Effects of resistant starch on the indicators of glucose regulation in persons diagnosed with type 2 diabetes and those at risk: A meta‐analysis

Green banana resistant starch: A promising potential as functional ingredient against certain maladies

This review covers the significance of green banana resistant starch (RS), a substantial polysaccharide. The food industry has taken an interest in green banana flour due to its 30% availability of resistant starch and its approximately 70% starch content on a dry basis, making its use suitable for food formulations where starch serves as the base. A variety of processing techniques, such as heat-moisture, autoclaving, microwaving, high hydrostatic pressure, extrusion, ultrasound, acid hydrolysis, and enzymatic debranching treatments, have made significant advancements in the preparation of resistant starch. These advancements aim to change the structure, techno-functionality, and subsequently the physiological functions of the resistant starch. Green bananas make up the highest RS as compared to other foods and cereals. Many food processing industries and cuisines now have a positive awareness due to the functional characteristics of green bananas, such as their pasting, thermal, gelatinization, foaming, and textural characteristics. It is also found useful for controlling the rates of cancer, obesity, and diabetic disorders. Moreover, the use of GBRS as prebiotics and probiotics might be significantly proved good for gut health. This study aimed at the awareness of the composition, extraction and application of the green banana resistant starch in the future food products.

Association of Dietary Resistant Starch Intake with Obesity and Metabolic Syndrome in Korean Adults

Research findings on the relationship between dietary resistant starch (RS) intake and metabolic diseases using population-based data are very scarce. This study examined the association of dietary RS intake with obesity and metabolic syndrome in Korean adults. A total of 12,491 adults (5292 men and 7199 women) were selected from the 2016-2018 Korea National Health and Nutrition Examination Survey data. The individual RS intake (g) was calculated by linking the 1-day 24 h recall data with the RS content database for common Korean foods. Obesity was defined as a BMI ≥ 25.0 kg/m2. Metabolic syndrome was defined as having three or more of the following: abdominal obesity, elevated triglycerides, low HDL cholesterol, elevated fasting blood glucose, and elevated blood pressure. Odds ratios (ORs) with 95% confidence intervals (CIs) for obesity and metabolic syndrome across quartiles (Qs) of RS intake were calculated using multiple logistic regression analysis. In men, the highest quartile of RS intake showed a significantly lower OR for metabolic syndrome compared to the lowest quartile after adjusting for covariates (OR = 0.71, 95% CI = 0.56-0.92, p-trend = 0.0057). Dietary RS intake in men was also inversely associated with obesity (Q4 vs. Q1: OR = 0.80, 95% CI = 0.67-0.97, p-trend = 0.0329) and elevated triglycerides (Q4 vs. Q1: OR = 0.80, 95% CI = 0.66-0.98, p-trend = 0.0314). In women, RS intake was not associated with metabolic syndrome. Our findings may serve as useful data for developing guidelines for RS intake and conducting further cohort and clinical studies to investigate the health effects of RS.

Naturally cultured high resistant starch rice improved postprandial glucose levels in patients with type 2 diabetes: A randomized, double-blinded, controlled trial

Objective

To assess the effect of a novel naturally cultured rice with high resistant starch (RS) on postprandial glycemia in patients with type 2 diabetes compared to ordinary rice.

Design

This study is a randomized, double-blinded controlled trial.

Methods

Patients with type 2 diabetes were recruited, and postprandial glucose levels were measured at 5-time points after the ingestion of one of two types of cooked rice in random order. Paired t-tests were used to compare postprandial blood glucose changes and increment areas under the blood glucose curve between high-RS rice and ordinary rice.

Results

The increments of the postprandial blood glucose levels for high-RS rice were significantly lower than that for ordinary rice, i.e., 2.80 ± 1.38 mmol/L vs. 3.04 ± 1.50 mmol/L (P = 0.043) and 3.94 ± 2.25 mmol/L vs. 4.25 ± 2.29 mmol/L (P = 0.036) at 30 min and 60 min, respectively. The incremental areas under the blood glucose curve for high-RS rice were also significantly lower than that for ordinary rice, i.e., 42.04 ± 20.65 [mmol/(L·min)] vs. 45.53 ± 22.45 [mmol/(L·min)] (P = 0.043), 143.54 ±69.63 [mmol/(L·min)] vs. 155.15 ± 73.53 [mmol/(L·min)] (P = 0.026), and 354.61 ± 191.96 [mmol/(L·min)] vs. 379.78 ± 195.30 [mmol/(L·min)] (P = 0.042) at 30, 60, and 120 min, respectively. Repeated-measures ANOVA showed that postprandial glucose levels were not affected by the test order.

Conclusion

The novel high-RS rice as a staple food when substituting for widely consumed ordinary rice may provide potential health benefits by lowering blood glucose in patients with type 2 diabetes.

Associations between dietary fiber intake and cardiovascular risk factors: An umbrella review of meta-analyses of randomized controlled trials

Although several meta-analyses have revealed the beneficial effects of dietary fiber intake on human health, some have reported inconsistent findings. The purpose of this work was to perform an umbrella meta-analysis to evaluate the relevant evidence and elucidate the effect of dietary fiber intake on glycemic control, lipid profiles, systematic inflammation, and blood pressure. Eligible studies were searched in several electronic databases, including Web of Science, PubMed, Scopus, and the Cochrane Library, up to March 2022. A total of 52 meta-analyses involving 47,197 subjects were identified to assess the pooled effect size. Overall, higher dietary fiber intake was significantly associated with reductions in parameters involving glycemic control, including fasting plasma glucose (ES = -0.55, 95% CI: -0.73, -0.38, P < 0.001), fasting plasma insulin (ES = -1.22, 95% CI: -1.63, -0.82, P < 0.001), homeostasis model assessment of insulin resistance (HOMA-IR) (ES = -0.43, 95% CI: -0.60, -0.27, P < 0.001), and glycosylated hemoglobin (HbA1c) (ES = -0.38, 95% CI: -0.50, -0.26, P < 0.001). In terms of lipid profiles, higher dietary fiber intake was associated with significant reductions in the serum level of total cholesterol (ES = -0.28, 95% CI: -0.39, -0.16, P < 0.001) and low-density lipoprotein cholesterol (ES = -0.25, 95% CI: -0.34, -0.16, P < 0.001), but not triglycerides (ES = -0.001, 95% CI: -0.006, 0.004, P = 0.759) and high-density lipoprotein cholesterol (ES = -0.002, 95% CI: -0.004, 0.000, P = 0.087). Higher dietary fiber intake was also significantly associated with improved tumor necrosis factor-alpha serum levels (ES = -0.78, 95% CI: -1.39, -0.16, P = 0.013), while no significant effect was observed for C-reactive protein (ES = -0.14, 95% CI: -0.33, 0.05, P = 0.156). Finally, blood pressure was also significantly improved following higher dietary fiber intake (systolic blood pressure: ES = -1.72, 95% CI: -2.13, -1.30, P < 0.001; diastolic blood pressure: ES = -0.67, 95% CI: -0.96, -0.37, P < 0.001). Subgroup analysis revealed that the study population and type of dietary fiber could be partial sources of heterogeneity. In conclusion, the present umbrella meta-analysis provides evidence for the role of dietary fiber supplementation in the improvement of established cardiovascular risk factors.

The effect of high-amylose resistant starch on the glycogen structure of diabetic mice

Glycogen is a complex branched glucose polymer found in many tissues and acts as a blood-glucose buffer. In the liver, smaller β glycogen particles can bind into larger composite α particles. In mouse models of diabetes, these liver glycogen particles are molecularly fragile, breaking up into smaller particles in the presence of solvents such as dimethyl sulfoxide (DMSO). If this occurs in vivo, such a rapid enzymatic degradation of these smaller particles into glucose could exacerbate the poor blood-glucose control that is characteristic of the disease. High-amylose resistant starch (RS) can escape digestion in the small intestine and ferment in the large intestine, which elicits positive effects on glycemic response and type 2 diabetes. Here we postulate that RS would help attenuate diabetes-related liver glycogen fragility. Normal maize starch and two types of high-amylose starch were fed to diabetic and non-diabetic mice. Molecular size distributions and chain-length distributions of liver glycogen from both groups were characterized to test glycogen fragility before and after DMSO treatment. Consistent with the hypothesis that high blood glucose is associated with glycogen fragility, a high-amylose RS diet prevented the fragility of liver-glycogen α particles. The diets had no significant effect on the glycogen chain-length distributions.

Higher intake of microbiota-accessible carbohydrates and improved cardiometabolic risk factors: a meta-analysis and umbrella review of dietary management in patients with type 2 diabetes

BACKGROUND

Microbiota-accessible carbohydrates (MACs) are critical substrates for intestinal microbes; the subsequent production of SCFAs may have some potential benefits for patients with type 2 diabetes mellitus (T2DM).

OBJECTIVES

We conducted a meta-analysis of randomized controlled trials (RCTs) to assess the effects of higher compared with lower MAC intakes on cardiovascular risk factors in T2DM patients and performed an umbrella review of RCTs to evaluate the evidence quality concerning existing dietary T2DM interventions.

METHODS

Publications were identified by searching MEDLINE, EMBASE, and CINAHL. In the meta-analysis, random-effects models were used to calculate pooled estimates, and sensitivity analyses, meta-regression, subgroup analyses, and Egger's test were performed. For the umbrella review, we summarized pooled estimates, 95% CIs, heterogeneity, and publication bias. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) and modified NutriGrade were used to assess the quality of evidence in the meta-analysis and umbrella review, respectively.

RESULTS

Forty-five RCTs with 1995 participants were included in the meta-analysis. High MAC intake significantly reduced glycated hemoglobin (HbA1c) (weighted mean difference [WMD] -0.436% [-0.556, -0.315]), fasting glucose (WMD -0.835 mmol/L [-1.048, -0.622]), total cholesterol (WMD -0.293 mmol/L [-0.397, -0.190]), triglycerides (WMD -0.118 mmol/L [-0.308, -0.058]), BMI (WMD -0.476 [-0.641, -0.312]), and systolic blood pressure (WMD -3.066 mmHg [-5.653, -0.478]), with a moderate-to-high quality of evidence, compared with low intake. Region, dose, and MAC type were key variables. The umbrella review of all dietary interventions for cardiovascular risk factors in patients with T2DM included 26 meta-analyses with 158 pooled estimates. The evidence quality of MACs, dietary fiber, high-protein diet, ω-3 (n-3), viscous fiber, vitamin D, and vitamin E intake was moderate to high.

CONCLUSIONS

When compared with lower intake, increased MAC intake improved glycemic control, blood lipid, body weight, and inflammatory markers for people with T2DM. This trial was registered at PROSPERO (https://www.crd.york.ac.uk/PROSPERO/#recordDetails) as CRD42019120531.