A comparison of the effects of resistant starch types on glycemic response in individuals with type 2 diabetes or prediabetes: A systematic review and meta-analysis

The impact of slowly digestible and resistant starch on glucose homeostasis and insulin resistance

PURPOSE OF REVIEW

This review will summarize recent studies assessing the effect of slowly digestible starch (SDS) and resistant starch (RS) on glucose metabolism in healthy, prediabetic or type 2 diabetic adults.

RECENT FINDINGS

Currently, a particular interest in starch and its digestibility has arisen, with data showing a positive effect of SDS and RS on the glucose homeostasis of healthy, at-risk, prediabetic and type 2 diabetic patients but research is ongoing.

SUMMARY

Carbohydrates (CHO) and especially starch play a major role in the prevention and management of metabolic diseases such as type 2 diabetes (T2D). This largely depends on the quality and the digestibility (rate and extent) of the ingested starchy products, beyond their quantity. SDS have been poorly studied but display a beneficial effect on reducing glucose excursions in healthy and insulin-resistant subjects and a relevant potential to improve glucose control in type 2 diabetic individuals. As for RS, the results appear to be encouraging but remain heterogeneous, depending the nature of the RS and its role on microbiota modulation. Further studies are needed to confirm the present results and investigate the potential complementary beneficial effects of SDS and RS on long-term glucose homeostasis to prevent cardiometabolic diseases.

Closing the Fibre Gap-The Impact of Combination of Soluble and Insoluble Dietary Fibre on Bread Quality and Health Benefits

Dietary fibre (DF) is important for overall health and disease prevention. However, the intake of DF in Westernised countries is below the recommended level, largely due to the excessive consumption of low-fibre foods. Fortifying staple foods, such as bread, with dietary fibre ingredients is one approach to closing the fibre gap in our diet. However, incorporating purified and chemically modified fibre ingredients into food is challenging. This study unveils interactions between soluble-fermentable (arabinoxylan), insoluble-fermentable (resistant starch type IV) and insoluble-unfermentable (cellulose) fibre ingredients and their impact on bread quality using Response Surface Methodology. This resulted in an optimised mixture of these fibre ingredients that can coexist within a bread matrix while maintaining quality characteristics comparable to white wheat bread. The partial replacement of flour with fibre ingredients led to an interference with the gluten network causing a reduction in gluten strength by 12.4% and prolonged gluten network development time by 24.4% compared to the control (no fibre addition). However, the CO2 retention coefficient during dough fermentation was not affected by fibre ingredient inclusion. The fibre content of the white bread was increased by 128%, with only a marginal negative impact on bread quality. Additionally, the fibre-fortified bread showed a lower release of reducing sugars during in vitro starch digestion. This study illustrates the synergy of different types of fibre ingredients in a bread system to advance in closing the fibre gap.

Structural and physicochemical properties of rice starch from a variety with high resistant starch and low amylose content

Research on the physicochemical properties of rice-derived endo-sperm high resistant starch (RS) with low amylose content (AC) is limited. In this study, we evaluated the physicochemical characteristics of such a starch variety and revealed that the starch granules exhibit a smoother, more refined surface with distinct edges, increased compactness, higher order of surface, and fewer cavities compared to those of a low RS rice variety. The starch crystal was classified as an A-type, which may be connected to the high amylose-lipid complex content. The branched internal long chains (B2 + B3) were abundant, allowing for easy entanglement with other molecular chains and a compact structure. Differential scanning calorimetry revealed the need for high temperature and energy to disrupt the double helix structure within the crystallization region of starch. Furthermore, starch viscosity analysis revealed a high cold paste viscosity, consistency, and setback value, with recrystallization yielding a stable structure, increased viscosity, and enhanced hydrolysis resistance to enzymes.

Harnessing the power of resistant starch: a narrative review of its health impact and processing challenges

Starch is a primary energy storage for plants, making it an essential component of many plant-based foods consumed today. Resistant starch (RS) refers to those starch fractions that escape digestion in the small intestine and reach the colon where they are fermented by the microflora. RS has been repeatedly reported as having benefits on health, but ensuring that its content remains in food processing may be challenging. The present work focuses on the impact RS on health and explores the different processes that may influence its presence in foods, thus potentially interfering with these effects. Clinical evidence published from 2010 to 2023 and studying the effect of RS on health parameters in adult populations, were identified, using PUBMED/Medline and Cochrane databases. The search focused as well on observational studies related to the effect of food processes on RS content. While processes such as milling, fermentation, cooking and heating seem to have a deleterious influence on RS content, other processes, such as cooling, cooking time, storage time, or water content, may positively impact its presence. Regarding the influence on health parameters, there is a body of evidence suggesting an overall significant beneficial effect of RS, especially type 1 and 2, on several health parameters such as glycemic response, insulin resistance index, bowel function or inflammatory markers. Effects are more substantiated in individuals suffering from metabolic diseases. The effects of RS may however be exerted differently depending on the type. A better understanding of the influence of food processes on RS can guide the development of dietary intake recommendations and contribute to the development of food products rich in RS.

Nutrition at the Intersection between Gut Microbiota Eubiosis and Effective Management of Type 2 Diabetes

Nutrition is one of the most influential environmental factors in both taxonomical shifts in gut microbiota as well as in the development of type 2 diabetes mellitus (T2DM). Emerging evidence has shown that the effects of nutrition on both these parameters is not mutually exclusive and that changes in gut microbiota and related metabolites such as short-chain fatty acids (SCFAs) and branched-chain amino acids (BCAAs) may influence systemic inflammation and signaling pathways that contribute to pathophysiological processes associated with T2DM. With this background, our review highlights the effects of macronutrients, carbohydrates, proteins, and lipids, as well as micronutrients, vitamins, and minerals, on T2DM, specifically through their alterations in gut microbiota and the metabolites they produce. Additionally, we describe the influences of common food groups, which incorporate varying combinations of these macronutrients and micronutrients, on both microbiota and metabolic parameters in the context of diabetes mellitus. Overall, nutrition is one of the first line modifiable therapies in the management of T2DM and a better understanding of the mechanisms by which gut microbiota influence its pathophysiology provides opportunities for optimizing dietary interventions.