Table 1.

Summary of Epidemiology Studies on Rice Consumption and Human Health Outcomes.

End Points	No. of Studies	Sample Sizes	Exposure	Consideration of Water Arsenic	Direction of Association	Summary of Findingsa	References
Cardiovascular Disease and Hypertension
Blood Pressure	5	N = 41,541; N = 1,879; N = 2,209 (1,164 boys, 1,045 girls in Song et al. 2015); N = 683; N = 12,609	White Rice, Brown Rice, Rice	Yes for one study	Inconsistent	Two prospective studies (US & China) suggest inverse relationship; one found a positive association between arsenic metabolism efficiency amonghigh rice consumers, cross-sectional studies suggest either no or positive associations.	Ascherio et al. 1996 [31]; Mattei et al. 2011 [34]; Song et al. 2015 [33]; Shi et al. 2012 [32]; Scannell Bryan (2019) [35]
Cardiovascular Disease Mortality	5	N = 48,688; N = 61,491; N = 91,223; N = 27,862 (15,301 women + 12,561 men in Oba et al. 2010); N = 53,469 (29,968 women, 23,501 men in Rebelo et al. 2014)	Rice	No	Inconsistent	Generally no association	Eshak et al. 2011 [24]; Iso et al. 2007 [54]; Eshak et al. 2014 [27]; Oba et al. 2010 [25]; Rebello et al. 2014 [26]
Stroke	3	N = 27,862 (15,301 women + 12,561 men in Oba et al. 2010); N = 838; N = 106,194 (44,703 men, 61,491 women in Iso et al. 2007); N = 114,573 (71,750 women, 42,823 men in Juan et al.)	White Rice, Brown Rice, Rice	No	Inconsistent	Positive association in one small case-control study from China, but cohort studies suggest no association	Oba et al. 2010 [25]; Liang et al. 2010 [23]; Iso et al. 2007 [54]; Juan et al. (2017) [28]
Coronary Heart Disease	3	N = 61,491; N = 53,469 (29,968 women, 23,501 men in Rebello et al. 2014); N = 106,194 (44,703 men, 61,491 women in Iso et al. 2007)	Rice, Brown Rice	No	Decreased risk	Large US prospective cohort of women inverse association with brown rice consumption, without consideration of water arsenic	Iso et al. 2007 [54]; Rebello et al. 2014 [26]; Liu et al. 1999 [29]
Cardiovascular Disease Incidence	1	N = 94,225	White Rice	Yes	Increased risk	One large prospective study from the US found no overall association, but an increased risk among those with low water arsenic concentrations	Muraki et al. 2015 [30]
Diabetes, Diabetes-Related Outcomes
Diabetes (Type 1 or 2)	10	N = 3,006; N = 2,658; N = 7,628 (1,529 North region, 2,719 Central region, 3,380 South region in Dong et al. 2015); N = 36,787; N = 75,521; N = 59,288 (33,622 women, 25,666 men in Nanri et al. 2010); N = 605; N = 197,228; N = 64,227; N = 690	White Rice, Rice, Brown Rice	No	Increased risk	Positively associations based on 2 meta-analyses, but not consistent so. Large cohorts outside of Asia observed no association, and 2 large prospective cohorts observed inverse associations with brown rice which was attributed to eating whole grains.	Khosravi- Boroujeni et al. 2013 [44]; Shimakaw a et al. 1993 [43]; Dong et al. 2015 [42]; Hodge et al. 2004 [45]; Liu et al. 2000 [48]; Nanri et al. 2010 [38]; Soriguer et al. 2013 [46]; Sun et al. 2010 [40]; Villegas et al. 2007 [39]; Yu et al. 2011 [41]
Diabetes-related Endpoints	5	N = 1,879; N = 2,209 (1,164 boys, 1,045 girls in Song et al. 2015); N = 2,728; N = 3,006; N = 1,025; N = 12,609	White Rice, Rice	Yes for one study	Increased risk	Positive associations with glucose levels, glycated hemoglobin (HbA1c) levels, insulin levels, hyperglycemia, insulin resistance, and β-cell function in prospective and cross- sectional studies. Positive associations of systolic and diastolic blood with iAs% and MMA% increase and negative association with DMA% increase. No association with HbA1c% or HOMA-IR and arsenic metabolism efficiency among high rice consumers.	Mattei et al. 2011 [34]; Song et al. 2015 [33]; Zuniga et al. 2014 [47]; Khosravi- Boroujeni et al. 2013 [44]; Shi et al. 2012 [32]; Scannell Bryan et al. [35]
Respiratory Conditions
Respiratory endpoints and diseases	3	N = 20,106; N = 1,466; N = 13,503; N = 6,814	Rice	Yes for one study	Inconsistent	Generally no associations, with one cross- sectional study finding an inverse relationship with bronchial hyperactivity, . Decreased lung capacity, forced expiratory volume and forced vital capacity and and increased cardiac-based HAA with similar findings for urinary arsenic concentrations.	Garcia- Marcos et al. 2007 [49]; Woods et al. 2003 [50]; Suárez- Varela et al. 2010 [111]; Sanchez et al. (2019) [51]
Neoplasms and Pre-Neoplastic Lesions
Kidney Cancer	1	N = 106,194 (44,703 men, 61,491 women)	Rice	No	Inconsistent	Increased risk of kidney cancer for women but not men.	Iso et al. (2007) [54]
Liver Cancer Mortality	1	N = 106,194 (44,703 men, 61,491 women)	Rice	No	Decreased risk	Observed decreased risk of liver cancer mortality for those with high rice consumption.	Iso et al. (2007) [54]
Lung Cancer Mortality	2	N = 106,194 (44,703 men, 61,491 women in Iso et al.); N = 98,248 (42,940 men, 55,308 women in Ozasa et al.)	Rice	No	Inconsistent	Generally no association between lung cancer mortality and rice consumption, with some weakly positive.	Iso et al. (2007) [54]; Ozasa et al. (2001) [112]
Pancreatic Cancer and Pancreatic Cancer Mortality	3	N = 2,233; N = 1,050 (890 men, 160 women in Falk et al.); N = 106,194 (44,703 men, 61,491 women in Iso et al. 2007)	Rice	No	Null	No clear association between pancreatic cancer or pancreatic cancer mortality and rice consumption.	Chan et al. (2007); Falk et al. (1988); Iso et al. (2007) [54]
Prostate Cancer mortality	2	N = 7,999; N = 44,703	Rice	No	Null	No association with prostate cancer mortality and rice consumption.	Severson et al. (1989) [115]; Iso et al. (2007) [54]
Bladder and Urothelial Tract Cancer	3	N = 106,194 (44,703 men, 61,491 women in Iso et al. 2007); N = 546; N = 205,639 (45,231 men and 160,408 women in Zhang et al.)	Rice, White Rice, Brown Rice	Yes for one study	Inconsistent	No association was found between urothelial tract cancer mortality.Weakl y increased risk of bladder cancer in US cohort and case- control studies.	Iso et al. 2007 [54]; Signes- Pastor et al. (2019) [56]; Zhang et al. 2016 [55]
Skin Lesions (Cancer & PreCancerous Lesions)	1	N = 18,470; N = 487 squamou s cell skin cancer cases and N = 462 controls (in Gossai et al. 2017)	Rice	Yes	Increased risk	Increased risk with rice consumption among those with lower drinking water arsenic concentrations.	Melkonian et al. 2013 Gossai et al., 2017 [52, 53]

^a.Summary of specific estimates can be found in Online Resource 1.