Resistant hormonal

Anne Rahen, Anna

starch: the effect on postprandial response, and satiety13

Tagliabue, effect Niels J Christensen, starch
lipids,

glycemia,
Jetis J Hoist, and Ante Astrup ie, diabetes, is still not stanch-is
in the small

Joop on postpran-

Madsen, The weight,

ABSTRACT
dial plasma

The
concentrations

of resistant
of glucose,

(RS)
and

hormones,

and

importance cardiovascular because

and therefore

of RS to human health, diseases, or cancer, RS-unlike

not absorbed

overknown. not
intestine

on subjective 10 healthy,
sisted of 50

satiety and normal-weight,

g pregelatinized

palatability young
starch

ratings was investigated males. The test meals

(0% RS)

in cong raw
sweet-

However,
gested

nonresistant
as glucose

digly-

(5)

on 50

of healthy
cemia and

humans
insulinemia

(8, 9), a reduction

can be expected

in both
after

postprandial
the intake of

potato

starch

(54%

RS)

(R) together

with

500 g

artificially

RS

Downloaded from ajcn.nutrition.org by guest on December 23, 2013

ened syrup. of glucose,

After the R meal postprandial plasma concentrations lactate, insulin, gastric inhibitory polypeptide (GIP),

compared
beneficial mechanisms

with
in the

digestible
control of to those

starch.
diabetes. exerted

Such
by

an effect
RS soluble

of RS
may dietary

may
through fiber

be
in-

Moreover,

glucagon-like peptideI , and epinephnine were significantly lower compared with after the S meal. Moreover, subjective scores for satiety and fullness were significantly lower after the R meal palatability
sion, significant the

similar

fluence the amount the diet, ie, glucose trol of glycemia The potential from

and rate of absorption of other and fat, which may be beneficial agent been

nutrients in in the conmay also the to (10).

agent;

than

after may

the have

S meal. been
of digestible

Differences in these
starch

in GIP, findings.
with RS

texture,
resulted

and
in

involved

In concluinsulinemia, J Cliii Nutr

or lipidemia. use of RS as a weight-reducing because kJ/g,

tempting

replacement reductions

be of interest contribution be only 9.0-9.8 It is therefore however, control

esis

the energy ie, halfthe

to suggest

value products, value

RS

of 1 g RS, has
as

including estimated starch and This

the

in postprandial sensations

glycemia of satiety.

and Am

fermentation

and

in the

subjective
I.

ofdigestible
a weight-loss

I994;60:544-5

the impact may be less

on the

of RS on macnonutrient beneficial
recently

balance regulation.
on

appetite hypoth-

KEY WORDS
insulin, gastric

Potato
inhibitory

starch,
polypeptide,

appetite,

palatability,

lactate,

to weight
developed

catecholamines

is based

concepts

regulation

Introduction
Until recently, stanch was believed to be 100% digested in the small intestineindependent of the source, type, and preparation of the starch. However, within the past 10 y it has been found that, despite the fact that pancreatic a-amylase
of the ingested

of energy and macnonutrient balance. Thus, there close regulation between the bodys macronutrient three macronutnents (fat, protein, and carbohydrate)

seems to be a stores and the in the diet

(1 1, 12). The maintenance of the bodys relatively small carbohydrate stones seems especially crucial to overall energy balance ( I I ). Moreover, recent studies have shown that the control of appetite may be influenced by the amount of available carbohydrate in the diet ( 13, 14) and that consumption of carbohydrate (or protein) in a meal
achieve with satiation a resultant

is present
starch

in the
passes

gut in ample amounts ( I ), a fraction undigested to the large bowel (2-4). a more and or less complete of short-chain fermentation, fatty acids uptake

Here resulting (acetic

the

starch acid,

undergoes butynic acid,

of a certain amount may be necessary to of RS

diet may

in the production

(15).
decreased

Increasing
amount ratio

the

amount
in the

in the
thus lead

diet
and to

of absorbed

carbohydrate

and propionic acid) (5, 6). This fraction of the starch has been named resistant starch (RS) and has been defined by the European FLAIR Concerted Action on Resistant Starch (EURESTA) the sum of starch and products of starch hydrolysis not sorbed in the small intestine of healthy individuals. The amount of RS present in starch-rich foods depends
as

a decreased

carbohydrate-to-fat

abon

Food
sity

From the Research Department of Human Nutrition. Research. The Royal Veterinary and Agricultural
Denmark: Italy: the the Department of of Internal Human Medicine Nutrition. and of Pavia, Department

Centre for University.

UniverEndocrin-

Fredeniksberg.

several factors, ic, the source, ripeness, processing, preparation, and storage of the foods. It has been shown that stanch from white bread, porridge oats, and cornflakes is almost completely digested in the small intestine (4) whereas native starch from banana and uncooked potato is highly resistant to hydrolysis in vitro
(7) and in vivo (8). When the potato is cooked the starch granules

ology.
2

Henley
Supported

Hospital.

Denmark:

and
The Danish

the

Department Denmark.
Research and

of

Physiology.
Development

The Panum

Institute,
by Food

University
grants from

of Copenhagen. 1990to A

Programme for Research Council

Technology

1994 and the Danish

Research Department

Medical
of

grant Centre

I 2-9537-3.
Raben.

Address

reprint
University.

requests
25

Human
Agricultural

Nutrition,

for Food
Rolighedsvej.

Research,

The Royal
DK-1958

Veterinary
C.

and

gelatinize potato the 544 starch

and reverses

become this

readily gelatinization

digestible, process intestinal

whereas and digestion

Am
J

cooling renders (9).

C/in Nuir

of the I 2% of

Frcderiksberg

Received

November

2. 1993.

resistant

to small

Accepted
1994;60:544-5 I . Printed

for publication
in USA.

May 9. 1994.
1994 American Society for Clinical Nutrition

RESISTANT TABLE
Subject

STARCH,

GLYCEMIA. TABLE 2 EURESTA

AND

SATIETY

545

I
characteristics Denmark
(ii
=

reference

starch

materials
Cal culated starch values

Italy 5) 1.9
3.0 1.1
(ii
=

All 5) 0.7
(ii
=

10)

Food
Age
Height Weight

DM %

TS

RDS (;y b z

SDS

RS

(y)
(m) (kg)

25.6
1.80 71.2

21.2
1.78 74.0 23.2

23.4
1.79 72.6 22.6

1.2

t 0.01

0.02 3.5 0.6

0.01 2.2 0.6

BMI2
Fat mass (%)

22.0

Raw potato

starch

83.4
95.1

81.3
92.9

6.0
87.9

21.2
5.2

54.1
-

18.6 2.4

20.8

1.3

19.7

1.3

Pregelatinizedpotatostarch

,.

SEM. In kg/m.

DM, dry matter: TS. total starch: RDS. rapidly digestible SDS, slowly digestible starch: RS. resistant starch. Analyzed Dunn Clinical Nutrition Centre. Methods described by Englyst and Englyst and Cummings (22).

starch:

from the et al (21)

a reduction

in the

satiating

power

of

the

diet.

This

may

result

in

ovenconsumption and has a dietary-fiber-like

increase weight in the amount maintenance.

subsequent

weight
effect in the diet

gain.
on may

However,
satiety be ( I 6beneficial

if RS
1 8) an to

positive RS

supplied (INRA), iust before

syrup avoid

from Nantes,
while an

lInstitut France.

National Both the

it with temperature

de Ia Recherche starches starch

of

Agronomique as a white poured

slowest Several

of

appeared was slowly

at the mixture.

flour. into the

to other

consumption
mixing increase in

The effects
changes tions of

purpose of RS
in hunger

of the present vs digestible

hormonal satiety. and

study nonresistant

was

to investigate starch
and starches

the acute postprandial

sensagiven in were

a hand

mixer the

speed

Downloaded from ajcn.nutrition.org by guest on December 23, 2013

on

glycemia,

response, The two test

subjective

ways meals.

of administration However, the

were

tested

before stanch

deciding could

on these not

test

pregelatinized

be mixed inedible properties

as pure
se without

a form
the

as possible
interference

to clarify
from other

the

role

of the starches

pen

nutrients.

into other substance.

liquids without producing Because heating would

a very unpleasant, affect the physical

of the raw starch, a cold-meal preparation had to be used. The starches could thus not be baked into a bread or used in a pasta.

Subjects
The EURESTA ducted Nutrition, Denmark, of Pavia, Subjects In each normal-weight,
obesity or

and methods
experiment framework. at two The and Italy. centers: Royal the was performed Exactly the as a joint same study within was the con-

The best compromise them with the syrup. mixture

by spoon.

for these two starches was therefore to mix For the R meal this resulted in a drinkable was
syrup

whereas
Although

the S meal
the

a porridge-like
was sweetened naturally sugars

gel to be eaten
with artificial in occurring

experiment

the Research Veterinary and of Human

Department Agricultural Nutrition,

of Human University, University

sweeteners the berries Each drate-nich

12%

it contained some and fruits (Table test day was preceded diet (60% of energy
and 3.5

fruit

3).
by 3 d on an identical as carbohydrate, 28%
fiber/Mi), prepared

Department

canbohyas fat, and

at the de-

as

protein. from

g dietary

partments

center
diabetes,

five

healthy

male not elite

subjects athletes)

(20-31

y of age,

nonsmokers, included
The

were
strual

not
cycle.

with no history of participated in the study (Table 1). Females to avoid possible differences due to the menenergy needs during the study were

energy subjects

food items according to each subjects individual requirements. and adjusted to the nearest 0.5 Mi. The were instructed to adhere strictly to the diet. If subjects

subjects

determined height, and count

by using sex. The

WHO tables multiplication activity

according factor 1 .78 level ofthe

to age, weight, was used to acsubjects (19). The by the bioimInc. Odense) in Italy.
Deunenberg Ethical

TABLE 3 Carbohydrate
(50 g potato

and energy
starch +

contents

in the fruit

two

test

meals

500

mL diluted

syrup)

for medium

physical

Test meal R S
46.5

body composition pedance method in Denmark

mass (20). mittee was The

of the subjects was estimated by an Animater (HTS Engineering BIA

was

and
calculated study

109 (Ril
by using approved and

Systems,
the by equation the

Detroit)
of Municipal

Fat-free
et Comwith al

Total

starch

in 50 g potato

starch

(g)

40.7

of Copenhagen

Fredeniksbeng

to be in accordance

RS (g) RDS (g) SDS(g)

Fruit sugars from syrup (g)

27.1
3.0

0.0
44.0 2.6
8.4

10.6
8.4

the Helsinki-Il after Diets

declaration

and procedure

all subjects had been

gave

written

consent

the experimental

explained

to them.

Glucose Fructose
Sucrose(g)

(g) (g) (g)2

2.9 4.4
1.1

2.9 4.4
1.1

The two test meals consisted RS) (R) on 50 g pregelatinized (5) mixed 2).
from

of 50 g raw potato stanch (54.1% potato starch (100% digestible) artificially

on cherry apple, and

Total Total

digestible carbohydrate energy (kl)3 R, raw potato

RDS. readily

22.0 367 potato

slowly

54.9 917 RS, resistant

starch.

into The
black

500
syrup

mL
current,

diluted
was based and

sweetened
grape. commercially

fruit
red

syrup
current, pun-

starch:
digestible

S. pregelatinized
starch: SDS,

starch:
digestible

(Table
elderberry, chased

starch:
2 3

Not taking
16.7 kJ/g.

fermentation

into consideration.

Irma,

Denmark.

The

starches

were

produced

and

546 could was not deducted consume from all the the diet hod, during they and had to bring the The

RABEN leftovers same food

ET

AL centrifuged for 10 mm at 300f x g and 4 #{176}C and stoned at -80 #{176}C until determination of catecholamines method measured Novo, glucagon-like on (27-29). from and (26). Immunoreactive with Gastric I (GLPextracted for insulin radioimmunoassay inhibitory I ) were with the GIP polydeterethanol and were (GIP) by in plasma Copenhagen. peptideplasma the con-

to the departments periods. physical

for weighing

registration.

diately plasma centrations

the following

preexpenimental

by a radioenzymatic kits purchased

The subjects were instructed activity for the 2 d before diet this should ensure

to abstain from strenuous the test days. Together with equally filled glycogen stones

the standard

peptide
mined as GLPjects. Nutrition
scnibed

and similar macnonutnient puter databases of foods Denmark of energy E.qeriitieiztal The two (Dankost) and nutrient prok)co/ test meals were and

balance on the 2 test days. The comfrom the National Food Agency of Italy (INN) were used in the calculations diets. of the test

radioimmunoassay described could analyses (United

et al (21

previously I analyses The starch Centre

by Englyst

Samples

composition

not be taken were performed Kingdom)

) and

from the Italian subat the Dunn Clinical using

and

by
Englyst

the

methods
(22).

de-

Cummings

given

in a crossover

design

on

sethe at
sub-

parate days with I wk and no more test days. On the test day the subjects
0800, with having a minimum fasted for of physical the

than 6 wk separating arrived at the institute

by car, before. bus, After evening

Statistical

analyses Data are presented as by using the second Responses analysis to the of variance

activity,

or train

All results are given as means SEM. changes from basal fasting concentrations fasting two blood test meals sample were as the basal compared pained nested and the 5-h concentration. measures into diet. degrees measurement by parametric

after
jects

12 h from

voided

and

were

weighed

(to the nearest

100 g), bioimped-

ance was measured. The subjects then rested in the supine position on a bed covered with an antidecubitus mattress with slight elevation of the head. A Venflon catheter (Viggo. Gothenborg. Sweden) was inserted in an antecubital arm vein. After a 10-mm rest a fasting blood sample was taken and after a further 20-mm rest nesting metabolic by using a ventilated taken
within

(ANOVA) for repeated, factors and with subject sented the with F or t values (AUCs) for curves

with time and diet as The key results are preof freedom. periods Areas were under calthe area
t test same

Downloaded from ajcn.nutrition.org by guest on December 23, 2013

rate was measured by indirect hood. A second fasting blood the test
the

calorimetry sample was and consumed

the two test

culated separately for each subject as the difference between integrated area of the response curve and the rectangular determined was used subject. between by the basal values ( = net response). A paired in the comparisons between two means on the Regression analyses were (referred performed to as S-R) peak/nadir to account the S and R meals

hereafter
10 mm.

and
Exactly

meal
same

was
time

then
was

served
spent

on

on the differences for the 5-h AUCs values, and peak/ for the data being

meals for each individual subject. tune was measured for 5 h (1000were taken IS, 30, 45, 60, 75, 90, and dial

energy expendi1500 h), and blood samples 105, 120, 150, 180, 210, 240,

Postprandial

and means for the VAS scores, Lnadir values. This was done paired.
ics

3(X) mm

after measurements
movies,

the meal was the subjects

and to have

consumed. During the postpnanwere allowed to watch light ena break of a maximum of 5

The software

level of significance was version 4.2 (Graphic

set at P < 0.05. StatgraphSoftware Systems, Inc. Package calculations. (SAS

tertainment

mm

after 2 and 4 h. During the break the subjects could sit, walk quietly, or go to the toilet. The exact time schedule was noted and repeated on the following test days. Water consumption duning the test period was allowed, but the total amount consumed

Rockville, Institute,

MD) and the Statistical Analysis Cany, NC) were used in the statistical

Results
Glucose Fasting mmol/L and lactate glucose the S meal concentrations and 4.91 averaged 0.07 mmolIL 4.97 0.08 the

was

noted

and

repeated

on the second

test day.

Immediately before and every names to assess hunger, satiety, sumption

30 mm after the meal, questionfullness, and prospective conon at

100-mm

were visual

filled out analogue

by each subject. Ratings were made scales (VAS) with words anchored

plasma before

before

each end, expressing the most positive (ie, good, pleasant) or the most negative ratings (ie, bad, unpleasant) (23). Immediately aften the test meals the palatability, taste, aftertaste, texture, and
visual using lished appeal VAS of the scones. two Data (A test on meals energy A were recorded by are ML the being Heijnen, subjects pubP expenditure Raben,

R meal observed
ing nine

(NS). A significant interaction between diet and after the test meals with glucose concentrations
times as much after the S meal as after the

time was increasR meal

(Lspeak 0.36 (Fig after

concentrations: 0.13 1). The the mmol/L 5-h and AUCs

5, 3.07 after -42.02 averaged

0.29 79.53

mmol/L
=

after
25.2,

30 mm; P < 0.0001) mmol after first

.

R,

15 mm)

(F1122151

separately

Tagliabue,

27.26 minlL the

(-

min/L
the R

Deusenbeng. 1994). Laborators

E Pasquali,

Astrup,

unpublished

observations,

S meal

9.5 1 mmol The AUCs for for the R meal the

0.0001).

meal U, = 4.5 1 , P = resulted in a negative mmol minlL) compared

0.0015).
area with

13.37

2 h also 6.71 test 21.53 meals

analyses was
cannula

meal

( 140.00 after both 0.09

Blood
tecubital

sampled
by

without
using iced

stasis

through

the
Plasma

indwelling
glucose

anand

mmol min/L) (t5 = 7. 1 1 , P < Plasma lactate concentrations with and tion from than a peak after 45 mm

increased

syringes.

for the S meal

(1 .36

mmolIL),

lactate Plasma

were analyzed glycerol was

by standard analyzed after

enzymatic tnichlonacetic

methods (24). acid precipi-

after 15 mm for the R meal ( 1 . I 8 0.10 mmol/L) (interacdiet-time: F,,215, = 25.2, P < 0.0001) (Fig I). The increase basal was twice after the R meal 10.0 as high after the S (0.52 (0.24 0.06 mmol/L). mmol min/L after after the R meal (t9 the
=

tation, essentially termination of containing tetraacetic acid

as described by Chernick (25). Blood for deplasma catecholamines was collected in tubes glycol-bis(fl-aminoethyl and glutathione. ether)-N.N.N,NSamples were imme(EGTA)

0.06 Five-hour S meal P and

=

mmoIIL) AUCs -26.3

ethylene

averaged 6.9 8.9 mmolminlL

3.70,

0.005).

RESISTANT

STARCH,

GLYCEMIA, Insulin,

AND GIP, and

SATIETY GLPI concentrations averaged and 75.4 10.0 pmolIL 53.7 before

547

Plasma
mmolL

glucose
5-hour
mmol
#{149}

AUC
#{149}

mm

E
-2.0 -1.0
0.0 1.0 2.0 3.0 4.0 5.0

Fasting plasma insulin pmol/L before the S meal meal (NS). served after trations
pmol/L

5.0 the R was obconcen 68.5 after the ) (Fig

A significantly the two test insulin

the S meal,

different response pattern meals. Compared with fasting by a factor

to only 84.6
=

plasma
after

increased
but

of six to 355.4
7.2 pmollL

R meal I ). The and

=

(interaction AUCs

diet-time:

F1514, after

15.14,
.

P < 0.0001 after

(t9

averaged I .2 nmol
.

19. 1 4.0 nmol

min/L
R meal and the

the S meal
=

-6.6
0.0008).

min/L

the

4.90, (-1.4

Also,

the AUCs 2.8

for the first 2 h resulted nmolmin/L)

in differences R meals as plasma GIP F1561 were increased was

=

Plasma
mmol

lactate
5-hour mmol ,
<
0.9*71

between
AUC mm L

the S (18.4

1.1 nmolmin/L) (t9 = 5.34, P = 0.0005). Plasma GIP showed the same response pattern sulin
served <

inobP

(Fig
after

I ). Thus of
the R

compared the S-R

=

with S meal for GIP

fasting whereas

values,

by a factor
.20! .40 R S

10 after
meal

no increase lactate after

(interaction 0.03). significantly after

diet-time: and

14.6,

0.0001).

The

AUC

positively

-2.0

-1.0

0.0

1.0

2.0

3.0

4.0

5.0

correlated Plasma no changes

(r = 0.91, P GLP-I increased were observed

Downloaded from ajcn.nutrition.org by guest on December 23, 2013

the S meal

whereas diet-time:

the R meal

(interaction

Plasma
pmol L

insulin
5-hour
nmol

AUC L

mm

F18.71 4.7, P = 0.0002) (Fig I ). The difference in the AUCs after the R and the S meals was nearly significant O = 2.56, P = 0.06). The AUC S-R for GLP-l was negatively correlated with GIP (r = -0.94, P 0.02) and lactate (r - -0.88, P
=

<

OMJO1

with

0.052) GIP

and (r =

Lpeak -0.91, (TG) and

S-R P
=

for 0.03).

GLP-l

negatively

correlated

Triglycerides -20 -1.0 0.0 1.0 2.0 3.0 4.0 5.0

R S

glycerol concentrations showed a similar response

Plasma pattern slightly

triglyceride after after

the two test meals (Fig 2). both meals with a nadir after effect, were F,9151 = significantly

Thus, TG decreased 2.5 h and returned to 4.1, P < 0.001). Tricorrelated with in-

Plasma
pmolL

GIP
5-hour nm mm AUC L

baseline glyceride
sulin for L.peak/Lnadir

after 5 h (time concentrations

the S-R AUCs values

40
I

20

.--H--#{149}---#{149}--1.0 0.0 1.0 2.0 3.0 4.0 5.0

(r = 0.65, P = 0.04) and the S-R (r = 0.83, P = 0.006). A tendency to a different response pattern for plasma glycerol was found after the two test meals. Thus plasma glycerol decreased after was observed
=

the S meal to a nadir after the R meal 0.06) (Fig 2). After with different mmolIL for the

after I .5 h whereas no decrease (interaction diet-time: F15 5 h glycerol S meal after the concentrations and two by test 39.8 The meals. mmolIL AUCs

Js$j

-2.0

1 .9, P

had

increased were not S-R

-0.75,

by 59.3 significantly

for the R meal

compared

fasting

concentrations. correlated S-R for triglyceride

The

Plasma
pmolL it
i(

GLP-l
5-hour nm mm AUC i#{149}

AUC (r =

for glycerol was negatively P = 0.01), whereas peak correlated with peak S-R

with glucose glycerol was (r

=

positively P = 0.02).

0.72,

-2.0

-1.0

0.0

1.0

2.0

3.0

4.0

5.0
<

0.0001; 0.0001): between

interaction

between

diet

and
F,,,5,

time:
=

F,,2,5, P

25.2,

Hours FIG
gastric

after

test
(GIP),

meal of glucose,
glucagon-like

<

plasma
diet

lactate
and

(diet effect:
time:
F,,2,5,

I . Change
inhibitory

in plasma
polypeptide

concentrations
and

lactate,
peptide-l

insulin,
(GLP-

action

I ) after a raw potato pregelatinized potato

weight. male subjects.

starch meal 154% resistant stanch (RS)] (R) and a starch meal (0% RS) (5) in 10 healthy, normalAll data arc mean (SEM), expressed as diffe-

rcnccs
effect:

from
P

fasting
0.0001);

concentrations.
plasma glucose

Left (diet

panel

<

(ANOVA): effect: F,,.,5,

all (time
=

25. 1. P

sulin (diet effect: F,,.,5, = 39.9, P < and time: F,5,43, = 15.1, P < 0.0001); plasma GIP (is = 5) (diet effect: F,,.5, = 27.3, P < 0.0001 : interaction between diet and time: F,5.53, = 14.6, P < 0.0001): plasma GLP-1 (, = 5) (interaction between diet and time: F,5..,7, = 4.7, P < 0.0001 ). Right panel: areas under the curves (AUC). D < 0.05. ** < 0.01, * p < 0.001.

inter= 25.2. P < 0.0001): plasma in0.0001 : interaction between diet

36.7.
<

0.0001:

548

RABEN

ET

AL and
=

Plasma
mmol L

triglycerides
5-hour
-.--

AUC L

tween aftertaste (r = -0.64, P

mean

satiety
and fullness

(r

0.65,

0.04), P
=

hunger

0.049).

(r

0.62,

0.054).

inmol mm

-s
-0.1
-2.0 -1.0 0.0 1.0 2.0 3.0 4.0 5.0 A S

Discussion
Marked hormones
served after

differences as well
the two

in
test

plasma

concentrations

of substrates

and

as in palatability
meals.

and
Overall,

satiety
the

scores
S meal

were
greatly

obsti-

mulated

plasma
hormones

concentrations
whereas no

of glucose,
or only

insulin.

and
stimulation

gastroof

Plasma
I

glycerol
5-hour inmol mm
8

intestinal
AUC L

a modest

jnolL
100

these indexes was observed Plasma glucose increased after the R meal. of the analytical This data

after the R meal. nine times more after unexpected of the two

the S meal

than

50
0
. . .

fr_:::;_2:_::ii:

6i 4

was not entirely on digestibility

on the basis test starches.

TT
1.0 2.0 3.0 4.0 5.0 R S

However, the differences what larger than would

Thus, the ratio between

in postprandial he expected from

the peak glucose

glycemia were somethe clinical analyses.

response after the R

-2.0

1.0

0.0

Hours FIG 2. Change

after a raw potato potato male subjects. pregelatinized weight.

after

test

meal
of triglycerides
resistant 07 mean RS) (S) starch in 10 and glycerol

and S meal was I :9 (0.3613.07 tween the amount of readily ( I I .4154.4

a dily apparent

mmoIlL), digestible reason factors in plasma for this

with

whereas the carbohydrate difference

differences

ratio was
in the

be1:5
sti-

Downloaded from ajcn.nutrition.org by guest on December 23, 2013

in plasma
starch starch All

concentrations meal meal data are (54%

g) (Table
but may

3). The
be

is not rcaafter the two

IRSI)
healthy,

(R)

and

connected

normalas changes

mulation meals. Despite the increase the increase present converted

of

gastrointestinal increase

and

insulin

( SEM

) expressed

from
<=

fasting 1.9.

concentrations. plasma glycerol

Right 0.()64). panel:

Left

panel
areas

(ANOVA):
between diet
curves the

all (time
and
AUC).

0(8)1);
P
=

(interaction

effect: P time: F,,,..,,

the minor in plasma after the

glucose

after

the R meal,

under

lactate concentration S meal. This may (4.4 g) or to a part

amounted to 50% of be due to the fructose of the glucose being in the splanchnic
after speak response the S compared of 30: 1

in the test to lactate

(30). plasma R meal, pmoIIL).

meal

via nonoxidative
increased a ratio

pathways
markedly between in insulin

Epinephriu

and significant (NE) different

Ploref)iPleJ)hri?le

region

No nephnine nificantly

differences after the two response changes R meal, S meal 3). The

were test pattern

observed meals (Fig for E was

in plasma 3). However, found after

norepia sigthe two

with

Also, the

insulin producing This

values is far

( I 82/6

difference

greater

meals. Thus, no served after the 2 to 4 h after the = 0.0()64) (Fig cantly
Satiet

in plasma E concentrations were obwhereas E increased significantly from (interaction diet-time: F,5,..,, = 2.68, P differences in AUCs were not signifi-

Plasma
pg #{149} ml 40

norepinephrme
-.--

5-hour
ngminL

AUC

different scores

for E on NE.

-.&-s

2:H*/i:::,Ac>f

Significant teraction P
=

differences diet-time: after

F,,,,,

were
=

found
1.95,

for satiety P the

=

and

fullness
=

(in2.30,

0.03

and Thus

F,,,,,5, than after

-2.0

-1.0

0.0

1.0

2.0

3.0

4.0

5.0

0.012) satisfied

the two and more

test meals full after

(Fig4).

the subjects the

felt R

more meal.

S meal

Plasma
showed no correlations and the blood indexes between when 5-h pg
40 2:
#{149}

epinephrine
5-hour nQ mm p<OJJJ 6
L

Simple regression analysis any of the mean satiety scores AUCs mean for
nadir
correlated

ml

AUC

were hunger lactate (r

with

used. S-R
=

When peak and was significantly 0.68, P

=

nadir values were included, correlated with peak S-R whereas peak P
= -

0.03) (r
=

GIP
0.057)

S-R
and

was
with

peak
food

fullness

-0.87,

prospective

consumption

(r

0.88,

0.046).

-2.0

-1.0

0.0

1.0

2.0

3.0

4.0

5.0

:I!1
and IRSI) expressed
(time effect:
F,,,,

Evaluation

of

t/,t

test

necil

Hours less taste P

=

after

test

meal
of norepinephrine
(54% resistant starch

The
=

3.52.

subjects found that the S meal looked P < 0.001 ). had a more unpleasant and had a firmer texture
(t
=

appetizing
(t,
=

(t

FIG 3. Changes
nephrine after a raw

in plasma
potato

concentrations
starch meal

epi(R) noras

2.84,

P than or rebe-

and

a pregelatinized male
from fasting
P

potato subjects.
<

starch All

meal data are

(0%
Plasma

RS)

(5)

in 10 healthy,

<

0.05),

-5.38,

0.0004)

mal-weight.
differences

mean between

(SEM),
epinephrine

the R meal (Table overall palatability

gression analysis

4). They did were different on the S-R

not find between scores

that the aftertaste the meals. Simple correlations

concentrations.

F,,
=

44)

8.37.
P
=

0.00()l Right

interaction areas

diet curves

and

time:

showed

2.7.

0.0064).

panel:

under

the

(AUC).

RESISTANT than glucose may

Not only

STARCH, load hormones.

blood glucose

GLYCEMIA. and TABLE it

Subjective

AND 4
evaluation

SATIETY

549

would be useful
did

be expected after to look

the R

from the two

result

the difference meals.

in

in glucose to explain

response

In trying in gastrointestinal
lower

this

of the test

meal

at the changes
meal

a much

R
Visual appeal (0: good. 10: bad) 5.3 5.4 7.7

S
0.7 8.1 7.2 7.0 3.4 0.5 0.8 0.7 OW

response seemed

compared

with

the S meal, on either the

but

at the same (GIP)

time

there

to be no effect

proximal

on distal

Taste
Aftertaste

(0: pleasant.
(0: none,

10: unpleasant)
10: much)

6.0 t).8
I. I 0.8

(GLP- I ) incretins after the S meal. stimulators

tween the

in contrast Both GIP insulin

in these

with the increase in these hormones and GLP- I are known to be potent (3 1 ). The
may

Texture
Palatability

(0: firm.

10: loose)
10: bad) starch meal: R (unpaired

of
meals

secretion
hormones

large
therefore

difference
explain

bethe

(0: good.

7.4

0.6

8.2
potato

0.6
starch
O.O()7.

difference-beyond stimulated two meals. The nificantly

pregelatinized

what insulin secretion-in feelings

and fully

can

be

expected insulin

from response fullness

starch

the

glucosethe sigthe
in

iT i: SEM.
4

R, raw potato
differentfrom
-

S. pregelatinized
ltest,

between were
meal

meal.
2 3P
=

Significantly 0.02.
4P

df=

9):

O.OO()4.

subjective influenced feelings

of satiety
digestible

and
potato

also Thus,
resulted

by the digestibility and starch fullness meal.

of the starch. compared Already, scones power changes were with back

greater tant raw

2.5-3

of satiety digestible meal whereas been

the nesisthe to fasting lasted after of plasma glucosena a

and potato

slowly starch

1-1 .5 h after of the S meal in satiety

flect study but shown

it may

the rate of nonoxidative glucose carbohydrate was the only energy because
be that

disposal. source in a meal power

sensations

In the present in the test meals, has

were

the subjective the satiating stated that

an
the

increased
differences

energy

load satiating

also
due

been

Downloaded from ajcn.nutrition.org by guest on December 23, 2013

concentrations, It has

to result

in an increased load

of the meal conclusion

(33),
to a

h postprandially.

in satiety

previously

different however, or glucose tiety

with

net energy

in the meals.

A firmer

may,

carbohydrate load glucose on hepatic

sitive cells in the

may be mediated through an effect glycogen concentration on specific

brain
(32)

require more direct measurements of glycogen stores disposal in order to explain changes in subjective sahormones
and obesity (34,

and

studies

have

demonstrated

scones. have
35).

satiating effect ficant correlations the four satiety

of carbohydrate per se ( 14). We found no signibetween the changes in plasma glucose and in scores. In a recent study from our department in a low-fiber for glucose either
between the

Gastrointestinal
satiety

previously
In the present

been
study

connected
some con-

which a high- and subjects, the AUCs nificantly

in hunger

meal were and satiety

two meals

given scores
were

to 10 healthy were not sigdifferences

correlated

relations were tween GLP-l GIP trast may with

found between GIP and satiety scones but not beand satiety. The correlations found indicate that

correlated
ratings

( I 8). In the present lactate concentration,

study
in fact

decrease satiety and increase hunger, which is in conthe previously suggested satiating power of GIP. In the study, The however, correlations data on GIP were must therefore only available be considered for five with

with

differences

in Lspeak

which

may

re-

present subjects.

How
I have
never been

hungry
more hungry

are

you?
I

How
cannot

satisfied
bite

do

you

feel?
-.-

eat another

5.0 I

5.0
2.5

0.0 -2.5 1
56
I am not hungry at at
I

-1
am completely

0
empty

How
Nothing

much
at all

do you

think

you

can

eat?
Totally full

How
5.0 2.5

full

do

you

feel?

_j1
A lot

0.0 -2.5
-1
Not at aM hit

I
0 1 2 3 4 5 6

Hours FIG 4. Subjective

potato

after scores
(5)

test

meal starch
effect:
F,,,,,,,

Hours meal (54%

male

after starch
data satiety

test

meal

satiety
(0% fasting RS)

after a raw potato

ANOVA: all (time 0.012).

resistant
All
<

IRSI ) (R) and a pregelatinized

are mean (top (SEM). right): diet expressed effect:
F,,,,,

starch

meal from

in 10 healthy.

normal-weight.

subjects.
P

as

differences
=

values.

F,,,.,951.
=

0.0001):
=

4.94,

between

P = 0.04: interaction diet and time: F,,,,95,

between
=

diet and time:

P
=

1.95,

0.03).

Fullness

(right

bottom):

interaction

2.30.

550 some caution, and need to be confirmed of the the test meals were before and any the further

RABEN conon

ET

AL 4. Englyst HN. Cummings JH. Digestion of the polysaccharidcs of some cereal foods in the human small intestine. Am I Clin Nutr I 985:42:778-87. 5. Cummings IH. Englyst HN. Fermentation in the large intestine and the available substrates. Am I Clin Nutr 1987:45:1243-55. 6. Cummings IH. Pomare EW. Branch WI, Naylon CPE, Macfarlane GT. Short-chain fatty acids in the human large intestine. portal. hepatic 7. ules and by venous amylascs. and blood. In: Gut Marshall 1987:28:1221-7.

clusions can be made. Because the volume consuming the meals cannot have influenced However, the gelatinization

time these

spent

on the 2 test days

similar,

factors

satiating power of the two meals. of the S meal and the fact that it was in gastric emptying and fullness after Also, the different

a solid meal may have resulted in a reduction rate (36) and in increased feelings of satiety this ratings satiety found meal compared with the liquid R meal.

Fuwa H. Takaya
polymerization 1980:73-100.

T. Sugimoto

Y. Degradation
Ii, ed. New

of various
of York:

starch

granPress.

Mechanisms

saccharide

of taste, visual appeal, and texture may have influenced and fullness ratings. In fact, positive correlations were between aftertaste and satiety and fullness. et at (23) preference This partly constudy by Hill with increased in which increased (palatability) of a fullness may be
I I. 12. 9. 10.

depolymerization.

Academic

8. Englyst
nana

firms the previous hunger was found

HN. Cummings IH. Digestion of the carbohydrates (Musa paradisiaca sapientum) in the human small Am I Clin Nutr 1986:44:42-50.
Englyst in the Mathers HN, small IC. Cummings intestine Digestion JH. of man. Digestion Am I Clin of polysaccharidcs Nutr 1987:45:423-31. polysaccharides

of baintestine. of potato

meal. However, in their study there was no effect on ratings of the meal preference (23). The effect of RS on satiety shown in the present study considered lation starch increasing cause crease with a negative also nondigestible the a high-fat, energy overall intake effect weight starch of RS with control. in the diet weight regard Replacement diet has under may ratio been to appetite pose in the shown ad libitum and perhaps

of non-starch

by non-rumi-

regua risk of Beto incondi-

of digestible diet.

nant omnivores. Flatt IP. Dietary Am I Clin Nutr

Astrup A, Raben

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balance,
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deficiency

in

fat-to-carbohydrate and body

low-carbohydrate

the control 611-20.

13.

of macronutnient
IE, Burley VI.

balance?

Eur

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Nutr
power

1992:46:
of dietary

Blundell in obesity

Evaluation Iohn

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tions, whereas a low-fat, high-carbohydrate to decrease spontaneous food intake and weight reductions (37-39), a replacement with RS may be undesirable Whether RS in a mixed meal in long-term has the same

diet has been shown result in unexpected of digestible starch weight regulation. effect on appetite as

fat in man. In: Oomuna

research.

Y, Tarui 5, Inoue S. Shimazu

T, eds. Progress

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14. van Amelsvoort JMM, van Stratum P. Kraal JH, Lussenburg RN, Dubbelman GP. Minor difference in postprandial responses of men between starch and sugar when replacing fat in a normal meal. Br I
Nutr 1990:63:37-51.

in the present study remains, however, to be elucidated. Moreover, it is not possible to predict the effect on 24-h appetite sensations from the present 5-h results. The RS not digested in the small intestine will at a later stage, digested and fermented by bacteria
in the production and uptake

15. Tremblay A, Lavall#{233}e N, Almeras N, Allard L, Despr#{233}s I-P. Bouchard C. Nutritional determinants of the increase in energy intake associated with a high-fat diet. Am I Clin Nutr 1991:53:11347.

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16. Ponikos
preload young
17.

K, Hagamen
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of short-chain

Whether elucidated.

this

may

contribute

to increasing

satiety

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S. Is fibre satiating? Effects of a high fibre food intake of normal-weight and obese
1986:7:153-62.

Burley
cade. Press,

VI. BlundeIl

JE. Action
D, Bonfleld

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casDietary

Anderson

In conclusion, the intake of RS resulted in significantly postprandial plasma glucose, lactate, insulin, GIP, and responses and with digestible
correlated with

fiber. Chemistry.
1990:227-46. A. Christensen 18. Raben

physiology,
NI,

and health
Madsen and

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New York:

Plenum

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satiety or fullness, but correlations

power glucose in texture

compared were not

were found

I, HoIst fat oxidation

JJ, Astrup but

A. Decreased fullness

postpnandial

thermogenesis

increased

between atability satiety

GIP

and

satiety

scores.

Differences

and

pal-

of the test meals may ratings. Further studies meal, thank

Knap.

also have influenced the subjective are needed to clarify the effect of and long term. the laboratory
Bente

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RS in a mixed
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nicians Bente

both Lene
Inge

acutely Mellem,
Timmermann,

U
tech-

Kjas Dcnsen,
John Lind,

Mathiasen. 21
.

Deuncnberg P. van den Kooy K, Leenen R, Weststnate IA, IC. Sex and age specific prediction formulas for estimating composition from bioclectnical impedance: a cross-validation
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sunement
22.

of nutritionally

important

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fractions.

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