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Medical treatment with Rice

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Rice solution and World Health Organization solution by gastric infusion for high stool output diarrhea

Article Abstract:

Dehydration, or the excessive loss of body fluids, may result from diarrhea and can be effectively treated by oral rehydration therapy (ORT), in which fluids are given through the mouth to restore the depleted volume of body fluids. ORT given for four to six hours, as recommended by the World Health Organization (WHO), was shown to be effective in 90 percent of patients with diarrhea-related dehydration. However, ORT is less effective in treating dehydration associated with diarrhea containing large amounts of stool, or high stool output diarrhea. Dehydration associated with high stool output diarrhea can be managed by administering fluids intravenously or through a nasogastric tube, which is inserted through the nose into the stomach. Studies show that the breakdown of starch contained in rice results in certain products that increase the absorption of water in the intestine; these include amylose, amylopectin, amino acids, dipeptides, and short-chain oligosaccharides. Oral rice solutions have been beneficial in children with dehydration associated with high stool output diarrhea. The effectiveness of a rice flour solution in treating dehydration was compared with that of the WHO formula given orally or by a nasogastric tube. Sixty-six children, aged 1 to 18 months, with high stool output diarrhea were given either the rice flour solution orally, the WHO formula through a nasogastric tube, or the WHO solution orally. Although the production of stool decreased in all children, the greatest reduction was observed in children given the rice flour solution. Rehydration was achieved in all patients given the rice flour solution, 73 percent of children who received the WHO solution through a nasogastric tube, and 69 percent of children given the WHO solution orally. These findings show that the rice flour solution is effective in children who require treatment for dehydration associated with high stool output diarrhea. (Consumer Summary produced by Reliance Medical Information, Inc.)

 

author: Mota-Hernandez, Felipe, Bross-Soriano, Daniel, Perez-Ricardez, Maria L., Velasquez-Jones, Luis

Publisher: American Medical Association

Publication Name: American Journal of Diseases of Children

Subject: Health

ISSN: 0002-922X

Year: 1991

 

 

Rice-based Diets


Rice is the most important cereal crop for human consumption. It is the staple food for over 3 billion people (most of them poor) constituting over half of the world's population. All of the world's great civilizations developed only after the domestication of various cereal grains, which provided an adequate food supply for large populations. These have included corn in the Americas, wheat in the Near East and southern Europe (Greece and Rome), and rice in China and India. The use of rice spread rapidly from

 The people of Sri Lanka get about 40 percent of their calories from rice. Though rice is the most important crop in Sri Lanka, the per-capita consumption of imported wheat is increasing.

[Photograph by Tim Page. Corbis. Reproduced by permission.]

China, India, and Africa, and at the present time it is used as a principal food throughout the world. After the discovery of the Americas, the use of rice took hold in both continents. The national dish of Belize in Central America, for example, is composed of rice and beans. There are now hundreds of rice recipes, with each ethnic cuisine having developed individual recipes. Almost all cookbooks have rice recipes, including recipes for risottos and pilafs. Vegetarians, in particular, cherish rice because it is such an excellent food and can be prepared in so many different and appetizing ways. Rice, delicious in itself, readily takes on any flavor that is added. Long-grain rice, when cooked, becomes separate and fluffy, while medium-grain rice is somewhat chewier. Short-grain rice tends to clump together and remains sticky with its starchy sauce. Arborio is an example of a short-grained rice. Wehani rice has a nutty flavor. Basmati rice (aromatic) is very popular, as is jasmine rice.

Rice is the only subsistence crop grown in soil that is poorly drained. It also requires no nitrogen fertilizer because soil microbes in the rice roots fix nitrogen and promote rice growth. Rice adapts itself to both wetlands and dry soil conditions.

Nutritional Properties

Rice is a high-carbohydrate food with 85percent of the energy from carbohydrate, 7 percent from fat, and 8 percent from protein. However, rice also has a considerable amount of protein, with an excellent spectrum of amino acids. The protein quality of rice (66%) is higher than that of whole wheat (53%) or corn (49%). Of the small amount of fat in brown rice, much is polyunsaturated. White rice is extremely low in fat content.

A cup of cooked rice has approximately 5 grams of protein, which is sufficient for growth and maintenance, provided that a person receives adequate calories to maintain body weight or to increase it, if full growth has not yet occurred. Asiatic children for whom rice is the chief food source have not developed protein deficiency disorders such as kwashiorkor, as have infants

 

THE NUTRITIONAL COMPOSITION OF ONE CUP OF COOKED RICE

 

Brown Rice

White Rice

*Daily requirement of thiamin is 1.2 mg for an adult man

**Enriched or parboiled rice

Calories

218

266

Protein (grams)

4.5

5.0

Carbohydrate (g)

45.8

58.6

Fiber (g)

3.5

0.5

Fat (g)

1.6

0.4

Polyunsaturated fatty acids (g)

0.6

0.1

Cholesterol (mg)

0

0

Thiamin (mg)*

0.20

0.34**

Vitamin A

0

0

that are fed corn or cassava as a chief staple after weaning. Growth and development are normal on a rice diet. Due to its easy digestibility, rice is a good transition food after the cessation of breast or formula feeding.

Rice and Thiamine Deficiency

In Asiatic populations, rice has been, and still is, a main source of nutrition. Thiamine, or vitamin B1, is contained in the outer husk and coating of the rice kernel. When the technology for polishing rice became available, people took to eating white rice in preference to brown rice, but that process removed thiamine, causing beriberi, or thiamine deficiency, in many people, as well as heart and nerve diseases.

Dutch physicians in Java and Japanese physicians particularly noted the occurrence of beriberi with edema, heart failure, neuropathy, and many deaths. Thiamine, of course, was an unknown substance at that time. The history of rice is of interest in illustrating how the technology to make a food more appetizing (i.e., white rice versus brown rice) led to an epidemic of a new disease for those populations whose food intake was largely based upon rice. Studies by physicians in Japan and in Indonesia led to a cure for beriberi that included a more varied diet, plus the use of rice husks and the outer coatings of rice, which contained thiamine.

Today, much of the rice consumed is either enriched with thiamine or parboiled, which leads to retention of thiamine in the matrix of the white rice kernel. Beriberi, as a disease from the consumption of white rice, is now rare if the rice is parboiled or enriched. However, some varieties of polished (white) rice may not be enriched with thiamine. Thus, when thiamine intake from other food sources is limited, thiamine deficiency could still occur. In the United States, thiamine deficiency typically occurs in chronic alcoholics.

Rice for Medical Therapy and Prevention

Rice has been the mainstay of treatment for a number of conditions, particularly for hypertension at a time when few effective drug therapies were available. In the 1940s, Walter Kempner developed a treatment for mild, and even malignant, hypertension at Duke University. His hypothesis was that a low-protein diet, free of salt, would be an effective treatment. He devised the "rice diet," which consisted of rice, fruits, and vegetables. This treatment had good results: the blood pressure of his patients fell, and even malignant hypertension was partially reversed. In addition, blood cholesterol levels also fell. Since this was a cholesterol-free and low-fat diet, it was one of the first to document a cholesterol-lowering effect from diet.

The other therapeutic role of rice is in the treatment of allergies. Rice seems to be nonallergenic, and rice milk has been fed to infants allergic to cow's milk. Rice proteins have also been incorporated into standard infant formulas.

Genetic Engineering of Rice

"Golden rice" was genetically engineered to contain beta-carotene, not present in standard rice, to combat the widespread vitamin A deficiency and ensuing blindness in the children of the developing world. Beta-carotene is a vitamin A precursor that is converted to the vitamin by enzymes of the intestinal mucosa. Vitamin A, or retinol, is then absorbed and transported to the tissues, including the structures of the eye. Golden rice would thus seem to be an advance in the fight against vitamin A deficiency in rice-eating populations. However, there are some concerns about golden rice and other genetically engineered foods. Genetically engineered products have not necessarily been proven safe, and environmental or social risks may outweigh potential benefits that they may bring about.

Clinical trials of golden rice are needed before it is accepted universally. Only when it is clearly determined that it can prevent vitamin A deficiency in experimental animals, and that it presents no hazards, will this genetically engineered food be considered safe for use in human nutrition. Further, society itself must also decide if genetically created foods are acceptable, a point currently in dispute.

Sequencing the Rice Genome

Since the 1960s, the "green revolution" has improved the yield of rice, and now the "green genome revolution" may bring about further improvements. The rice genome has now been sequenced, an achievement of great importance. The sequence of the rice genome will provide the template for the sequencing of other grasses (maize, barley, wheat, etc.). The genome sequences are now known for the japonica rice favored in Japan and other countries with a temperate climate, and for the indica subspecies of rice grown in China and most other parts of Asia. This knowledge will permit a future harnessing of genes for disease prevention, drought resistance, nutritional improvement, and many other possible modifiable features of rice. As a recent issue of Science suggested, a "green gene revolution" is needed to meet the challenge of "population growth, loss of arable land and climate changes."

In summary, rice is an inexpensive, easily prepared, and delicious food. It is also a very nutritious food that benefits humans all over the world.

SEE ALSO ASIAN AMERICANS, DIETS OF; ASIANS, DIET OF; BERIBERI; BETA-CAROTENE; CORN- OR MAIZE-BASED DIETS; DIETARY SUPPLEMENTS; FORTIFICATION; KWASHIORKOR; NUTRITIONAL DEFICIENCY.

William E. Connor
Sonja L. Connor

http://www.faqs.org/

Rice-based mucosal vaccine as a global strategy for cold-chain- and needle-free vaccination

  1. Tomonori Nochi*,,
  2. Hidenori Takagi,
  3. Yoshikazu Yuki*,,
  4. Lijun Yang,
  5. Takehiro Masumura§,,
  6. Mio Mejima*,,
  7. Ushio Nakanishi*,
  8. Akiko Matsumura*,,
  9. Akihiro Uozumi*,
  10. Takachika Hiroi?,
  11. Shigeto Morita§,,
  12. Kunisuke Tanaka§,,
  13. Fumio Takaiwa, and
  14. Hiroshi Kiyono*,,**

+Author Affiliations

  1. *Division of Mucosal Immunology, Department of Microbiology and Immunology, The Institute of Medical Science, University of Tokyo, Tokyo 108-8639, Japan;
  2. Core Research for Evolutional Science and Technology, Japan Science and Technology Corporation, Saitama 332-0012, Japan;
  3. Transgenic Crop Research and Development Center, National Institute of Agrobiological Sciences, Ibaraki 305-8602, Japan;
  4. §Laboratory of Genetic Engineering, Graduate School of Agriculture, Kyoto Prefectural University, Shimogamo, Kyoto 606-8522, Japan;
  5. Kyoto Prefectural Institute of Agricultural Biotechnology, Seika-cho, Kyoto 619-0244, Japan; and
  6. ?Department of Allergy and Immunology, Tokyo Metropolitan Institute of Medical Science, Tokyo 113-8613, Japan
  1. Communicated by Roy Curtiss, Arizona State University, Tempe, AZ, April 26, 2007 (received for review February 6, 2007)

Abstract

Capable of inducing antigen-specific immune responses in both systemic and mucosal compartments without the use of syringe and needle, mucosal vaccination is considered ideal for the global control of infectious diseases. In this study, we developed a rice-based oral vaccine expressing cholera toxin B subunit (CTB) under the control of the endosperm-specific expression promoter 2.3-kb glutelin GluB-1 with codon usage optimization for expression in rice seed. An average of 30 ?g of CTB per seed was stored in the protein bodies, which are storage organelles in rice. When mucosally fed, rice seeds expressing CTB were taken up by the M cells covering the Peyer's patches and induced CTB-specific serum IgG and mucosal IgA antibodies with neutralizing activity. When expressed in rice, CTB was protected from pepsin digestion in vitro. Rice-expressed CTB also remained stable and thus maintained immunogenicity at room temperature for >1.5 years, meaning that antigen-specific mucosal immune responses were induced at much lower doses than were necessary with purified recombinant CTB. Because they require neither refrigeration (cold-chain management) nor a needle, these rice-based mucosal vaccines offer a highly practical and cost-effective strategy for orally vaccinating large populations against mucosal infections, including those that may result from an act of bioterrorism.

Rice-Based Oral Rehydration Salts (ORS)

The story began in Bangladesh during the 1980s at the International Centre for Diarrheal Disease Research (ICDDR, B) in Dhaka. Packets of glucose ORS were often not available due to seasonal availability of sugar, especially in rural areas. Intravenous therapy is expensive and often not a possibility in many areas around the world, including Bangladesh. The ICDDRB began to do research and investigate what source of carbohydrate might be available and effective. Research was done on corn, wheat, sorghum, potatoes, rice and other substrates that researchers Dr. Majid Molla and Dr. WB Greenough, thought might work. All possible solutions worked as well or better than simple sugars, but since rice was the most likely not to cause allergies, continued research was done on the rice.

Child Health Foundation (CHF) of Columbia, MD, held two major symposia on this topic involving corporations, government agencies, international agencies and governments. One in 1987 was held in collaboration with the National Council for International Health (NCIH) which is now the Global Health Council, in Washington, DC, at the National Academy of Sciences. The other conference, in 1989, was in Pakistan, in collaboration with the Aga Khan Foundation, which funded early work on rice-ORS. These conferences reviewed the science behind the theories, investigating why a large molecule would be more effective ORS than simple glucose.

Research:

July 2001

MARYLAND RICE-BASED ORS PRODUCT CLINICALLY SUPERIOR TO GLUCOSE-BASED ORAL REHYDRATION SALTS

STUDY IN SWEDISH PEDIATRIC JOURNAL ACTA PAEDIATRICA

What:
A study of 167 boys with cholera compared the safety and efficacy of CeraLyte, a rice-based oral rehydration solution (ORS) to the standard "World Health Organization formula" glucose ORS, concluding that the CeraLyte ORS, as in other studies with long-chain rice carbohydrate, is more effective than glucose ORS. The boys, ages 5 to 15 years, suffered severe dehydrating diarrhea, with losses equivalent to about 30% of their body weight while hospitalized. On average, these boys were admitted 14 hours after their illness began, by which time they had already lost 14% of their body weight to dehydration. Thus, total average volume lost during illness was about 44%.

In a controlled study, the boys who received CeraLyte-90 had a significantly lower rate of diarrhea during the critical first eight to 12 hours: "The mean stool output was 20% less in the rice ORS group," according to the article titled, 'ORS among children with cholera and cholera-like illness,' Acta Paediatrica, May 2001, Stockholm, by K. Zaman, MBB, PhD, Md. Yunus, MBBS, MSc, A Rahman, MBBS, H.R. Chowdhury, MBBS, MSc, and D.A. Sack, MD. The article continues, ".the outputs during the other time periods were similar in the two groups." Antibiotics and food given to the boys leveled the two groups after the 8 to 12 hour period.

Severe purging is "a major problem to simple treatment of cholera patients. None of the patients in this study died but it is likely that more than 50% admitted into the study would have died without the treatment provided," according to the article. All children in this study had cholera or cholera-like illnesses, were malnourished and, thus, at high risk.

Cera Products donated its packet form of rice-based CeraLyte 90 for the study. CeraLyte comes in three sodium strengths. CeraLyte-90 is for the most severe cases, such as cholera, where a healthy adult can die in as short a time as eight hours. Although glucose ORS packets are subsidized in UNICEF and WHO programs in developing countries, the increased cost of CeraLyte may be considered marginal as less of the CeraLyte may be needed for rehydration. In addition, recovery with a rice-based formula provides more energy, as well as, quick and sustained hydration.


Where:
The study took place at the rural treatment center in Matlab, of the International Centre for Diarrheal Disease Research Bangladesh (ICDDR, B) in conjunction with the Johns Hopkins University School of Hygiene and Public Health.

Cera Products (9017 Mendenhall Court, Columbia, MD 21045) is a young, applied bio-technology firm that produces a patented line of advanced rice-based products, including oral hydration and drug delivery products for health and wellness markets in the U.S. and abroad. Charlene Riikonen, Cera's President, worked at the ICDDR, B in the 1980s. The ICDDR, B received the first Gates Foundation Global Health award in Washington, D.C., at the annual Global Health Council meeting on May 31, 2001.

The Benefits of Rice-Based Oral Rehydration Therapy

  • Cost Effective (IV vs. Oral)
  • Lack of Complications
  • Lack of Pain
  • Provides calories from complex carbohydrates
  • Less worry when mixing because rice-based ORS has a lower osmolarity then glucose-based ORS
  • Lower osmolarity also means better absorption
  • Always works as well as glucose-based ORS and is even more effective in severe cases of dehydration
  • Sustained hydration (larger molecule, more substrate)
  • Tastes better

Research Continued:


 Rice-Based ORS Bibliography
 General ORS Bibliography

 

Last Updated on Thursday, 18 June 2009 23:58  

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