(1): e1-e3. doi: 10.17140/DROJ-5-e013 hen I visited Bangkok in Thailand about five years ago, I saw had a good lifestyle with a low risk of illness. In addition, brown the label “medical rice” on a package of ‘diabetes and health rice eaters showed healthy bowel movements, which suggested a W promotion’ rice, and I was hopeful that the concept could be wid- good intestinal environment.
ened beyond Thailand. On December 10-12, 2014, the “East Asia Functional Standardization of Rice Conference” was held at Kyoto Re- Actually, brown rice eaters showed abundance of Fermi- search Park to promote the idea among related countries. cutes and low relative abundance of Fusobacterium in the intestinal microbiota at the phylum level. Abundance of microbiota at spe- Since then, I am considering what is “medical rice”.1 To cies level showed a rich Faecalibacterium prausnitzii (5.28%), and then say ‘medical rice’ we need evidence from human studies. We have Blautia wexlerae (3.67%), Fusicatenibacter saccharivorans (3.41%), Me- learned of the health effects of unpolished brown rice, genmai in gamonas funiformis (3.35%), Collinsella aerofaciens (3.21%), and Bacte- Japanese, from Japanese history. Sagen Ishizuka (1850-1909) was a roides vulgates (3.12%).6 They belong to Fermicutes phyla and butyrate pioneer doctor in the Imperial Japanese Army who proposed the producing bacteria. Butyrate is the preferred energy source for the concepts of shokuiku (eating education) and the macrobiotic diet. colon epithelial cells, and contributes to the maintenance of the He was one of the first to investigate the nutritional value of whole epithelial barrier functions of intestinal mucosa, and has immu- 2 7 grains as well as kelp, radish, and kudzu.2 In Kenji Miyazawa’s fa- nomodulatory and anti-inflammatory properties.7 Blautiais consid- mous poem “Unbeaten by rain, Unbeaten by wind”, his daily intake ered to control the intestinal immunity. Dietary fiber in brown rice “With a handful brown rice a day, miso and a small amount of vegetable seems to be the most important factor, but other ingredients could 8-10 suffice” was confirmed to contain all necessary daily nutrients by our influence bacterial co-existence.8-10 Then, Bifidobacterium adolescen- recalculation.3 tis (2.35%) and B. longum (1.92%), Bacteroides uniformis (2.22%), B. plebelius (1.96%), and B. dorei (1.71%), and Akkermansia muciniphila We thought that it was necessary to clarify the actual (2.16%) were followed. Brown rice eaters, compared with the white health effects of brown rice diet by a well-designed epidemiologi- rice eaters, showed less Actinobacteria (12.1 vs. 8.5% p=0.078) and cal study, so we started GENKI study (Genmai Evidence of Nutri- Fusobacterium (1.6 vs. 0.018%, p=0.011). These are pathogenic in 4,5 tion for Kenko (health) Innovation).4,5 There are 1,223 participants intestinal conditions.
from groups promoting a brown rice diet. Brown rice eaters show lower body mass index (BMI) in men and women at all ages. The So, brown rice could be considered to be typical medical 2 2 1 average BMI in males was 22.0±3.2 kg/m2 and 20.7±2.8 kg/m2 in rice by contributing to healthy life.1 Organic brown rice contains females. Dietary habits consisting of brown rice, rich in vegetables, many functional ingredients, such as γ-aminobutyric acid (GABA), and avoidance of meat seemed to support healthy life and quality γ- oryzanol, ferulic acids with high antioxidant function, in addi- of life (QoL).4 Obese people were more likely to eat white rice and tion to the dietary fiber. The wax-free brown rice is made to im- had a high risk of lifestyle-related diseases, such as diabetes and hy- prove palatability by scraping the surface wax layer from rice grain. pertension. On the contrary, brown rice eaters were less obese and Wax free brown rice contains almost all nutrients of brown rice. cc Copyright 2019 by Watanabe S. This is an open-access article distributed under Creative Commons Attribution 4.0 International License (CC BY 4.0), which allows to copy, redistribute, remix, transform, and reproduce in any medium or format, even commercially, provided the original work is properly cited. Diabetes Res Open J. 2019; 5(1): e1-e3. doi: 10.17140/DROJ-5-e013 Dietary fibers remained the same as in brown rice, although water- not be shared among various institutes. Long-term large-scale in- soluble fiber seemed to be more easily dissolved than insoluble tervention studies have not been conducted for epidemiological dietary fiber during boiling.
purposes in which humans are at the center of control, and human clinical studies are insufficiently carried out only for the application From wax-free brown rice a low protein brown rice has of supplements.
11-13 been produced. The protein in rice is stored in two different types of compartments. The major proteins are prolamin and glu- Integration of these knowledges under the recently es- telin. Prolamin is the alcohol soluble protein that remained after tablished Medical Rice Association by researchers, rice-processing salt extraction of globulin. Glutelin is the dilute-acid or dilute-al- industries, farmers and consumers could produce great energy for kaline soluble protein after prolamin extraction. Most of the pro- building a healthy society.19 Researchers, farmers, and distributors lamin is present at the periphery in whole rice grains, so prolamin in Japan were able to establish the association with the purpose of could be easily removed by the enzymatic digestion on polished constructing and computerizing the evidence of the fragmentary white rice, but it has been difficult to remove from brown rice research, and disseminating it widely to the society. With the coop- directly. Removal of the wax layer made it possible to immerse eration of producers and consumers, standardization of medical the enzyme solution beneath the bran layer. Removal of rice pro- rice should enable disease prevention with diet-based evidence for tein yielded low protein brown rice (LPBR) which is beneficial for health. Within the association, there will be a research grant com- chronic kidney disease patients.11 mittee and a function evaluation committee, and we hope to foster young researchers in this field.
Medical rice for chronic kidney disease (CKD) should contain enough energy source and low protein, as well as low Rice is the main staple food for approximately 70 percent potassium and phosphate. Reduction of these minerals is a great of the world’s population, mainly living in ten areas of the Asia- benefit for CKD patients, because hyperkalemia and hyperphos- Pacific region. In many countries, rice contributes to overall better phatemia are often difficult to avoid when eating meat.14 Distinct health by supplying dietary energy, protein and fat. It accounts for mechanisms of low protein diet for CKD patients are identified, more than 50% of the diet in Bangladesh, Myanmar, Lao People’s such as improvement of hyperphosphatemia and hyperkalemia, Democratic Republic, Vietnam and Indonesia.13 The high preva- decrease in urinary protein, improvement of subjective symptoms, lence of diabetes among polished white rice eaters has become prevention of complication, and good control even after the in- well-known. Rice with high amylase with a low glycemic index (GI) troduction of hemodialysis for better survival. Protein overload may be used to prevent diabetes, and high GABA containing large promotes glomerular hyper-infiltration which causes prefibrotic germ rice could contribute to mental health. In this regard, the nu- effects. Recently, the therapy of CKD targeted at reducing hyper- tritional aspects of brown rice should be re-evaluated, and further 20,21 filtration within the glomerular capillaries by using the angiotensin development should produce wonderful medical rice.
converting enzyme inhibitor or angiotensin receptor blocker to dilate the glomerular arterioles.15 Other classes of diabetes medi-