Effects of resistant starch on glycaemic control: a systematic review and meta-analysis

The effects of resistant starch on glycaemic control are controversial. In this study, a systematic review and meta-analysis of results from nineteen randomised controlled trials (RCT) was performed to illustrate the effects of resistant starch on glycaemic control. A literature search was conducted on PubMed, Scopus and Cochrane electronic databases for related publications from inception to 6 April 2020. Key inclusion criteria were: RCT; resistant starch as intervention substances and reporting glucose- and insulin-related endpoints. Exclusion criteria were: using type I resistant starch or a mixture of resistant starch and other functional food ingredients as intervention; using substances other than digestible starch as controls. The effect of resistant starch on fasting plasma glucose was significant (effect size (ES) -0 center dot 09 (95 % CI -0 center dot 13, -0 center dot 04) mmol/l, P = 0 center dot 001) compared with digestible starch. Subgroup analyses revealed that the ES was larger when the dosage of resistant starch was more than 28 g/d (ES -0 center dot 16 (95 % CI -0 center dot 24, -0 center dot 08) mmol/l, P < 0 center dot 001) or the intervention period was more than 8 weeks (ES -0 center dot 12 (95 % CI -0 center dot 18, -0 center dot 06) mmol/l, P < 0 center dot 001). The effect on homoeostatic model assessment (HOMA)-insulin resistance (IR) was significant (ES -0 center dot 33 (95 % CI -0 center dot 51, -0 center dot 14), P = 0 center dot 001). However, the effects on other insulin-related endpoints were not significant, including fasting plasma insulin, four endpoints from the frequently sampled intravenous glucose tolerance test (insulin sensitivity index, acute insulin response, disposition index and glucose effectiveness) and HOMA-beta. The current study indicated moderate effects of resistant starch on improving glycaemic control.

Automated summary

Resistant starch has moderate effects on improving glycaemic control, with greater impact seen at higher dosages and longer intervention periods.