Resistant Starch Research
49 peer-reviewed studies · Evidence score: 9/10
Galactomannans are the most effective soluble dietary fibers in type 2 diabetes: a systematic review and network meta-analysis
Juhász AE et al. • The American journal of clinical nutrition (2023)
Galactomannans were the most effective dietary fiber for reducing the levels of HbA1c, fasting blood glucose, triglycerides, and LDL cholesterol in patients with type 2 diabetes.
- Galactomannans had the highest effect on reducing the levels of HbA1c (SUCRA: 92.33%) and fasting blood glucose (SUCRA: 85.92%).
- With regard to fasting insulin level, HOMA-IR, β-glucans (SUCRA: 73.45%), and psyllium (SUCRA: 96.67%) were the most effective interventions.
- Galactomannans were ranked first in reducing the levels of triglycerides (SUCRA: 82.77%) and LDL cholesterol (SUCRA: 86.56%).
The effects of resistant starch on glycemic control: a systematic review and meta-analysis
Wang Y et al. • Nutrition & Diabetes (2023)
Resistant starch supplementation significantly reduced fasting glucose, fasting insulin, and HOMA-IR in pooled analysis.
- Significant reductions in fasting glucose (WMD: -3.32 mg/dL) and fasting insulin across pooled trials
- Improved HOMA-IR indicating better insulin sensitivity, particularly in type 2 diabetes populations
- Benefits most pronounced with RS2 (high-amylose starch) at doses of 20-40g daily for 4+ weeks
Tolerability and SCFA production after resistant starch supplementation in humans: a systematic review of randomized controlled studies
Sobh M et al. • The American journal of clinical nutrition (2022)
Available evidence suggests that RS supplementation is tolerated in both healthy subjects and in those with an underlying medical condition.
- Twenty-seven (69%) studies evaluated the impact of RS supplementation in healthy subjects whereas 12 (31%) studies included individuals with an underlying medical condition (e.g., obesity, prediabetes).
- Twenty-one (78%) studies reporting SCFAs used type 2 RS with a dose of 20-40 g/d for 1-4 wk.
- In 16 of 23 studies (70%), SCFA production was increased, in 7 studies there was no change in SCFA concentration before and after RS supplementation, and in 1 study SCFA concentration decreased.
The Effects of Resistant Starch on Biomarkers of Inflammation and Oxidative Stress: A Systematic Review and Meta-Analysis
Wei Y et al. • Nutrition and cancer (2022)
Subgroup analysis shown that CRP level significant reduced in subjects from the east (SMD = -1.501; 95%CI: -2.662, -0.340; P = 0.011) or suffering from diseases (SMD: -1.057; 95%CI: -1.999, -0.115; P = 0.028).Supplemental data for this article is available online at https://doi.org/10.1080/01635581.2021.2019284.
- We used from the effect size, as estimated by the standardized mean difference (SMD) with 95% confidence intervals (95%CI) to perform the random method meta-analysis, with P value ≦0.05 as statistically significant.
- The 16 included trials with 17 effect sizes included a total of 739 participants in this paper.
- No significant effects on C-reactive protein (CRP) (SMD = -0.583; 95%CI: -1.270, 0.104; ), superoxide dismutase (SOD) (SMD = 0.091; 95%CI: -0.156, 0.338; ), and malondialdehyde (MDA) (SMD = -0.320; 95%CI: -0.907, 0.266; ).
Effects of resistant starch supplementation on renal function and inflammatory markers in patients with chronic kidney disease: a meta-analysis of randomized controlled trials
Zhang Y et al. • Renal failure (2024)
The RS diet has potential beneficial effects on uremic toxin levels and renal function indices in patients with CKD.
- The analysis revealed that RS dietary intervention can significantly reduce indoxyl sulfate (IS) levels (SMD: -0.37, 95% confidence interval (CI): -0.70 to -0.04, p = .03) and blood urea nitrogen (BUN) levels (SMD: -0.30, 95% CI: -0.57 to -0.02, p = .03).
- The RS diet has potential beneficial effects on uremic toxin levels and renal function indices in patients with CKD.
- Nevertheless, results should be cautiously interpreted, because of the limited sample size and different treatment dosages.
Metabolic Effects of Resistant Starch Type 2: A Systematic Literature Review and Meta-Analysis of Randomized Controlled Trials
Snelson M et al. • Nutrients (2019)
Short-term RS2 supplementation in humans is of limited cardiometabolic benefit.
- However, these outcomes were heavily influenced by positive results from a small number of individual studies which contradicted the conclusions of the majority of trials.
- RS2 had no effects on any other metabolic outcomes.
- All studies ranged from 1-12 weeks in duration and contained small sample sizes (10-60 participants), and most had an unclear risk of bias.
Benefits of resistant starch type 2 for patients with end-stage renal disease under maintenance hemodialysis: a systematic review and meta-analysis
Jia L et al. • International journal of medical sciences (2021)
Conclusions: Our results suggest that RS2 may improve the residual renal function of patients under MHD and mitigate a proinflammatory response.© The author(s).
- Results: After screening 65 records, five RCTs (n = 179) were included.
- Analyses of blood levels of uric acid, p-cresyl sulfate, indoxyl sulfate, high sensitive C-reaction protein, albumin and phosphorus yielded no significant difference.
- Conclusions: Our results suggest that RS2 may improve the residual renal function of patients under MHD and mitigate a proinflammatory response.© The author(s).
Meta-analysis reveals gut microbiome and functional pathway alterations in response to resistant starch
Chen R et al. • Food & function (2023)
The altered gut microbiome may contribute to improve the blood glucose level and insulin resistance, which may be a potential treatment route for diabetes, obesity and other metabolic diseases.
- In this article, we performed a meta-analysis of a total of 955 samples of 248 individuals from the seven studies included to compare the gut microbiota of the baseline and the end-point of RS intake.
- Different types of resistant starch and different populations led to varied responses on the gut microbiome.
- The altered gut microbiome may contribute to improve the blood glucose level and insulin resistance, which may be a potential treatment route for diabetes, obesity and other metabolic diseases.
Effects of Resistant Starch on Patients with Chronic Kidney Disease: A Systematic Review and Meta-Analysis
Du X et al. • Journal of diabetes research (2022)
The intake of RS reduced the serum IS, serum phosphorus, IL-6, and uric acid levels significantly in dialysis patients, while hs-CRP, serum creatinine, BUN, serum paracresol sulfate, and blood lipid showed no significant changes.
- RS intake significantly reduced serum indolephenol sulfate (IS), blood phosphorus, IL-6, and uric acid levels in dialysis patients.
- The mean difference (MD) of serum IS (P = 0.0002) in the dialysis subgroup was -12.57 μmol/L (95% CI: -19.28, -5.86 μmol/L).
- The MD of blood phosphorus (P = 0.03) was -0.39 mg/dl (95% CI: -0.78, -0.01 mg/dl).
Acute Effects of Dietary Fiber in Starchy Foods on Glycemic and Insulinemic Responses: A Systematic Review of Randomized Controlled Crossover Trials
Tsitsou S et al. • Nutrients (2023)
Additionally, more studies are needed to prove whether ingesting high-fiber carbohydrate-containing products per se can result in blunted glycemic and insulinemic responses and which DF type and amount are more effective.
- Data on insoluble DF and glucose metabolism are scarce.
- The same mixed results for glycemia can be seen in healthy volunteers with overweight/obesity, while resistant starch seems to improve insulinemic responses.
- Finally, more studies need to examine the acute effects of DF in starchy foods on glucose metabolism and insulin secretion in individuals facing glucose abnormalities.
Systematic review of the nuclear factor erythroid 2-related factor 2 (NRF2) system in human chronic kidney disease: alterations, interventions and relation to morbidity
Juul-Nielsen C et al. • Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association (2022)
In patients with CKD, NRF2 expression was downregulated, while NQO1 and HO-1 showed varying alterations related to inflammation, comorbidities and severity of kidney damage.
- Two-thirds of intervention studies (50% dietary, such as using resistant starch) reported an increase of NRF2, NQO1 or HO-1.
- In patients with CKD, NRF2 expression was downregulated, while NQO1 and HO-1 showed varying alterations related to inflammation, comorbidities and severity of kidney damage.
- Interventions that increased NRF2 system components were described, but their effectiveness and clinical relevance require further clinical studies of high quality.
The effects of resistant starches on inflammatory bowel disease in preclinical and clinical settings: a systematic review and meta-analysis
Montroy J et al. • BMC gastroenterology (2020)
Our review demonstrates that resistant starch is associated with reduced histology damage in animal studies, and improvements in clinical remission in IBD patients.
- Preclinically, resistant starch was associated with a significant reduction in bowel mucosal damage compared to placebo (standardized mean difference - 1.83, 95% CI - 2.45 to - 1.20).
- Our review demonstrates that resistant starch is associated with reduced histology damage in animal studies, and improvements in clinical remission in IBD patients.
- These results need to be tempered by the risk of bias of included studies.
Effects of the resistant starch on glucose, insulin, insulin resistance, and lipid parameters in overweight or obese adults: a systematic review and meta-analysis
Wang Y et al. • Nutrition & diabetes (2019)
This meta-analysis has provided evidence that RS supplementation can improve fasting glucose, fasting insulin, insulin resistance and sensitivity, especially for diabetic with overweight or obesity.
- RS supplementation increased HOMA-S% (SMD = 1.19; 95% CI: 0.59-1.78) and reduced HOMA-B (SMD =-1.2; 95% CI: -1.64 to -0.77), LDL-c concentration (SMD =-0.35; 95% CI: -0.61 to -0.09), and HbA1c (SMD = -0.43; 95% CI: -0.74 to -0.13) in overall analysis.
- This meta-analysis has provided evidence that RS supplementation can improve fasting glucose, fasting insulin, insulin resistance and sensitivity, especially for diabetic with overweight or obesity.
- However, owing to potential sophistication, individual difference and composition of intestinal microbiota, this result should be carefully taken into account.
The effect of acute consumption of resistant starch on appetite in healthy adults; a systematic review and meta-analysis of the controlled clinical trials
Amini S et al. • Clinical nutrition ESPEN (2021)
To decrease the rate of appetite more effectively, we suggest other researchers to identify RS dose and type.
- Meta-analysis showed a lower appetite in RS group compared to the controls (weighted mean difference [WMD] = -1.375 mm min, 95% confidence interval [95%CI]: -1.673, -1.076).
- Since high heterogeneity was observed among the included studies (I2 = 94.5%, P < 0.001), subgroup analysis was carried out by RS dose, RS type, duration of supplementation, and time of AUC measuring.
- In studies that used RS dose of ≥25 gr, heterogeneity disappeared (P = 0.560, I2 = 0%).
Positive effects of resistant starch supplementation on bowel function in healthy adults: a systematic review and meta-analysis of randomized controlled trials
Shen D et al. • International journal of food sciences and nutrition (2017)
To conclude, our study found that resistant starch elicited a beneficial effect on the function of large bowel in healthy adults.[Formula: see text].
- Animal experimental studies have found that resistant starch can significantly improve bowel function, but the outcomes are mixed while conducting human studies.
- The standardized mean difference (SMD) or weighted mean difference (WMD) was calculated using a fixed-effects model or a random-effects model.
- The pooled findings revealed that resistant starch significantly increased fecal wet weight (WMD 35.51 g/d, 95% CI 1.21, 69.82) and butyrate concentration (SMD 0.61, 95% CI 0.32, 0.89).
Effects of the amount and type of carbohydrates used in type 2 diabetes diets in animal models: A systematic review
Marques AM et al. • PloS one (2020)
Results show that current literature is at high risk of bias due to neglecting experimental methods.
- On the other hand, fiber, particularly resistant starch, improved blood glucose parameters through direct and indirect mechanisms, such as delayed gastric emptying and improved gut microbiota.
- All studies used rodents as animal models and male animals were preferred over females.
- Improvements in T2DM parameters in animal models were more closely related to the type of dietary carbohydrate than to its content on a diet, i. e., resistant starch seems to be the most beneficial source for maintaining normoglycemia.
The Effects of Prebiotics and Substances with Prebiotic Properties on Metabolic and Inflammatory Biomarkers in Individuals with Type 2 Diabetes Mellitus: A Systematic Review
Colantonio AG et al. • Journal of the Academy of Nutrition and Dietetics (2020)
Based on these results, there is fair evidence that prebiotics and substances with prebiotic properties may improve metabolic and inflammatory biomarkers related to T2DM in women aged 18 years at least.
- Based on these results, there is fair evidence that prebiotics and substances with prebiotic properties may improve metabolic and inflammatory biomarkers related to T2DM in women aged 18 years at least.
- Interventions with resistant starch, resistant dextrin, and oligofructose-enriched inulin exhibited the strongest evidence for improvements due to the quantity of publications and quality grades.
- Other prebiotics and substances with prebiotic properties show promise but the number of studies is few.
Resistant starch ameliorated insulin resistant in patients of type 2 diabetes with obesity: a systematic review and meta-analysis
Gao C et al. • Lipids in health and disease (2019)
RS supplementation can ameliorate IR in T2DM, especially for the patients of T2DM with obesity, but not in simple obesity.
- The results indicated that there was no significant difference in the amelioration of BMI, HOMA-%S and HOMA-%B in T2DM patients between RS and the non-RS supplementation.
- RS supplementation can ameliorate IR in T2DM, especially for the patients of T2DM with obesity, but not in simple obesity.
- Further research warranted to confirm findings
Meta-analysis indicates that resistant starch lowers serum total cholesterol and low-density cholesterol
Yuan HC et al. • Nutrition research (New York, N.Y.) (2018)
Published by Elsevier Inc.
- The meta-analysis of these data showed that RS supplementation has an effect on lowering TC and LDL-C (TC: mean difference, -7.33mg/dL [95% confidence interval -12.15 to -2.52mg/dL]; LDL-C: mean difference: -3.40mg/dL [95% confidence interval, -6.74 to -0.07mg/dL]).
- Future research should focus on the relationship between RS type and cholesterol-lowering effects, and the effects on subjects of different health status or those with different baseline levels of serum lipids.
- Moreover, the mechanism for the cholesterol-lowering effects of RS should be further explored.
Effects of resistant starch on glycemic control, serum lipoproteins and systemic inflammation in patients with metabolic syndrome and related disorders: A systematic review and meta-analysis of randomized controlled clinical trials
Halajzadeh J et al. • Critical reviews in food science and nutrition (2020)
This meta-analysis showed beneficial effects of RS on improving FPG, insulin, HbA1c, total cholesterol, LDL-cholesterol and TNF-α levels in patients with MetS and related disorders, but it did not affect HOMA-IR, triglycerides, HDL-cholesterol, CRP and IL-6 levels.
- Data were pooled using a random-effects model and weighted mean difference (WMD) was considered as the overall effect size.
- Administration of RS resulted in significant reduction in fasting plasma glucose (FPG) (14 studies) (WMD: -4.28; 95% CI: -7.01, -1.55), insulin (12 studies) (WMD: -1.95; 95% CI: -3.22, -0.68), and HbA1C (8 studies) (WMD: -0.60; 95% CI: -0.95, -0.24).
- When pooling data from 13 studies, a significant reduction in total cholesterol levels (WMD: -8.19; 95% CI: -15.38, -1.00) and LDL-cholesterol (WMD: -8.57; 95% CI: -13.48, -3.66) were found as well.