Metabolic effects of resistant starch type 2: a systematic literature review and meta-analysis of randomised controlled trials

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 randomised controlled trials (RCTs) published in English between 1982-2018, with trials eligible for inclusion if they reported RCTs involving humans where at least one group consumed ≥8 grams 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, 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.