Resistant starch improves cardiometabolic disease outcomes: A narrative review of randomized trials

糖尿病前期 血糖性 医学 2型糖尿病 餐后 交叉研究 随机对照试验 血糖负荷 糖尿病 内科学 胰岛素 内分泌学 升糖指数 安慰剂 病理 替代医学
作者
Madhura Maiya,Andrew Adorno,Sahar B. Toulabi,Wesley J. Tucker,Mindy Patterson
出处
期刊:Nutrition Research [Elsevier BV]
卷期号:114: 20-40 被引量:2
标识
DOI:10.1016/j.nutres.2023.04.001
摘要

Healthy dietary patterns with adequate fiber improve cardiometabolic (CM) outcomes and attenuate disease progression. Resistant starch (RS) is a fermentable fiber that affects CM outcomes; however, studies are heterogeneous and inconsistent. Thus, the purpose of this narrative review is to assess the impact of RS intake by type and amount on CM outcomes while considering subject characteristics and trial duration. Randomized crossover or parallel studies (n = 31) were selected and compared according to acute (1 day; n = 12), medium (>1-30 days; n = 8), or long (>30 days; n = 11) duration. Most acute trials in healthy adults showed improvements in postprandial glycemic outcomes irrespective of RS type or amount. However, a more pronounced reduction occurred when test meals did not match for available carbohydrate. Daily RS intake had a minimal effect on CM outcomes in medium duration trials, but insulin resistant adults had better glycemic control at 4 weeks. Several longer duration trials (8-12 weeks) showed favorable CM outcomes with daily RS intake in adults with type 2 diabetes (T2D), but not in those at risk for T2D. Furthermore, some studies reported improved lipids, inflammatory biomarkers, and heart rate. Future studies should consider matching for available carbohydrates between the RS and control groups to understand the gut microbiome's role. Furthermore, energy and fiber should be considered. Overall, the acute intake of RS improves glycemic outcomes, and consuming RS at for least 4 and up to 8 to 12 weeks in adults with prediabetes and T2D, respectively, appears to improve CM outcomes.
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