Resistant starch type 4-enriched diet lowered blood cholesterols and improved body composition in a double blind controlled cross-over intervention

Abstract

A metabolic health crisis is evident as cardiovascular diseases (CVD) remain the leading cause of mortality in the United States. Effects of resistant starch type 4 (RS4), a prebiotic fiber, in comprehensive management of metabolic syndrome (MetS) remain unknown. This study examined the effects of a blinded exchange of RS4-enriched flour (30% v/v) with regular/control flour (CF) diet on multiple MetS comorbidities. In a double blind (participants-investigators), placebo-controlled, cluster cross-over intervention (n = 86, age≥18, 2-12 week interventions, 2-week washout) in the United States, individuals were classified as having MetS (With-MetS) or not (No-MetS) following International Diabetes Federation (IDF)-criteria. RS4 consumption compared with CF resulted in 7.2% (p = 0.002) lower mean total cholesterol, 5.5% (p = 0.04) lower non-HDL, and a 12.8% (p < 0.001) lower HDL cholesterol in the With-MetS group. No-MetS individuals had a 2.6% (p = 0.02) smaller waist circumference and 1.5% (p = 0.03) lower percent body fat following RS4 intervention compared to CF. A small but significant 1% increase in fat-free mass was observed in all participants combined (p = 0.02). No significant effect of RS4 was observed for glycemic variables and blood pressures. RS4 consumption improved dyslipidemia and body composition. Incorporation of RS4 in routine diets could offer an effective strategy for public cardio-metabolic health promotion.

Keywords: Cardiovascular diseases; Dietary intervention; Metabolic syndrome; Resistant starch type 4.

Figure 1. A placebo (CF)-controlled, crossover, dietary intervention with RS4

Study design (A), Effects of RS4 flour on lipids (B), glucose (C) and anthropometric variables (D). Differences between means (RS4-CF) following the intervention periods were obtained from a linear mixed model adjusting for age, gender, season, and colony (± standard error of the mean). Participants were stratified into three groups based on the presence of metabolic syndrome during the study: With-MetS, had metabolic syndrome throughout the study; No-MetS, never had metabolic syndrome during the study; Change, changed status during the study (data not shown); ALL= With-MetS + No-MetS + Change. Asterisks above the difference in the means indicates that RS4 consumption had a significant effect (p≤0.05).

Figure 1. A placebo (CF)-controlled, crossover, dietary intervention with RS4

Study design (A), Effects of RS4 flour on lipids (B), glucose (C) and anthropometric variables (D). Differences between means (RS4-CF) following the intervention periods were obtained from a linear mixed model adjusting for age, gender, season, and colony (± standard error of the mean). Participants were stratified into three groups based on the presence of metabolic syndrome during the study: With-MetS, had metabolic syndrome throughout the study; No-MetS, never had metabolic syndrome during the study; Change, changed status during the study (data not shown); ALL= With-MetS + No-MetS + Change. Asterisks above the difference in the means indicates that RS4 consumption had a significant effect (p≤0.05).