Metabolic syndrome and insulin resistance are a significant health care problem in the United States. Type 2 diabetes affects more than 300 million people.

Insulin resistance is preventable and reversible through lifestyle changes, proper nutrition, supplements, exercise and stress management. Weight loss and exercise are the best treatments for restoring the body’s ability to respond to insulin.

Previous research has shown a variety of health benefits from resistant starch including preventing obesity, lowering cholesterol, preventing constipation, and producing short chain fatty acids in the gut.

According to a new review published last week in Lipids in Health and Disease, researchers investigated the effect of resistant start supplementation on mitigating insulin resistance in patients with type 2 diabetes and obesity.

This review consisted of 14 randomized clinical trials including 515 patients published between 2006 and 2017. All these studies took place over a 4 to 12-week period with the exception of one study lasting one year. There were 6 studies for obesity without type 2 diabetes and 8 studies for patients with type 2 diabetes. Six of the studies for diabetes had obesity and the other two that had diabetes and did not have obesity.

The research team found a better effect from resistant starch supplementation in patients with type 2 diabetes who were obese. The dosage of resistant starch can have different effects. A higher dose of 30-40 grams per day decreased fasting glucose levels, however, 10 grams per day was effective in lowering fasting insulin levels.

A high fiber diet leads to the production of short chain fatty acids (SCFAs) in the gastrointestinal tract. SCFAs can increase insulin sensitivity, improve glucose tolerance, and reduce B-cell apoptosis by modulating the gut microbiome.

Other research has indicated that obesity has a microbial component that alters the caloric extraction from ingested food. For example, if one has more Bacteroidetes bacteria, the individual tends to be leaner. High Firmicutes:Bacteroidetes ratios have been known to increase the caloric extraction from food and these individuals tend to be more obese. This also ties together the importance of dietary fiber, prebiotics, and weight loss.

Resistant starch should be considered for patients with obesity, insulin resistance, dyslipidemia, and metabolic syndrome. It can also be a great substitute to regular starch in baked goods, which lowers the caloric density and glycemic index of food products. Other nutrients to consider include curcumin, tocotrienols, fish oil, magnesium, vitamin, and glycine.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Gao C, Rao M, et al. Resistant starch ameliorated insulin resistant in patients of type 2 diabetes with obesity: a systemic review and meta-analysis. Lipids Health Dis. 2019 Nov 24;18(1):205.

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