Prebiotic Type Spotlight: Resistant Starch

Last updated Sept 2023

Each edition of GPA’s Prebiotic Spotlight focuses on a specific prebiotic type to raise awareness around the prebiotic itself, its sources, any notable and/or recent research, and how it is used in the marketplace. In this issue, Resistant Starch (RS) is highlighted.

Overview
RS is an insoluble type of dietary fiber that is resistant to digestion by α-amylase and pullulanase enzymes in the small intestine and may be fermented by the colon microbiota, producing carbon dioxide, hydrogen, methane, and short-chain fatty acids (SCFAs) (Bojarczuk et al., 2022; Tekin & Dincer, 2023).

Before the rise of processed foods, RS was a primary dietary feature worldwide and people routinely consumed 30 to 40 g of RS per day (Stephen et al., 1995; O’Keefe et al., 2015). Food processing has converted most of the RS in our diet into high glycemic, easily digestible starch, reducing the total amount consumed (Ashwar et al., 2016; Birt et al., 2013). Males and females in the United States (US) only consume about 4.6 g and 3.3 g of RS per day, respectively (Miketinas et al., 2020), while individuals following Ketogenic or Paleolithic diets may consume even less (Genoni et al., 2019). With lower consumption, the metabolic consequences of less dietary RS are now becoming known, including microbiome dysbiosis, manifested in a depletion of the keystone species Bifidobacterium (Ang et al., 2020), and various other health disruptions.

Benefit Areas
Extensive research over the past 40 years has demonstrated considerable health benefits of RS in over 600 preclinical and 300 clinical trials published, which include:

  • Improving appetite and reducing hunger (Amini et al., 2021).
  • Reducing glycemic response (Liu et al., 2022; Ma & Lee, 2021).
  • Modulating the microbiome towards health and wellness via prebiotic activity (Bojarczuk et al., 2022; Bush et al., 2023).
  • Producing higher butyrate than other fermentable fibers (Cummings et al., 2001).
  • Increasing insulin sensitivity and reducing the risk of type 2 diabetes (Liu et al., 2022; FDA, 2016).
  • Improving hemoglobin A1c in diabetes (Frias et al., 2023).
  • Protecting against upper gastrointestinal cancers in high-risk individuals (Mathers et al., 2022).
  • Reducing intrahepatic triglyceride content and reducing the liver enzymes indicative of liver injury and markers for systemic inflammation in individuals with Non-alcoholic Fatty Liver Disease (NAFLD) (Ni et al., 2023)
  • Ameliorating inflammation markers (Warman et al., 2022; Wei et al., 2022).
  • Improving metabolic biomarkers in diabetic and metabolic syndrome patients (Halajzadeh et al., 2020; Rashed et al., 2022).
  • Improving kidney health by reducing inflammatory markers (Du et al., 2022; Tayebi Khosroshahi et al., 2018).
  • Reducing blood pressure in individuals with hypertension (Jama et al., 2023)
  • Strengthening the intestinal gut barrier, reducing the translocation of toxins, and ameliorating autoimmune disease in an in vivo preclinical model (Zegarra-Ruiz et al., 2019).

Sources

RS is available in natural and processed starchy foods in variable quantities, including whole grains and raw starches like green bananas, raw potatoes, legumes, and wheat (Fuentes-Zaragoza et al., 2011). Historically, the predominant food source of starch varied depending on the location; for example, green bananas dominated in the tropics, potatoes in the Andes, corn in Mexico and Central America, and barley in the Fertile Crescent of Egypt and Mesopotamia. Today, these foods are available worldwide, and they remain a key source of RS. Lower levels of RS also exist in cooked and cooled foods such as rice, pasta, and potato salad (Birt et al., 2013). Natural RS sources include green banana starch, raw potato starch, high amylose corn starch, high amylose wheat flour, and high amylose barley (Grand View Research, 2022), which have demonstrated improvements in insulin sensitivity in published clinical trials (FDA, 2016; Tavares da Silva et al., 2014; Alfa et al., 2018). Notably, the different natural RS sources have similar digestion and fermentation profiles and have been utilized in the vast range of research.

Commercially, RS is extracted and modified using different physical, enzymatic, and chemical processes (Ashwar et al., 2016), generally called type RS4 resistant starches. RS is usually chemically modified by phosphorylation and commercially available from wheat, corn, potato, and tapioca starch (Ashwar et al., 2016; Bojarczuk et al., 2022). The RS4 ingredients are often used in low-carbohydrate food formulations and have significantly different digestion and fermentation profiles compared to natural RS (Li et al., 2023; Teichmann & Cockburn, 2021; Martinez et al., 2010). Thus, the health and prebiotic effects demonstrated by natural RS may not apply to type RS4 resistant starches.

Green banana flour
Credit: Solnul

Dose Range
RS is available in powdered form as a natural extract or chemically modified to be added to foods and other products, increasing their fiber content. While the recommended intake of dietary fiber is 25-30 g/day (UCSF, 2023), no official recommended daily dose of RS is available. Recently, lower levels of RS/day have been shown to significantly impact the microbiome composition (Bush et al., 2023). However, most published studies have shown that health benefits require higher RS quantities; for example, satiety has been demonstrated with 8 grams/day (Willis et al., 2009), while major metabolic health benefits typically require 15-30 g of RS/day (Bojarczuk et al., 2022; Lockyer & Nugent, 2017). Nonetheless, most published records report a daily dose of RS between 6 g and 48 g, with lower amounts (<6 g/day) used in multi-ingredient prebiotic mixtures (Bojarczuk et al., 2022; ClinicalTrials.gov, 2023).

Recent Research
Research on RS continues as awareness increases of its health benefits. Fourteen registered studies on ClinicalTrials.gov are currently recruiting to investigate RS on various health conditions, which include inflammatory bowel diseases (IBS), diabetes, Behcet syndrome, chronic kidney disease (CKD), polycystic ovary syndrome (PCOS), and colon cancer (ClinicalTrials.gov). On PubMed, searching “resistant starch” yielded 278 articles published during 2023, focusing on conditions such as renal inflammation, intestinal integrity, diabetes, and others (PubMed, 2023). One study by Wan et al. (2022) investigated the association between RS intake and all-cause and cause-specific mortality, demonstrating that RS is associated with lower cancer and all-cause mortality. Another study by Ismail et al. (2022) reported that RS4 acetylated and butyrylated high amylose resistant starch was effective in preventing Type 1 Diabetes (T1D) in mouse models and is being investigated for glycemic benefits in newly diagnosed youth with T1D. In addition, Zhou et al. (2023) reported that RS4 acetylated and butyrylated high amylose resistant starch enhanced cognition and alleviated disease in a mouse model of Alzheimer’s Disease. Specific prebiotic effects of RS on influencing the abundance of certain beneficial gut bacteria such as Bifidobacteria are well studied. Jung and Park (2023) highlight the genetic advantage that allows Bifidobacteria to utilize RS by possessing specific RS-degrading enzymes. However, quantifiable effects on other beneficial bacteria like Akkermansia are not as well documented. Bush et al. (2023) established the prebiotic effect of RS, specifically significantly increasing the abundance of Bifidobacterium and Akkermansia and improving stool consistency, with only 3.5 g of an unmodified resistant potato starch (RPS). While RS’ prebiotic activity is commonly evaluated at high doses, its effects at doses <10 g/day are now being researched. The study’s reported quantifiable effect on Akkermansia can be also considered novel as this strain is an emerging probiotic.

How is RS used in the marketplace?
RS has gained considerable interest for its unique functional properties and physiological benefits as a dietary fiber and prebiotic. Its small particle size, tastelessness, and white appearance, in addition to its physicochemical properties, including viscosity increase, gel formation, swelling index, and water-holding capacity make RS an ideal candidate to make high-quality products (Ashwar et al., 2016; Bojarczuk et al., 2022). While natural RS ingredients are utilized for their metabolic health benefits, RS4 ingredients are utilized for their low glycemic response in low-carbohydrate food products.

Commercially, RS is extracted from corn, rice, wheat, potatoes, cereals, and beans as an extract that withstands processing and storage conditions. With a long history of safe consumption, RS is added to dairy products, baked goods, sugar confections, starchy foods, and beverages to increase their total fiber content without affecting taste or texture (Tekin & Dincer, 2023).

The global market for RS exceeded USD 10.5 billion in 2022 and is anticipated to increase between 2023 and 2032 by over a 6% compound annual growth rate (CAGR) to reach USD 20.4 billion in 2032 (Global Market Insights, 2023).

GPA Member Resistant Starch Brands & Suppliers

ADM

References

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