Can the Diabetes/Cardiovascular Disease Epidemic in India Be Explained, at Least in Part, By Excess Refined Grain (Rice) Intake? (Editorial‪)‬

The prevalence of chronic non communicable diseases (NCDs) is now reaching epidemic proportions in the developing countries. Indeed, India already has the highest number of diabetic patients in the world (50.8 million) and this is projected to increase to 87 million by the year 2030 (1). Indians have an increased susceptibility to diabetes which can, at least partly, be explained by genetic factors (2). However, genetic factors alone cannot explain the rapid rise in diabetes prevalence in urban India within a period of three decades (3). This strongly suggests the role of environmental factors. Economic progress is inevitably associated with increasing urbanization. In addition to several features of urban life such as physical inactivity and unhealthy dietary practices, outdoor and indoor air pollution tend to increase the prevalence of diabetes and cardiovascular disease (CVD) also in urban India (4). The association between physical inactivity and obesity and the prevalence of diabetes has been established (5,6).