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According to an eminent diabetes expert, white rice is one of the root causes of Malaysia’s rocketing obesity figures, which are fuelling the country’s diabetes crisis. The trouble is that healthier alternatives, such as brown rice and low-carb noodles, are not catching on just yet in Malaysia, and nor are they, for that matter, in other Asia Pacific countries. Public health needs do not automatically translate into consumer demand, and a push from the industry will be needed to open up these markets to healthier alternatives and curb the virtually exclusive reign of white rice.
In May 2014, the prestigious British medical journal The Lancet published a new systematic analysis on overweight and obesity involving 188 countries, which identified Malaysia as the most “obese country” in the Asia Pacific region. According to the new data, 48.6% of Malaysian women and 43.8% of men are either overweight or obese. For comparison, in neighbouring Indonesia, the incidence is 30.6% and 21.4%, respectively, whilst it is 39.7% and 32.1% in Thailand.
Excess body weight is the number one predisposing factor for type 2 diabetes, and Malaysia’s prevalence is high: 11.5% of the population aged 20-79 years has type 2 diabetes, compared to a global average of 8.4%, which roughly coincides with the incidence in Asia Pacific overall. In fact, only Singaporeans have higher diabetes rates than Malaysians in Asia Pacific. Incidentally, the US, which continues to lead global overweight/obesity charts, is slightly behind Malaysia, with a diabetes incidence rate of 11.0%.
In an interview for FoodNavigator-Asia in July 2014, the President of the Malaysian Endocrine and Metabolic Society, Professor Dr Nor Azmi Kamaruddin, stated that white rice, rather than the array of “junk foods” popular in the West, was one of the major culprits responsible for Malaysia’s soaring obesity rates. He cited several studies backing up his conclusion, adding the widely-known fact that white rice scores almost as highly on the glycaemic index scale as sucrose.
Malaysians do seem to eat a lot of rice. Euromonitor International packaged food data shows that Malaysian per capita consumption of (dried) rice (retail and foodservice combined) is the second highest in the world, at 51.3kg in 2013, behind Hong Kong’s 55.2kg. South Korea follows in third place, whilst Indonesia ranks fifth with 39.9kg. Japan finds itself in eighth place, at 33.6kg per capita. The average Thai person consumes 16.2kg, whilst the Chinese (excluding Hong Kong) eat a rather abstemious 10.9kg on average.
In line with other diabetes specialists, Dr Kamaruddin is a proponent of the low-GI diet, revealing that his team is developing low-carb noodles and other low-GI foods to wean Malaysian consumers off white rice.
Professor Dr Kamaruddin may have quite a battle on his hands, as Euromonitor International health and wellness data shows that there is virtually no market in Malaysia at present for BFY reduced carb packaged food. Nor is there any appreciable uptake of naturally healthy high fibre rice, ie unpolished brown rice, which retains the hull, bran and the germ parts of the grain that are rich in vitamins, minerals and fibre. Brown rice also has a lower glycaemic index than white rice, making it a more suitable choice for diabetics.
Like in Western countries, where soft white bread was once a highly desirable, “aspirational” product compared to the coarse brown bread eaten by the lower classes, white rice has won out across Asia Pacific, where brown rice was once widely consumed, but regarded as “food for the poor”. In Europe, North America and Australasia, the nutritional superiority of dark wholegrain breads started to be valued from the 1970s onwards, and the trajectory towards NH high fibre products continues to this day. Across most of Asia Pacific, however, brown rice has not yet managed to make a successful comeback.
Euromonitor International data shows that only around half of NH high fibre rice sold in 2013 (retail volumes) was accounted for by sales across Asia Pacific, while 35% (174,000 tonnes) were shifted in North America and Western Europe, where rice counts as, at best, a tertiary carbohydrate staple behind bread and potatoes. Health-conscious Japan emerged as the single biggest country market for NH high fibre rice in 2013, garnering 41% of global retail volume sales.
Clearly, Malaysia is not alone in its reluctance as far as wholesome brown rice consumption is concerned. There is not yet an appreciable market for the product in China, Indonesia, the Philippines and South Korea either.
Soaring obesity and diabetes levels in the region cannot be ignored forever. Their detrimental impact on economic activity and the burden they constitute on healthcare systems as well as on families, particularly in countries where no public healthcare coverage exists, are just too great.
A considerable investment in consumer education is going to be required in order to make foods like brown rice and low-carb noodles not just acceptable, but desirable in markets where a large number of consumers still only have a hazy idea of the link between diet and chronic disease.
Merely making these products available because there appears to be a pressing need for them – in the Malaysian case, to help manage diabetes – is not enough to create actual consumer demand. The responsibility for disseminating appropriate information cannot be carried by governmental public health bodies and poorly funded not-for-profit institutions alone. The industry also needs to do its share.