Transcript Resistant Starch: A Novel Food Ingredient

Metabolism of Carbohydrates:
Implications for Health
Janine Higgins, PhD
University of Colorado Denver
Dietary Recommendations
Enjoy a wide variety of nutritious foods
• Eat plenty of vegetables, legumes and fruits
• Eat plenty of cereals, preferably wholegrain
• Include lean meat, fish, poultry and/or alternatives
• Include milks, yoghurts, cheeses – choose low fat
• Drink plenty of water
and take care to:
• Limit saturated fat and moderate total fat intake
• Choose foods low in salt
• Limit your alcohol intake if you choose to drink
• Consume only moderate amounts of sugars and
foods containing added sugars
Dietary Recommendations
Enjoy a wide variety of nutritious foods
• Eat plenty
of vegetables,
legumes
and
Cochrane
Database Syst
Rev. 2011
Julfruits
6;(7):CD002137.
or modified
dietary fat
• Eat plenty
of cereals, Reduced
preferably
wholegrain
for preventing cardiovascular disease.
• Include Hooper
lean meat,
fish, poultry
alternatives
L, Summerbell
CD, etand/or
al.
importantcheeses
reduction in
• Include “Small
milks,but
yoghurts,
cardiovascular risk for reduction of saturated
• Drink plenty
of water
fat, but not reduction of total fat, in longer trials”
and take care to:
• Limit saturated fat and moderate total fat intake
• Choose foods low in salt
• Limit your alcohol intake if you choose to drink
• Consume only moderate amounts of sugars and
foods containing added sugars
Dietary Recommendations
Enjoy a wide variety of nutritious foods
• Eat plenty of vegetables,
legumes
and fruits
J Int Med Res.
2010 Mar-Apr;38:318-85.
Nutritional
profiles in
a public health
• Eat plenty of cereals,
preferably
wholegrain
perspective: a critical review.
• Include lean meat,
fish,F,poultry
and/or
Foltran
Verduci E,
et al. alternatives
“Evidencecheeses
linking a reduced fat intake
• Include milks, yoghurts,
with cardiovascular mortality and
• Drink plenty of water
obesity is generally non-significant.”
and take care to:
• Limit saturated fat and moderate total fat intake
• Choose foods low in salt
• Limit your alcohol intake if you choose to drink
• Consume only moderate amounts of sugars and
foods containing added sugars
Dietary Recommendations
Enjoy a wide variety of nutritious foods
• Eat plenty of vegetables, legumes and fruits
• Eat plenty of cereals, preferably wholegrain
• Include lean meat, fish, poultry and/or alternatives
• Include milks, yoghurts, cheeses
• Drink plenty of water
and take care to:
• Limit saturated fat and moderate total fat intake
• Choose foods low in salt
• Limit your alcohol intake if you choose to drink
• Consume only moderate amounts of sugars and
foods containing added sugars
Dietary Recommendations
Enjoy a wide variety of nutritious foods
• Eat plenty of vegetables,
legumes
and
fruits
Cochrane
Database
Syst
Rev. 2011
Julpreferably
6;(7). Reduced
dietary salt for the
• Eat plenty of cereals,
wholegrain
prevention of cardiovascular disease.
• Include lean meat, fish,
poultry
Taylor,
Ashton,and/or
et al. alternatives
665 deaths
in some 6,250
• Include milks, yoghurts,
cheeses
participants: “No strong evidence of
• Drink plenty of water
benefit of salt restriction on all cause
and take care to:
or cardiovascular mortality in normal
or hypertensive
• Limit saturated fat and
moderatepatients”
total fat intake
• Choose foods low in salt
• Limit your alcohol intake if you choose to drink
• Consume only moderate amounts of sugars and
foods containing added sugars
Dietary Recommendations
Enjoy a wide variety of nutritious foods
• Eat plenty of vegetables, legumes and fruits
• Eat plenty of cereals, preferably wholegrain
• Include lean meat, fish, poultry and/or alternatives
• Include milks, yoghurts, cheeses
• Drink plenty of water
and take care to:
• Limit saturated fat and moderate total fat intake
• Choose foods low in salt
• Limit your alcohol intake if you choose to drink
• Consume only moderate amounts of sugars and
foods containing added sugars
Dietary Recommendations
Enjoy a wide variety of nutritious foods
BMJ. 2011 Feb 22;342:d671. doi:
• Eat plenty
of vegetables,
legumesofand
fruits
10.1136/bmj.d671.
Association
alcohol
consumption
withpreferably
selected cardiovascular
• Eat plenty
of cereals,
wholegrain
disease outcomes: a systematic review and meta• Includeanalysis.
lean meat,
fish, PE,
poultry
Ronksley
Brien and/or
SE, et al.alternatives
alcohol consumption
• Include“Moderate
milks, yoghurts,
cheeses is associated
with a reduced risk of multiple cardiovascular
• Drink plenty
of water
outcomes. Dose-response analysis revealed that
and takethe
care
to: risk of coronary heart disease mortality
lowest
occurred with
1-2 drinks
a day”total fat intake
• Limit saturated
fat and
moderate
• Choose foods low in salt
• Limit your alcohol intake if you choose to drink
Av. Aus intake = 9.8L/y or 188mL/wk = < 2 glasses
wine/wk
• Consume only moderate amounts of sugars and
Dietary Recommendations
Enjoy a wide variety of nutritious foods
• Eat plenty of vegetables, legumes and fruits
• Eat plenty of cereals, preferably wholegrain
• Include lean meat, fish, poultry and/or alternatives
• Include milks, yoghurts, cheeses
• Drink plenty of water
and take care to:
• Limit saturated fat and moderate total fat intake
• Choose foods low in salt
• Limit your alcohol intake if you choose to drink
• Consume only moderate amounts of sugars and
foods containing added sugars
Added/Simple Sugars
• Glucose and fructose (sucrose) most
commonly consumed
- In USA, adults consume ~23 tsp (120g) of
added sugar/d; from soft drinks, juice,
desserts (pastries, pies), and lollies
- 9% of energy from fructose, 10% from
sucrose (total 19%)
- In UK, ~16% of total energy from sucrose
• Glucose and fructose are metabolized
differently and have different metabolic
effects
food in
Rapidly Digested Starch
Slowly Digested Starch
Resistant Starch
Glucose x
Fructose ^
^
x
x
x
x
^
^
x
x^^
^
Lactate
x^ ^ x
x
^xx
CO2
TG
Glucose (50%)
Lactate (25%)
waste out
TG
Glycogen (15%)
Fructose vs Glucose
• Liver:
- Increases gluconeogenesis
- Increases de novo lipogenesis
- Causes insulin resistance
- Increases intracellular lipid
• Whole Body:
- Increases TG production
- Decreases TG clearance
- Decreases plasma FFA – lower adipocyte
lipolysis
Fructose Increases CHO Oxidation
Higher CHO ox’n after
sucrose meal than
starch meal
FROM SUCROSE:
Higher fructose ox’n,
delayed glucose ox’n
N=7
22-68 yo, healthy
Crossover design
Daly et al (2000) Am J Clin Nutr 71: 1516.
Fructose Increases CHO Oxidation
Higher CHO ox’n after
sucrose meal than
starch meal
FROM SUCROSE:
Higher fructose ox’n,
delayed glucose ox’n
Fructose caused higher CHO ox’n
No change in TEE
Lower fat oxidation
Brown et al (2000) Am J Physiol 294: R730.
Sucrose Decreases Fat Oxidation
N=7
22-68 yo, healthy
Crossover design
Daly et al (2000) Am J Clin Nutr 71: 1516.
Total CHO Intake Is Associated with Lower BMI
NHSII
N=90,655
26
23
HPFS
N=39,926
26.1
24.8
Gaesser, J Am Diet Assoc. (2007) 107:1768
Sugar Intake Is Associated with Higher Adiposity
• Total sugar (g/d) positively
correlated with body mass
index (BMI; in kg/m2), BMI z
scores, and total fat mass (r
0.20, r 0.22, and r 21)
• Total sugar (g/d) negatively
correlated with SI (r0.29)
• Dietary fiber, glycemic index,
and glycemic load were not
correlated with adiposity or
insulin dynamics before or
after control for covariates.
N=120
10-17 yo, overweight
24 h diet recalls
Davis et al, Am J Clin Nutr. (2007) 86:1331
Large epidemiological studies
• Multiple large studies – generally no
association between high fructose corn
syrup intake and body weight or obesity
• Difficult to interpret data
– ↑ intake of artificial sweeteners is in obese; ↑
intake of sucrose is in the most lean individuals
– No relationship between regular soft drink intake
and obesity or BMI; positive association of diet
soft drink intake with obesity and BMI
Sucrose impairs insulin action at liver not
peripheral tissue – Rat study
No significant change in glucose uptake in isolated muscle or adipose tissues.
Rat study
Storlien et al (1988) Am J Clin Nutr 47: 420
Rats 2
• Relative to chow, both high sucrose
and high cornstarch diet:
– decreased glucose uptake in muscle
– increased intramuscular triglyceride
– increased visceral fat with no change in
total body weight
– increased fasting insulin
Kim et al, Am J Physiol. (1999) 276:R665
Human Data
• High fructose ingestion for one or 10
weeks caused insulin resistance vs
glucose
• Moderate fructose intake for 4 wk
increased TG but did not impair
insulin action
• Fructose and sucrose have similar
effects
Fructose Increases Circulating TG
N=7
Stanhope et al (2009) J Clinical Invest 119: 1322.
Overweight/obese postmenopausal
25% of daily energy from sweetened drinks
Fructose Increases Blood Pressure in
Healthy Adults
Fructose causes increased systolic and diastolic BP
- due to increased cardiac output, no change in
peripheral vasodilation
N=15
21-33 yo, healthy
Crossover design
Brown et al (2000) Am J Physiol 294: R730.
Conclusions
• Simple sugars are absorbed and
metabolized differently from starches
• To impact health outcomes need to
consider CHO quality NOT just quantity
– quality is more than simple vs complex
• Fructose has several negative impacts on
metabolism vs glucose or starch
• Large epidemiological studies cannot
provide meaningful data to demonstrate
benefits/risks of simple sugar
consumption.
• Limit simple sugars?
• How about focusing on limiting total
caloric intake???
Thanks to:
Troy Donahoo
Paul MacLean
Ian Brown
CCTSI Nutrition
Core