Insulin-sensitizing effects of dietary resistant starch and effects on skeletal muscle and adipose tissue metabolism

Background: Resistant starch may modulate insulin sensitivity, although the precise mechanism of this action is unknown. Objective: We studied the effects of resistant starch on insulin sensitivity and tissue metabolism. Design: We used a 4-wk supplementation period with 30 g resistant starch/d. compared with placebo, in 10 healthy subjects and assessed the results by using arteriovenous difference methods. Results: When assessed by euglycemic-hyperinsulinemic clamp, insulin sensitivity was higher after resistant starch supplementation than after placebo treatment (9.7 and 8.5 X 10(-2) mg glucose (.) kg(-1) min(-1) (.) (mU insulin[L)(-1), respectively; P = 0.03); insulin sensitivity during the meal tolerance test (MTT) was 33% higher (P = 0.05). Forearm muscle Glucose clearance during the MTT was also higher after resistant starch supplementation (P = 0.03) despite lower insulin concentrations (P = 0.02); glucose clearance adjusted for insulin was 44% higher. Subcutaneous abdominal adipose tissue nonesterified fatty acid (NEFA;, P = 0.02) and glycerol (P = 0.05) release were lower with resistant starch supplementation, although systemic NEFA concentrations were not significantly altered. Shortchain fatty acid concentrations (acetate and propionate) were higher during the MTT (P = 0.05 and 0.01, respectively), as was acetate uptake by adipose tissue (P = 0.03). Fasting plasma ghrelin concentrations were higher with resistant starch supplementation (2769 compared with 2062 pg/mL, P = 0.03), although postprandial suppression (40-44%) did not differ significantly. Measurements of Gene expression in adipose tissue and muscle were uninformative, which suggests effects at a metabolic level. The resistant starch supplement was well tolerated. Conclusion: These results suggest that dietary supplementation with resistant starch has the potential to improve insulin sensitivity. Further studies in insulin-resistant persons are needed.