Resistant starch

From Wikipedia, the free encyclopedia
Jump to: navigation, search
A specially developed strain of Barley, high in resistant starch

Resistant starch (RS) is starch and starch degradation products that escape from digestion in the small intestine of healthy individuals.[1] Resistant starch is considered the third type of dietary fiber, as it can deliver some of the benefits of insoluble fiber and some of the benefits of soluble fiber.

Some carbohydrates, such as sugars and most starch, are rapidly digested and absorbed as glucose into the body through the small intestine and subsequently used for short-term energy needs or stored. Resistant starch, on the other hand, resists digestion and passes through to the large intestine where it acts like dietary fiber.

Resistant starch has been categorized into four types:

  • RS1 Physically inaccessible or undigestible resistant starch, such as that found in seeds or legumes and unprocessed whole grains.
  • RS2 Resistant starch that occurs in its natural granular form, such as uncooked potato, green banana and high amylose corn.
  • RS3 Resistant starch that is formed when starch-containing foods are cooked and cooled, such as legumes, bread, cornflakes, potatoes, sushi rice[citation needed] or pasta salad.[2] Occurs due to retrogradation, which refers to the collective processes of dissolved starch becoming less soluble after being heated and dissolved in water and then cooled.
  • RS4 Starches that have been chemically modified to resist digestion. This type of resistant starches can have a wide variety of structures and are not found in nature.

There is some discussion about resistant dextrins being described as "resistant starch." Resistant dextrins are not starches, and they can be soluble or insoluble. They might be described as "starch degradation products," a phrase which is included in the EURESTA definition, but their characteristics and performance are very different from those of insoluble resistant starches.

As functional fiber[edit]

Resistant starch is considered both a dietary fiber and a functional fiber, depending on whether it is naturally in foods or added.[3][4][5] The U.S. Institute of Medicine has defined total fiber as equal to functional fiber plus dietary fiber,[6] and U.S. food labeling doesn't distinguish between them.[7]

Examples of naturally occurring resistant starch[8]
Food Serving size Resistant starch
Banana flour,[9] from green bananas 1/4 cup, uncooked 10.5-13.2
Banana, raw, slightly green 1 medium, peeled 4.7
High amylose RS2 corn resistant starch 1 tablespoon (9.5 g) 4.5
Oats, rolled 1/4 cup, uncooked 4.4
Green peas, frozen 1 cup, cooked 4.0
White beans 1/2 cup, cooked 3.7
Lentils 1/2 cup cooked 2.5
Cold pasta 1 cup 1.9
Pearl barley 1/2 cup cooked 1.6
Cold potato 1/2" diameter 0.6 - 0.8
Oatmeal 1 cup cooked 0.5

In 1971, Painter and Burkitt suggested[10] that a significant gap exists between the amount of dietary fiber urbanized people consume and the optimal amount of fiber for health and wellness, but some skepticism remains.[11][12] In 1982, Englyst et al.[13] gelatinized starch then post-processed it with both alpha-amylase and pullulanase in order to analyze it, found that some starch remained, and called it resistant starch.[14][15] In 1986, Berry formed[16] functional RS3[17] dietary fibers by a process of heating and cooling[18] a variety of starch sources, one of which was amylopectin pre-processed with the enzyme pullulanase. That source had the second highest alpha-amylase resistant starch level, while amylomaize or high-amylose starch had the highest.[19][20][21] In 2007, the Federal Register published a 2001 U.S. Institute of Medicine (IOM) Panel on the Definition of Dietary Fiber's response to a request from the U.S. Food and Drug Administration. The IOM Panel proposed two definitions: functional fiber as "isolated, nondigestible carbohydrates that have beneficial physiological effects in humans", and dietary fiber as "nondigestible carbohydrates and lignin that are intrinsic and intact in plants." They also proposed that the prior classifications of soluble versus insoluble be phased out and replaced with viscous versus fermentable with respect to each specific fiber.[22]

The National Academy of Sciences of the Institute of Medicine within the United States has recommended a daily fiber intake of 38 grams for adult men and 25 grams for adult women. Many countries around the world recommend 25-30 grams for their populations.[citation needed]

Potential health benefits[edit]

Public health authorities and food organizations such as the Food and Agricultural Organization, the World Health Organization,[23] the British Nutrition Foundation[15] and the U.S. National Academy of Sciences[5] recognize resistant starch as a beneficial carbohydrate. The WIC program (Women, Infants, Children) includes many foods high in resistant starch. The Joint Food and Agricultural Organization of the United Nations/World Health Organization Expert Consultation on Human Nutrition stated, "One of the major developments in our understanding of the importance of carbohydrates for health in the past twenty years has been the discovery of resistant starch."[23]

Research of RS2 resistant starches from high amylose corn indicates benefits in intestinal/colonic health as well as metabolic benefits in glycemic management,[24][25][26][27][28][29] satiety and hunger [30][31][32] and eye health.[33][34] Different types and sources of resistant starch are digested and/or fermented differently and thus must be considered individually.[35][36][37][38][39][40]

Weight management[edit]

Consumption of foods containing natural resistant starch seems to positively affect weight management in six ways.

  • Fiber fortification: When added to foods such as bread, biscuits, sweet goods, pasta, nutritional bars and cereal, resistant starch can increase fiber content without affecting taste or texture. In 2003, the World Health Organization concluded that dietary fiber was the only dietary component that had convincing evidence showing a protective effect against weight gain and obesity.[41][dubious ] While the exact mechanisms of fiber protecting against weight gain are still under investigation, its ability to increase satiety and decrease subsequent hunger, along with altering the secretion of hormones related to food digestion, are considered likely mechanisms.[42]
  • Calorie reduction: Resistant starch can be used to replace higher calorie food ingredients, such as flour or other rapidly digested carbohydrates. Natural resistant starch delivers between 2-3 kilocalories/gram (8-12 kilojoules/gram) versus 4 kilocalories/gram (16 kilojoules/gram).[43][44] Consequently, resistant starch is a valuable tool for formulators of reduced-calorie foods.
  • Satiety: Multiple recent studies have shown that naturally occurring resistant starch (from high amylose corn and from barley kernels) increases satiety and reduces food intake in the short term (within a few hours) and longer-term (for 20–24 hours).[32][45][46][47] However, chemically modified resistant wheat starch, chemically modified resistant potato starch and retrograded, acid-treated high amylose resistant corn starch was shown to have no impact on subjective satiety and no impact on subsequent food intake.[48][49][50]
  • Lipid oxidation: Resistant starch may help burn fat and may lead to lower fat accumulation. One clinical trial with high amylose corn resistant starch showed that it increased fat oxidation after a meal. These findings suggest a possible metabolic effect of resistant starch that may affect body weight.[51]
  • Fat storage: Resistant starch from high amylose corn has been shown to improve fatty acid metabolism within adipose tissue. A human clinical trial[29] found increased levels of lipases (hormone-sensitive lipase (HSL), lipoprotein lipase (LPL), and adipose triglyceride lipase (ATGL)) which may indicate increased adipocyte differentiation within the adipose tissue.[52]

Glycemic (blood sugar) management[edit]

Consumption of natural resistant starch by humans has been shown to result in

  • Decreased glycemic response in healthy individuals,[53] decreased glycemic response in diabetics.[54]
  • Increase insulin sensitivity in healthy individuals,[24][25] individuals with Type II diabetes[27] as well as insulin resistant individuals.[28][29] One study found a 50% increase in insulin sensitivity in overweight men consuming 15 grams of resistant starch/day for 4 weeks.[55] One additional study found that 12 grams of ingredients containing resistant starch did not improve insulin sensitivity in African American adults at risk for diabetes.[56]
  • Increase glycemic health of next generation when fed to pregnant mothers An animal study demonstrated that when RS2 resistant starch from high amylose corn was fed to pregnant, diabetic rats, it resulted in increased insulin sensitivity and preservation of beta-cell mass within the pancreas of the dams as well as lower fasting blood glucose levels in the pups.[57]
  • Improves first phase insulin secretion A human clinical trial demonstrated improved first phase insulin secretion when RS2 resistant starch from high amylose corn was fed to overweight, insulin resistant adults.[58]

Animal studies have shown that RS2 resistant starch from high amylose corn prevented the development of insulin resistance (compared to high glycemic starch), but does not reverse insulin resistance that has already developed.[59][60][61]

Digestive system[edit]

Natural resistant starch appears to help maintain a healthy colon and a healthy digestive system, possibly via several mechanisms.

  • It encourages the growth of healthy bacteria in the bowel and, therefore, is called "prebiotic fiber." The fermentation of natural resistant starch reduces intestinal pH and the production of potentially harmful secondary bile acids, ammonia, and phenols.[62]
  • It is predicted to help maintain "regularity" with a mild laxative effect due to increased microbial activity in the large intestine. Its bulking effects are generated by increasing the bacterial mass, and not through water holding, which accounts for its milder regularity effects compared to non-fermenting, bulking fibers like cellulose.[63][64][65]
  • It may help to keep colon tissue healthy by producing protective compounds called short-chain fatty acids. One of these, called butyrate, is particularly important for colon health because it is the primary energy source for colonic cells and has anti-carcinogenic as well as anti-inflammatory properties[66] that are important for keeping colon cells healthy.[67][68] Published research has shown that butyrate inhibits the growth and proliferation of tumor cell lines in vitro, induces differentiation of tumor cells, producing a phenotype similar to that of the normal mature cell,[69] and induces apoptosis or programmed cell death of human colorectal cancer cells.[70][71]
  • Resistant starch may contribute to oral rehydration solutions for the treatment of diarrhea.[72][73]
  • Laboratory studies indicate that RS protects against experimental colo-rectal cancer[74] and diet-induced colonocyte genetic damage through short-chain fatty acids [75] However, resistant starch did not prevent colon cancer in two international clinical trials in individuals with Lynch Syndrome,[76][77] or in young people with familial adenomatous polyposis.[78][79] It has been speculated that the colon cancer prevention trials did not feed their subjects sufficient quantities of resistant starch.[80] Human studies suggest that >20 g of RS/day is needed to raise SCFA as reported by faecal levels.[81] The clinical trial in individuals with Lynch Syndrome only fed their subjects 9 grams of resistant starch/day.


  1. ^ Asp NG. (1992). "Resistant starch. Proceedings from the second plenary meeting of EURESTA: European FLAIR Concerted Action No. 11 on physiological implications of the consumption of resistant starch in man. Crete, 29 May-2 June 1991". European Journal of Clinical Nutrition 46 (Suppl 2): S1–148. PMID 1425538. 
  2. ^ Yadav BS, Sharma A, Yadav RB (2009). "Studies on effect of multiple heating/cooling cycles on the resistant starch formation in cereals, legumes and tubers". Int J Food Sci Nutr. 60 Suppl 4: 258–72. doi:10.1080/09637480902970975. PMID 19562607. 
  3. ^ Jo Ann Tatum Hattner; Susan Anderes (2009). Gut Insight: probiotics and prebiotics for digestive health and well-being. p. 45. ISBN 978-0-615-28524-5. Retrieved Mar 16, 2011. 
  4. ^ name="p.134.snack.foods.processing.rooney.lusas">Lloyd W. Rooney; Lusas, Edmund W. (2001). Snack Foods Processing. Boca Raton: CRC. p. 134. ISBN 1-56676-932-9. Retrieved Mar 16, 2011. 
  5. ^ a b National Research Council (2005). Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. National Academies Press. ISBN 0309085373. 
  6. ^ Jane Higdon (2007). An evidence-based approach to dietary phytochemicals. New York: Thieme Medical Publishers. p. 102. ISBN 3-13-141841-9. Retrieved Mar 16, 2011. 
  7. ^ Bier, Dennis M.; Alpers, David H.; Stenson, William F.; Taylor, Beth Weir (2008). Manual of nutritional therapeutics. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. p. 419. ISBN 0-7817-6841-1. Retrieved Mar 16, 2011. 
  8. ^ Murphy M, Douglass JS, Birkett A. Resistant starch intake in the United States, Journal of the American Dietetic Association 2008; 108:67-78.
  9. ^ Moogngarm et al. (2014). "RESISTANT STARCH AND BIOACTIVE CONTENTS OF UNRIPE BANANA FLOUR AS INFLUENCED BY HARVESTING PERIODS AND ITS APPLICATION". American Journal of Agricultural and Biological Sciences 9 (3): 457–465. 
  10. ^ Painter NS, Burkitt DP (May 1971). "Diverticular disease of the colon: a deficiency disease of Western civilization". Br Med J 2 (5759): 450–4. doi:10.1136/bmj.2.5759.450. PMC 1796198. PMID 4930390. 
  11. ^ Floch MH, White JA (May 2006). "Management of diverticular disease is changing". World J. Gastroenterol. 12 (20): 3225–8. PMID 16718843. Retrieved Mar 13, 2011. 
  12. ^ Stollman N, Raskin JB (February 2004). "Diverticular disease of the colon". Lancet 363 (9409): 631–9. doi:10.1016/S0140-6736(04)15597-9. PMID 14987890. 
  13. ^ Englyst, H; Wiggins, HS; Cummings, JH (1982). "Determination of the non-starch polysaccharides in plant foods by gas-liquid chromatography of constituent sugars as alditol acetates". Analyst 107 (1272): 307–318. doi:10.1039/AN9820700307. PMID 6283946. 
  14. ^ Hedley, C. L. (2001). Carbohydrates in grain legume seeds: improving nutritional quality and agronomic characteristics. Wallingford, Oxon, UK: CABI Pub. p. 47. ISBN 0-85199-467-9. Retrieved Mar 25, 2011. 
  15. ^ a b Nugent A.P. (2005). "Health properties of resistant starch, British Nutrition Foundation". Nutrition Bulletin 30 (1): 27–54. doi:10.1111/j.1467-3010.2005.00481.x. 
  16. ^ Berry CS, "Resistant starch: Formation and measurement of starch that survives exhaustive digestion with amylolytic enzymes during the determination of dietary fibre" Journal of Cereal Science, October 1986;4(4): 301–314. doi:10.1016/S0733-5210(86)80034-0
  17. ^ Claudio P. Ribeiro; Passos, Maria Helena (2009). Innovation in Food Engineering: New Techniques and Products (Contemporary Food Engineering). Boca Raton: CRC Press. p. 646. ISBN 1-4200-8606-5. Retrieved Mar 17, 2011. 
  18. ^ Sievert D, Pomeranz Y (Jul–Aug 1989). "Enzyme-resistant starch. I. Characterization and evaluation by enzymatic, thermoanalytical, and microscopic methods" (PDF). Cereal chemistry 66 (4): 342–347. ISSN 0009-0352. 
  19. ^ Chapman, C. Stuart; Henry, C. E. (2002). The nutrition handbook for food processors. Boca Raton: CRC Press. p. 307. ISBN 1-85573-464-8. Retrieved Mar 17, 2011. 
  20. ^ Johan B Ubbink; Stefan Kasapis; Ian T. Norton (2009). Modern Biopolymer Science: Bridging the Divide between Fundamental Treatise and Industrial Application. Boston: Academic Press. pp. 462–478. ISBN 0-12-374195-5. Retrieved Mar 17, 2011. 
  21. ^ Wiseman, J. D. A.; Varley, M. C. (2001). The Weaner Pig: Nutrition and Management. Oxon: CAB International. ISBN 0-85199-532-2. Retrieved Mar 17, 2011. 
  22. ^ "Federal Register | Food Labeling: Revision of Reference Values and Mandatory Nutrients". 11/2/2007. Retrieved Mar 18, 2011.  Check date values in: |date= (help)
  23. ^ a b Carbohydrates in human nutrition (Report of a Joint FAO/WHO Expert Consultation, Rome, Italy, 14-18 April 1997). FAO food and nutrition paper 66. World Health Organization. 1998. ISBN 9251041148. 
  24. ^ a b Robertson, MD; Currie, JM; Morgan, LM; Jewell, DP; Frayn, KN (May 2003). "Prior short-term consumption of resistant starch enhances postprandial insulin sensitivity in healthy subjects". Diabetologia 46 (5): 659–665. doi:10.1007/s00125-003-1081-0. PMID 12712245. 
  25. ^ a b Robertson, MD; Bickerton, AS; Dennis, AL; Vidal, H; Frayn, KN (September 2005). "Insulin-sensitizing effects of dietary resistant starch and effects on skeletal muscle and adipose tissue metabolism". The American Journal of Clinical Nutrition 82 (3): 559–567. PMID 16155268. 
  26. ^ Birt DF, Boylston T, Hendrich S et al. (November 2013). "Resistant starch: promise for improving human health". Adv Nutr 4 (6): 587–601. doi:10.3945/an.113.004325. PMID 24228189. Retrieved 2014-07-18. 
  27. ^ a b Zhang WQ, Wang HW, Zhang YM, Yang YX (March 2007). "[Effects of resistant starch on insulin resistance of type 2 diabetes mellitus patients]". Zhonghua Yu Fang Yi Xue Za Zhi (in Chinese) 41 (2): 101–4. PMID 17605234. 
  28. ^ a b Johnston KL, Thomas EL, Bell JD, Frost GS, Robertson MD (April 2010). "Resistant starch improves insulin sensitivity in metabolic syndrome". Diabet. Med. 27 (4): 391–7. doi:10.1111/j.1464-5491.2010.02923.x. PMID 20536509. 
  29. ^ a b c Robertson, MD; Wright, JW; Loizon, E; Debard, C; Vidal, H; Shojaee-Moradie, F; Russell-Jones, D; Umpleby, AM (September 2012). "Insulin-sensitizing effects on muscle and adipose tissue after dietary fiber intake in men and women with metabolic syndrome". The Journal of Clinical Endocrinology & Metabolism 97 (9): 3326–3332. doi:10.1210/jc.2012-1513. PMID 22745235. 
  30. ^ Willis, HJ; Eldridge, AL; Beiseigel, J; Thomas, W; Slavin, JL. (2009). "Greater satiety response with resistant starch and corn bran in human subjects". Nutrition Research 29 (2): 100–105. doi:10.1016/j.nutres.2009.01.004. PMID 19285600. 
  31. ^ Nilsson A.C., Ostman E.M., Holst J.J., Bjorck I.M.E. (April 2008). "Including indigestible carbohydrates in the evening meal of healthy subjects improves glucose tolerance, lowers inflammatory markers, and increases satiety after a subsequent standardized breakfast". J. Nutr. 138 (4): 732–9. PMID 18356328. 
  32. ^ a b Anderson, G Harvey; Cho, Clara E; Akhavan, Tina; Mollard, Rebecca C; Luhovyy, Bohdan L; Finocchiaro, E Terry (February 17, 2010). "Relation between estimates of cornstarch digestibility by the Englyst in vitro method and glycemic response, subjective appetite, and short-term food intake in young men". The American Journal of Clinical Nutrition 91 (4): 932–939. doi:10.3945/ajcn.2009.28443. 
  33. ^ Uchiki T, Weikel KA, Jiao W, Shang F, Caceres A, Pawlak D, Handa JT, Brownlee M, Nagaraj R, Taylor A. Glycation-altered preolysis as a pathobiologic mechanism that links dietary glycemic index, aging, and age-related disease (in nondiabetics). Aging Cell 2012; 11(1):1-13. doi:10.1111/j.1474-9726.2011.00752.x
  34. ^ Weikel, KA; FitzGerald, P; Shang, F; Caceres, MA; Bian, Q; Handa, JT; Stitt, AW; Taylor, A. (Feb 2012). "Natural History of Age-Related Retinal Lesions that Precede AMD in Mice Fed High or Low Glycemic Index Diets". Investigative Ophthalmology & Visual Science 53 (2): 622–32. doi:10.1167/iovs.11-8545. 
  35. ^ Rideout TC, Liu Q, Wood P, Fan MZ (May 2008). "Nutrient utilisation and intestinal fermentation are differentially affected by the consumption of resistant starch varieties and conventional fibres in pigs". Br. J. Nutr. 99 (5): 984–92. doi:10.1017/S0007114507853396. PMID 18005479. 
  36. ^ Fässler C, Arrigoni E, Venema K, Hafner V, Brouns F, Amadò R (December 2006). "Digestibility of resistant starch containing preparations using two in vitro models". Eur J Nutr 45 (8): 445–53. doi:10.1007/s00394-006-0618-7. PMC 1705489. PMID 17036261. 
  37. ^ Fässler C, Arrigoni E, Venema K, Brouns F, Amadò R (December 2006). "In vitro fermentability of differently digested resistant starch preparations". Mol Nutr Food Res 50 (12): 1220–8. doi:10.1002/mnfr.200600106. PMID 17103375. 
  38. ^ Ferguson LR, Tasman-Jones C, Englyst H, Harris PJ (2000). "Comparative effects of three resistant starch preparations on transit time and short-chain fatty acid production in rats". Nutr Cancer 36 (2): 230–7. doi:10.1207/S15327914NC3602_13. PMID 10890035. 
  39. ^ Haub, MD; Hubach, KL; Al-tamimi, EK; Ornelas, S; Seib, PA. "Different types of resistant starch elicit different glucose responses in humans". Journal of Nutrition and Metabolism 2010: 230501. doi:10.1155/2010/230501. 
  40. ^ Martinez, I; Kim, J; Duffy, PR; Schlegel, VL; Walter, J (2010). "Resistant starches types 2 and 4 have differential effects on the composition of the fecal microbiota in human subjects". PLOS ONE 5 (11): 1–11. doi:10.13171/journal.pone.0015046. 
  41. ^ World Health Organization, Joint WHO/FAO Expert Consultation "Diet, Nutrition and the Prevention of Chronic Diseases" 2003, WHO Technical Report Series 916. [1]
  42. ^ Slavin JL (March 2005). "Dietary fiber and body weight". Nutrition 21 (3): 411–8. doi:10.1016/j.nut.2004.08.018. PMID 15797686. 
  43. ^ Behall KM, Howe JC (June 1996). "Resistant starch as energy". J Am Coll Nutr 15 (3): 248–54. PMID 8935440. 
  44. ^ Aust L, Dongowski G, Frenz U, Täufel A, Noack R (February 2001). "Estimation of available energy of dietary fibres by indirect calorimetry in rats". Eur J Nutr 40 (1): 23–9. doi:10.1007/pl00007382. PMID 11315502. 
  45. ^ Bodinham CL, Frost GS, Robertson MD (March 2010). "Acute ingestion of resistant starch reduces food intake in healthy adults". Br. J. Nutr. 103 (6): 917–22. doi:10.1017/S0007114509992534. PMID 19857367. 
  46. ^ Willis HJ, Eldridge AL, Beiseigel J, Thomas W, Slavin JL (February 2009). "Greater satiety response with resistant starch and corn bran in human subjects". Nutr Res 29 (2): 100–5. doi:10.1016/j.nutres.2009.01.004. PMID 19285600. 
  47. ^ Nilsson AC, Ostman EM, Holst JJ, Björck IM (April 2008). "Including indigestible carbohydrates in the evening meal of healthy subjects improves glucose tolerance, lowers inflammatory markers, and increases satiety after a subsequent standardized breakfast". J. Nutr. 138 (4): 732–9. PMID 18356328. 
  48. ^ Karalus M, Clark M, Greaves KA, Thomas W, Vickers Z, Kuyama M, Slavin J. Fermentable Fibers do not Affect Satiety or Food Intake by Women Who do not Practice Restrained Eating. Journal of the Academy of Nutrition and Dietetics 2012; 112(9):1356-1362. article doi:10.1016/j.jand.2012.05.022, PMID 22771185
  49. ^ Klosterbuer, AS; Thomas, W; Slavin, JL. (2012). "Resistant starch and pullulan reduce postprandial glucose, insulin, and GLP-1, but have no effect on satiety in healthy humans". Journal of Agricultural and Food Chemistry 60 (48): 11928–11934. doi:10.1021/jf303083r. 
  50. ^ Haub, MD; Louk, JA; Lopez, TC. "Article ID 478043". Journal of Nutrition and Metabolism 2012: 4. doi:10.1155/2012/478043. 
  51. ^ Higgins JA, Higbee DR, Donahoo WT, Brown IL, Bell ML, Bessesen DH (2004). "Resistant starch consumption promotes lipid oxidation". Nutr Metab (Lond) 1 (1): 8. doi:10.1186/1743-7075-1-8. PMC 526391. PMID 15507129. 
  52. ^ Langin, D; Dicker, A; Tavernier, G; Hoffstedt, J; Mairal, A; Ryden, M; Arner, E; Sicard, A et al. (2005). "Adipocyte lipases and defect of lipolysis in human obesity". Diabetes 54 (11): 3190–3197. doi:10.2337/diabetes.54.11.3190. PMID 16249444. 
  53. ^ Vonk RJ; Hagedoorn RE; de Graaff R et al. (August 2000). "Digestion of so-called resistant starch sources in the human small intestine". Am. J. Clin. Nutr. 72 (2): 432–8. PMID 10919938. 
  54. ^ Giacco R., Clemente G., Brighenti F., Mancini M., Coppola S., Ruffa G., Rivieccio A.M., Rivellese A., Riccardi G. et al. "Metabolic effects of resistant starch in patients with Type 2 diabetes". Diab Nutr Metab 1998 (11): 330–335. 
  55. ^ Maki, K. C.; Pelkman, C. L.; Finocchiaro, E. T.; Kelley, K. M.; Lawless, A. L.; Schild, A. L.; Rains, T. M. (2012). "Resistant Starch from High-Amylose Maize Increases Insulin Sensitivity in Overweight and Obese Men". Journal of Nutrition 142 (4): 717–23. doi:10.3945/jn.111.152975. PMC 3301990. PMID 22357745. 
  56. ^ Penn-Marshall M, Holtzman GI, Holtzman GI, Barbeau WE (August 2010). "African americans may have to consume more than 12 grams a day of resistant starch to lower their risk for type 2 diabetes". J Med Food 13 (4): 999–1004. doi:10.1089/jmf.2009.0195. PMID 20482275. 
  57. ^ Shen, Li; Keenan, Michael J.; Raggio, Anne; Williams, Cathy; Martin, Roy J. (2011). "Dietary-resistant starch improves maternal glycemic control in Goto-Kakizaki rat". Molecular Nutrition & Food Research 55 (10): 1499–508. doi:10.1002/mnfr.201000605. PMID 21638778. 
  58. ^ Bodinham, CL; Smith, L; Wright, J; Frost, GS; Robertson, MD. (2012). "Dietary fibre improves first-phase insulin secretion in overweight individuals". PLOS One 7 (7): e40834. doi:10.1371/journal.pone.0040834. 
  59. ^ Wiseman CE, Higgins JA, Denyer GS, Miller JC (February 1996). "Amylopectin starch induces nonreversible insulin resistance in rats". J. Nutr. 126 (2): 410–5. PMID 8632213. 
  60. ^ Byrnes SE, Miller JC, Denyer GS (June 1995). "Amylopectin starch promotes the development of insulin resistance in rats". J. Nutr. 125 (6): 1430–7. PMID 7782895. 
  61. ^ Higgins JA, Brand Miller JC, Denyer GS (March 1996). "Development of insulin resistance in the rat is dependent on the rate of glucose absorption from the diet". J. Nutr. 126 (3): 596–602. PMID 8598543. 
  62. ^ Whitehead RH, Young GP, Bhathal PS (December 1986). "Effects of short chain fatty acids on a new human colon carcinoma cell line (LIM1215)". Gut 27 (12): 1457–63. doi:10.1136/gut.27.12.1457. PMC 1433981. PMID 3804021. 
  63. ^ J.H. Cummings, G.T. Macfarlane, H.N. Englyst. "Prebiotic digestion and fermentation" Am J Clin Nutr 2001;73(2 suppl): 415S-20S. PubMed 11157351
  64. ^ Phillips J, Muir JG, Birkett A, Lu ZX, Jones GP, O’Dea K. "Effect of resistant starch on fecal bulk and fermentation-dependent events in humans. American Journal of Clinical Nutrition, 1995; 62, 121-130.
  65. ^ Hylla S, Gostner A, Dusel G, Anger H, Bartram H-P, Christl SU, Kasper H, Scheppach W. Effects of resistant starch on the colon in healthy volunteers: possible implications for cancer prevention. American Journal of Clinical Nutrition, (1998), 67, 136-142.
  66. ^ Greer JB, O'Keefe SJ (2011). "Microbial induction of immunity, inflammation, and cancer". Front Physiol 1: 168. doi:10.3389/fphys.2010.00168. PMC 3059938. PMID 21423403. 
  67. ^ Scheppach W (January 1994). "Effects of short chain fatty acids on gut morphology and function". Gut 35 (1 Suppl): S35–8. doi:10.1136/gut.35.1_Suppl.S35. PMC 1378144. PMID 8125387. 
  68. ^ Andoh A, Tsujikawa T, Fujiyama Y (2003). "Role of dietary fiber and short-chain fatty acids in the colon". Curr. Pharm. Des. 9 (4): 347–58. doi:10.2174/1381612033391973. PMID 12570825. 
  69. ^ Toscani A, Soprano DR, Soprano KJ (1988). "Molecular analysis of sodium butyrate-induced growth arrest". Oncogene Res. 3 (3): 223–38. PMID 3144695. 
  70. ^ Wong JM, de Souza R, Kendall CW, Emam A, Jenkins DJ (March 2006). "Colonic health: fermentation and short chain fatty acids". J. Clin. Gastroenterol. 40 (3): 235–43. doi:10.1097/00004836-200603000-00015. PMID 16633129. 
  71. ^ Scharlau D; Borowicki A; Habermann N et al. (2009). "Mechanisms of primary cancer prevention by butyrate and other products formed during gut flora-mediated fermentation of dietary fibre". Mutat. Res. 682 (1): 39–53. doi:10.1016/j.mrrev.2009.04.001. PMID 19383551. 
  72. ^ Raghupathy P; Ramakrishna BS; Oommen SP et al. (April 2006). "Amylase-resistant starch as adjunct to oral rehydration therapy in children with diarrhea". J. Pediatr. Gastroenterol. Nutr. 42 (4): 362–8. doi:10.1097/01.mpg.0000214163.83316.41. PMID 16641573. 
  73. ^ Ramakrishna BS, Venkataraman S, Srinivasan P, Dash P, Young GP, Binder HJ (February 2000). "Amylase-resistant starch plus oral rehydration solution for cholera". N. Engl. J. Med. 342 (5): 308–13. doi:10.1056/NEJM200002033420502. PMID 10655529. 
  74. ^ Le Leu RK, Brown IL, Hu (2007). "Suppression of azoxymethane-induced colon cancer development in rats by dietary resistant starch". Cancer Biol Therapy 6: 1621–26. doi:10.4161/cbt.6.10.4764. 
  75. ^ Toden S, Bird AR, Topping DL; Bird; Topping; Conlon et al. (2007). "High red meat diets induce greater numbers of colonic DNA double-strand breaks than white meat in rats: attenuation by high-amylose maize starch". Carcinogenesis 28 (11): 2355–62. doi:10.1093/carcin/bgm216. PMID 17916911. 
  76. ^ Burn J, Bishop T, Mecklin JP, Macrae F, Moslein G, Olschwang S, Bisgaard ML, Ramesar R, Eccles D; Bishop; Mecklin; MacRae; Möslein; Olschwang; Bisgaard; Ramesar; Eccles; Maher; Bertario; Jarvinen; Lindblom; Evans; Lubinski; Morrison; Ho; Vasen; Side; Thomas; Scott; Dunlop; Barker; Elliott; Jass; Fodde; Lynch; Mathers; Capp2 et al. (2008). "Effect of aspirin or resistant starch on colorectal neoplasia in the Lynch Syndrome". New England Journal of Medicine 359 (24): 2567–78. doi:10.1056/NEJMoa0801297. PMID 19073976. 
  77. ^ Mathers JC, Movahedi M, Macrae F, Mecklin JP, Moeslein G, Olschwang S, Eccles D, Evans E, Maher ER, Bertario L, Bisgaard ML, Dunlop M, Ho JWC, Hodson S, Lindblom A, Lubinski J, Morrison PJ, Murday V, Ramesar R, Side L, Scott RJ, Thomas HJW, Vasen H, Gerdes AM, Barker G, Crawford G, Elliott F, Pylvanainen K, Wijnen J, Fodde R, Lynch H, Bishop T, Burn J. Long-term effect of resistant starch on cancer risk in carriers of hereditary colorectal cancer: an analysis from the CAPP2 randomised controlled trial. The Lancet Oncology. Dec 2012; 13(12):1242-1249. PMID=23140761
  78. ^ Burn J, Bishop DT, Chapman PD, Elliott F, Bertario L, Dunlop MG, Eccles D, Ellis A, Evans DG, Fodde R, Maher ER, Möslein G, Vasen HF, Coaker J, Phillips RK, Bülow S, Mathers JC "A Randomized Placebo-Controlled Prevention Trial of Aspirin and/or Resistant Starch in Young People with Familial Adenomatous Polyposis. Cancer Prevention Research (Phila). 2011 May;4(5):655-665. doi: 10.1158/1940-6207.CAPR-11-0106. PMID 21543343
  79. ^ Burn, John; Gerdes, Anne-Marie; MacRae, Finlay; Mecklin, Jukka-Pekka; Moeslein, Gabriela; Olschwang, Sylviane; Eccles, Diane; Evans, D Gareth; Maher, Eamonn R; Bertario, Lucio; Bisgaard, Marie-Luise; Dunlop, Malcolm G; Ho, Judy WC; Hodgson, Shirley V; Lindblom, Annika; Lubinski, Jan; Morrison, Patrick J; Murday, Victoria; Ramesar, Raj; Side, Lucy; Scott, Rodney J; Thomas, Huw JW; Vasen, Hans F; Barker, Gail; Crawford, Gillian; Elliott, Faye; Movahedi, Mohammad; Pylvanainen, Kirsi; Wijnen, Juul T et al. (2011). "Long-term effect of aspirin on cancer risk in carriers of hereditary colorectal cancer: An analysis from the CAPP2 randomised controlled trial". The Lancet 378 (9809): 2081–2087. doi:10.1016/S0140-6736(11)61049-0. 
  80. ^ Topping DL, Bird AR, Young GP (April 2009). "Effect of aspirin or resistant starch on colorectal neoplasia in the Lynch syndrome". N. Engl. J. Med. 360 (14): 1462. doi:10.1056/nejmc090032. PMID 19348022. 
  81. ^ Noakes M, Clifton PM, Nestel PJ et al. (1996). "Effect of high amylose starch and oat bran on metabolic variables and bowel function in subjects with hypertriglyceridemia". Am J Clin Nutr 64 (6): 944–51. PMID 8942421.