Assessment of Adverse Effect of Daily Consumption Amounts of Resistant Starch Type 2 from Maize Fortified in Chocolate-flavored Milk on the GI Tract in Healthy Thai Women of Reproductive Age: a Pilot Study
Keywords:resistant starch, adverse effect on gastrointestinal tract, resistant starch fortified in chocolate-flavored milk
Resistant starch is a non-digestible carbohydrate that is unabsorbed in the small intestine but has been reported to provide various health benefits. However, high-dose consumption of resistant starch may generate adverse effects on the gastrointestinal tract (GI tract). This pilot study assessed the side effects of daily consumption of resistant starch type 2 (RS) from maize fortified in chocolate-flavored milk on the GI tract. The study was conducted on 30 apparently healthy females. Participants received 30 g/d RS fortified in chocolate-flavored milk for 14 days, and 7 days washed out, and 40 g/d RS fortified in a similar product for another 14 days. Adverse effects on the GI tract were recorded after drinking the RS fortified product for 3, 7, 10, and 14 days. Consumption of 30 g/d RS fortified in chocolate-flavored milk for 2 weeks showed a weaker adverse effect on the GI tract than consumption of 40 g/d RS. The common symptoms were stomach gas, flatulence, belching, and stomach growling. There was no significant effect on weight change and dietary intake after consumption of the RS fortified product relative to baseline. The low water solubility of RS leads to low product sensory acceptability, therefore, the fortification level of resistant starch in food products to minimize the adverse GI symptoms and the undesirable mouthfeel caused by resistant starch has to be optimized. Besides, resistant starch fortified in other food products needs to be explored to increase the number of product choices for investigation of its beneficial effects on human health.
Peters R, Ee N, Peters J, Beckett N, Booth A, Rockwood K, et al. Common risk factors for major noncommunicable disease, a systematic overview of reviews and commentary: the implied potential for targeted risk reduction. Ther Adv Chronic Dis. 2019; 10:2040622319880392.
Budreviciute A, Damiati S, Sabir DK, Onder K, Schuller-Goetzburg P, Plakys G, et al. Management and Prevention Strategies for Non-communicable Diseases (NCDs) and Their Risk Factors. Front Public Health. 2020;8:574111.
Nediani C, Dinu M. Oxidative Stress and Inflammation as Targets for Novel Preventive and Therapeutic Approaches in Non-Communicable Diseases II. Antioxidants (Basel). 2022;11(5).
Rastogi S, Rastogi D. The Epidemiology and Mechanisms of Lifetime Cardiopulmonary Morbidities Associated with Pre-Pregnancy Obesity and Excessive Gestational Weight Gain. Front Cardiovasc Med. 2022;9:844905.
Al-Ani Z, Al-Dulaimy W, Al-Dulaimy K, Al-Haj S, Abdulraheem Y, Al-Maraie A, et al. Postpartum Weight: A Guide for Calculation of the Expected Prepregnancy Weight to Study the Risk of Maternal Overweight and Obesity on Congenital Anomalies. J Obes Weight Loss Ther. 2016;6:1-12.
Birt D, Boylston T, Hendrich S, Jane J-L, Hollis J, Li L, et al. Resistant Starch: Promise for Improving Human Health. Advances in nutrition (Bethesda, Md). 2013;4:587-601.
Drake AM, Coughlan MT, Christophersen CT, Snelson M. Resistant Starch as a Dietary Intervention to Limit the Progression of Diabetic Kidney Disease. Nutrients. 2022;14(21).
Raigond P, Dutt S, Singh B. Resistant Starch in Food. In: Mérillon J-M, Ramawat KG, editors. Bioactive Molecules in Food. Cham: Springer International Publishing; 2019. 815-46.
Hasjim J, Lee S-O, Hendrich S, Setiawan S, Ai Y, Jane J-l. Characterization of a Novel Resistant-Starch and Its Effects on Postprandial Plasma-Glucose and Insulin Responses. Cereal Chem. 2010;87(4):257-62.
Kwak JH, Paik JK, Kim HI, Kim OY, Shin DY, Kim HJ, et al. Dietary treatment with rice containing resistant starch improves markers of endothelial function with reduction of postprandial blood glucose and oxidative stress in patients with prediabetes or newly diagnosed type 2 diabetes. Atherosclerosis. 2012;224(2):457-64.
Tan L-l, Duan W-q, Chen M-x, Mei Y, Qi X-y, Zhang Y. Naturally cultured high resistant starch rice improved postprandial glucose levels in patients with type 2 diabetes: A randomized, double-blinded, controlled trial. Front Nutr. 2022;9:1-7.
Bodinham CL, Smith L, Thomas EL, Bell JD, Swann JR, Costabile A, et al. Efficacy of increased resistant starch consumption in human type 2 diabetes. Endocr Connect. 2014;3(2):75-84.
Keenan MJ, Zhou J, Hegsted M, Pelkman C, Durham HA, Coulon DB, et al. Role of resistant starch in improving gut health, adiposity, and insulin resistance. Adv Nutr. 2015;6(2):198-205.
Dainty SA, Klingel SL, Pilkey SE, McDonald E, McKeown B, Emes MJ, et al. Resistant Starch Bagels Reduce Fasting and Postprandial Insulin in Adults at Risk of Type 2 Diabetes123.J Nutr. 2016;146(11): 2252-9.
Karimi P, Abbasalizad Farhangi M, Sarmadi B, Pourghassem Gargari B, Javid A, Pouraghaei M, et al. The Therapeutic Potential of Resistant Starch in Modulation of Insulin Resistance, Endotoxemia, Oxidative Stress and Antioxidant Biomarkers in Women with Type 2 Diabetes: A Randomized Controlled Clinical Trial. Ann Nutr Metab. 2015;68:85-93.
Vidrine K, Ye J, Martin RJ, McCutcheon KL, Raggio AM, Pelkman C, et al. Resistant starch from high amylose maize (HAM-RS2) and dietary butyrate reduce abdominal fat by a different apparent mechanism. Obesity (Silver Spring). 2014;22(2):344-8.
Robertson MD, Bickerton AS, Dennis AL, Vidal H, Frayn KN. Insulin-sensitizing effects of dietary resistant starch and effects on skeletal muscle and adipose tissue metabolism. Am J Clin Nutr. 2005;82(3):559-67.
Pedersen A, Sandström B, Van Amelsvoort JM. The effect of ingestion of inulin on blood lipids and gastrointestinal symptoms in healthy females. Br J Nutr. 1997;78(2):215-22.
Johnston KL, Thomas EL, Bell JD, Frost GS, Robertson MD. Resistant starch improves insulin sensitivity in metabolic syndrome. Diabet Med. 2010;27(4):391-7.
Mysonhimer AR, Holscher HD. Gastrointestinal Effects and Tolerance of Nondigestible Carbohydrate Consumption. Adv Nutr. 2022;13(6):2237-76.
Englyst HN, Hudson GJ. The classification and measurement of dietary carbohydrates. Food Chem. 1996;57(1):15-21.
Magallanes-Cruz PA, Flores-Silva PC, Bello-Perez LA. Starch Structure Influences Its Digestibility: A Review. J Food Sci. 2017; 82(9):2016-23.
Asp NG, EURESTA., Starch EF-CAoR, Research F-LA-I, Commission of the European Communities. Directorate General XII: Science R, Development. Resistant Starch: Proceedings from the 2nd Plenary Meeting of EURESTA: European FLAIR Concerted Action No. 11 (COST 911): Physiological Implications of the Consumption of Resistant Starch in Man: Macmillan; 1992.
Portincasa P, Bonfrate L, Vacca M, De Angelis M, Farella I, Lanza E, et al. Gut Microbiota and Short Chain Fatty Acids: Implications in Glucose Homeostasis. Int J Mol Sci. 2022;23(3).
Platel K, Shurpalekar KS. Resistant starch content of Indian foods. Plant Foods Hum Nutr. 1994;45(1):91-5.
Chen L, Liu R, Qin C, Meng Y, Zhang J, Wang Y, et al. Sources and intake of resistant starch in the Chinese diet. Asia Pac J Clin Nutr. 2010;19:274-82.
Muir JG, Walker KZ, Kaimakamis MA, Cameron MA, Govers MJ, Lu ZX, et al. Modulation of fecal markers relevant to colon cancer risk: a high-starch Chinese diet did not generate expected beneficial changes relative to a Western-type diet. Am J Clin Nutr. 1998;68(2):372-9.
Brighenti F, Casiraghi MC, Baggio C. Resistant starch in the Italian diet. Br J Nutr. 1998;80(4):333-41.
Tomlin J, Read NW. The effect of resistant starch on colon function in humans. Br J Nutr. 1990;64(2):589-95.
Baghurst KI, Baghurst PA, Record SJ. Dietary fiber, nonstarch polysaccharide, and resistant starch intakes in Australia. In Spiller, G.A. (Ed.). CRC Handbook of Dietary Fiber in Human Nutrition (3rd ed.). CRC Press: 2001. p. 583-91.
Liljeberg Elmståhl H. Resistant starch content in a selection of starchy foods on the Swedish market. Eur J Clin Nutr. 2002;56(6):500-5.
Landon S, Colyer C, Salman H. The resistant starch report: an Australian update on health benefits, measurement and dietary intakes 2013 [Available from: https://www.scribd.com/document/374726324/Resistant-Starch-Report#.
Stewart ML, Nikhanj SD, Timm DA, Thomas W, Slavin JL. Evaluation of the effect of four fibers on laxation, gastrointestinal tolerance and serum markers in healthy humans. Ann Nutr Metab. 2010;56(2):91-8.
van den Heuvel EG, Wils D, Pasman WJ, Bakker M, Saniez MH, Kardinaal AF. Short-term digestive tolerance of different doses of NUTRIOSE FB, a food dextrin, in adult men. Eur J Clin Nutr. 2004;58(7):1046-55.
Grabitske HA, Slavin JL. Gastrointestinal effects of low-digestible carbohydrates. Crit Rev Food Sci Nutr. 2009;49(4):327-60.
Wang M, Wichienchot S, He X, Fu X, Huang Q, Zhang B. In vitro colonic fermentation of dietary fibers: Fermentation rate, short-chain fatty acid production and changes in microbiota. Trends Food Sci Technol. 2019;88:1-9.
Pasman W, Wils D, Saniez MH, Kardinaal A. Long-term gastrointestinal tolerance of NUTRIOSE FB in healthy men. Eur J Clin Nutr. 2006;60(8):1024-34.
White U, Peterson CM, Beyl RA, Martin CK, Ravussin E. Resistant Starch Has No Effect on Appetite and Food Intake in Individuals with Prediabetes. J Acad Nutr Diet. 2020;120(6):1034-41.
Martini MC, Lampe JW, Slavin JL, Kurzer MS. Effect of the menstrual cycle on energy and nutrient intake. Am J Clin Nutr. 1994;60(6):895-9.
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