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Meta-Analysis
. 2019 Aug 8;11(8):1833.
doi: 10.3390/nu11081833.

Metabolic Effects of Resistant Starch Type 2: A Systematic Literature Review and Meta-Analysis of Randomized Controlled Trials

Matthew Snelson  1 , Jessica Jong  2 , Deanna Manolas  2 , Smonda Kok  2 , Audrey Louise  2 , Romi Stern  2 , Nicole J Kellow  3
Affiliations
Meta-Analysis

Metabolic Effects of Resistant Starch Type 2: A Systematic Literature Review and Meta-Analysis of Randomized Controlled Trials

Matthew Snelson et al. Nutrients. .

Abstract

Published evidence exploring the effects of dietary resistant starch (RS) on human cardiometabolic health is inconsistent. This review aimed to investigate the effect of dietary RS type 2 (RS2) supplementation on body weight, satiety ratings, fasting plasma glucose, glycated hemoglobin (HbA1c), insulin resistance and lipid levels in healthy individuals and those with overweight/obesity, the metabolic syndrome (MetS), prediabetes or type 2 diabetes mellitus (T2DM). Five electronic databases were searched for randomized controlled trials (RCTs) published in English between 1982 and 2018, with trials eligible for inclusion if they reported RCTs involving humans where at least one group consumed ≥ 8 g of RS2 per day and measured body weight, satiety, glucose and/or lipid metabolic outcomes. Twenty-two RCTs involving 670 participants were included. Meta-analyses indicated that RS2 supplementation significantly reduced serum triacylglycerol concentrations (mean difference (MD) = -0.10 mmol/L; 95% CI -0.19, -0.01, P = 0.03) in healthy individuals (n = 269) and reduced body weight (MD = -1.29 kg; 95% CI -2.40, -0.17, P = 0.02) in people with T2DM (n = 90). 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. Short-term RS2 supplementation in humans is of limited cardiometabolic benefit.

Keywords: dietary fiber; metabolic health; metabolic syndrome; obesity; resistant starch; systematic review; type 2 diabetes.

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Conflict of interest statement

The authors declare that there were no personal or financial conflicts of interest.

Figures

Figure 1
Figure 1
Literature search and review flowchart for selection of studies.
Figure 2
Figure 2
Effect of RS2 supplementation on fasting plasma glucose (mmol/L) in healthy subjects, subjects with MetS and subjects with T2DM. Mean Difference (95% CI) shown for individual and pooled trials.
Figure 3
Figure 3
Effect of RS2 supplementation on glycated hemoglobin (HbA1c %) in subjects with T2DM. Mean Difference (95% CI) shown for individual and pooled trials.
Figure 4
Figure 4
Effect of RS2 supplementation on body weight (kg) in healthy subjects, overweight subjects, subjects with MetS, and subjects with T2DM. Mean Difference (95% CI) shown for individual and pooled trials.
Figure 5
Figure 5
Effect of RS2 supplementation on HOMA-IR in healthy subjects, subjects with MetS and subjects with T2DM. Mean Difference (95% CI) shown for individual and pooled trials.
Figure 6
Figure 6
Effect of RS2 supplementation on total cholesterol (mmol/L) in healthy subjects, subjects with MetS and subjects with T2DM. Mean Difference (95% CI) shown for individual and pooled trials.
Figure 7
Figure 7
Effect of RS2 supplementation on LDL cholesterol (mmol/L) in healthy subjects, subjects with MetS and subjects with T2DM. Mean Difference (95% CI) shown for individual and pooled trials.
Figure 8
Figure 8
Effect of RS2 supplementation on HDL cholesterol (mmol/L) in healthy subjects, subjects with MetS and subjects with T2DM. Mean Difference (95% CI) shown for individual and pooled trials.
Figure 9
Figure 9
Effect of RS2 supplementation on TAG (mmol/L) in healthy subjects, subjects with MetS and subjects with T2DM. Mean Difference (95% CI) shown for individual and pooled trials.
See this image and copyright information in PMC

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