0
selected
-
1.
A triple-blinded crossover study to evaluate the short-term safety of sweet manioc starch for the treatment of glycogen storage disease type Ia.
Monteiro, VCL, de Oliveira, BM, Dos Santos, BB, Sperb-Ludwig, F, Refosco, LF, Nalin, T, Derks, TGJ, Moura de Souza, CF, Schwartz, IVD
Orphanet journal of rare diseases. 2021;(1):254
Abstract
BACKGROUND Glycogen storage disease type 1a (GSD Ia) is characterized by severe fasting hypoglycemia. The clinical management includes the administration of uncooked cornstarch (UCCS). Although such a diet approach is effective in achieving euglycemia, its impact on the quality of life of patients should be considered. In vitro analyses suggest a longer release of glucose when using sweet manioc starch (SMS). METHODS We compared the efficacy and safety of the administration of SMS and UCCS during a short-fasting challenge in patients with GSD Ia in a randomized, triple-blind, phase I/II, cross-over study. GSD Ia patients aged ≥ 16 years and treated with UCCS were enrolled. Participants were hospitalized for two consecutive nights, receiving UCCS or SMS in each night. After the administration of the starches, glucose, lactate and insulin levels were measured in 1-h interval throughout the hospitalization period. The procedures were interrupted after 10 h of fasting or in a hypoglycemic episode (< 3.88 mmol/L). RESULTS Eleven individuals (mean age: 21.6 ± 4.3 years; all presenting body mass index > 25 kg/m2) participated in the study. The average fasting period was 8.2 ± 2.0 h for SMS and 7.7 ± 2.3 h for UCCS (p = 0.04). SMS maintained euglycemia for a greater period over UCCS. Increased lactate concentrations were detected even in absence of hypoglycemia, not being influenced by the different starches investigated (p = 0.17). No significant difference was found in total cholesterol, HDL, triglycerides and uric acid levels in both arms. None of the patients showed severe adverse events. CONCLUSIONS SMS appears to be non-inferior to UCCS in the maintenance of euglycemia, thus emerging as a promising alternative to the treatment of GSD Ia.
-
2.
A phase 2 randomized controlled trial of oral resistant starch supplements in the prevention of acute radiation proctitis in patients treated for cervical cancer.
Sasidharan, BK, Ramadass, B, Viswanathan, PN, Samuel, P, Gowri, M, Pugazhendhi, S, Ramakrishna, BS
Journal of cancer research and therapeutics. 2019;(6):1383-1391
-
-
Free full text
-
Abstract
BACKGROUND Radiation induced proctitis is frequently encountered during the radiation therapy of cervical and prostate cancers that causes pain and occasionally with bleeding and may affect the continuity of radiation therapy. AIMS AND OBJECTIVES The purpose of the study is to look at the benefit of administration of an oral prebiotic amylase resistant starch in reducing the incidence of acute radiation proctitis, a distressing symptom in patients receiving radiation therapy for cancer of the cervix. MATERIAL AND METHODS The study was conducted between 2011 and 2014 in 104 patients receiving radical chemo-radiotherapy for carcinoma cervix. Patients were randomized in to two arms, one receiving 30 gm of resistant starch and the other digestible starch on a daily basis throughout the course of the external radiotherapy. All patients received standard 4-field box radiation portals, 50 Gy in 25 fractions with 4 cycles of weekly concurrent Cisplatin. At completion of external beam radiotherapy, all patients underwent LDR/HDR brachytherapy. The study was double blinded and allocation was concealed from the investigators. The investigator recorded the radiotherapy related toxicity of the patients according to CTC V 3.0. The incidence and severity of grade 2-4 diarrhoea and proctitis were documented on a weekly basis and compared across the two groups and analyzed. Stool short chain fatty acid concentrations were measured at baseline at 2nd and 4th week and after 6 weeks of completion of radiotherapy in both study placebo arms and reported. The pattern of microbiota in the stool were also estimated in all patients at 4 time points. Two patients who progressed during therapy were not included in the analyses and two patients discontinued the intervention. A per protocol analyses was done. RESULTS At analysis there were 50 patients in each arm. The severity of clinical proctitis was found to be similar in both groups of patients with 12.2 % of patients experiencing toxicity of grade 2 and above in digestible starch group versus 14.6% in the resistant starch group. Functional proctitis was similarly graded and it was found that 16.3 % patients in digestible starch group experienced toxicity against 10.2 % patients in the resistant starch group. This difference was seen at 4th week and continued in the subsequent weeks till the end of radiation. Both groups had similar reported toxicity at 6 weeks post intervention and similar incidence of grade 2 and above diarrhea. The resistant starch group was found to have 8% incidence as compared to 2% in the other group at the 5th and 6th week. The short chain fatty acid concentrations were not significantly different in the groups at any point. CONCLUSION The study did not demonstrate a significant benefit in administering resistant starch over and above normal diet to patients receiving pelvic radiotherapy. The reasons may be attributed to concurrent use of chemotherapy and decrease in intestinal probiotics. The use of digestible starch in the control arm may have contributed to lower incidence of the toxicity endpoints as well.
-
3.
Starch-entrapped microsphere fibers improve bowel habit but do not exhibit prebiotic capacity in those with unsatisfactory bowel habits: a phase I, randomized, double-blind, controlled human trial.
Rasmussen, HE, Hamaker, B, Rajan, KB, Mutlu, E, Green, SJ, Brown, M, Kaur, A, Keshavarzian, A
Nutrition research (New York, N.Y.). 2017;:27-37
-
-
Free full text
-
Abstract
Approximately one-third of individuals in the United States experience unsatisfactory bowel habits, and dietary intake, especially one low in fiber, could be partly responsible. We hypothesized that intake of a fermentable fiber (starch-entrapped microspheres, SM) that has a delayed, slow fermentation profile in vitro would improve bowel habit while exhibiting prebiotic capacity in those with self-described unsatisfactory bowel habits, all with minimal adverse effects. A total of 43 healthy volunteers completed a 3-month, double-blind, parallel-arm randomized clinical trial to assess the ability of a daily dose (9 or 12 g) of SM vs psyllium (12 g) to improve bowel habit, including stool consistency and frequency, and modify gut milieu through changes in stool microbiota and short-chain fatty acids while remaining tolerable through minimal gastrointestinal symptoms. All outcomes were compared before and after fiber treatment. Stool frequency significantly improved (P=.0003) in all groups after 3 months, but stool consistency improved only in both SM groups compared with psyllium. In addition, all groups self-reported a similar improvement in overall bowel habit with fiber intake. Both SM and psyllium resulted in minimal changes in microbiota composition and short-chain fatty acid concentrations. The present study suggests that supplementation with a delayed and slow-fermenting fiber in vitro may improve bowel habit in those with constipation, but further investigation is warranted to determine capacity to alter microbiota and fermentation profiles in humans. This trial was registered at ClinicalTrials.gov as NCT01210625.
-
4.
Green tea extract decreases starch digestion and absorption from a test meal in humans: a randomized, placebo-controlled crossover study.
Lochocka, K, Bajerska, J, Glapa, A, Fidler-Witon, E, Nowak, JK, Szczapa, T, Grebowiec, P, Lisowska, A, Walkowiak, J
Scientific reports. 2015;:12015
Abstract
Green tea is known worldwide for its beneficial effects on human health. However, objective data evaluating this influence in humans is scarce. The aim of the study was to assess the impact of green tea extract (GTE) on starch digestion and absorption. The study comprised of 28 healthy volunteers, aged 19 to 28 years. In all subjects, a starch (13)C breath test was performed twice. Subjects randomly ingested naturally (13)C-abundant cornflakes during the GTE test (GTE 4 g) or placebo test. The cumulative percentage dose recovery (CPDR) was significantly lower for the GTE test than for the placebo test (median [interquartile range]: 11.4% [5.5-15.5] vs. 16.1% [12.7-19.5]; p = 0.003). Likewise, CPDR expressed per hour was considerably lower in each point of the measurement. In conclusion, a single dose of green tea extract taken with a test meal decreases starch digestion and absorption.
-
5.
A combined 13CO2/H2 breath test can be used to assess starch digestion and fermentation in humans.
Symonds, EL, Kritas, S, Omari, TI, Butler, RN
The Journal of nutrition. 2004;(5):1193-6
-
-
Free full text
-
Abstract
Ingestion of starch from corn (naturally enriched with (13)C) should produce (13)CO(2) after small intestinal digestion and (13)CO(2) and H(2) from colonic fermentation. This study used a combined (13)CO(2)/H(2) breath test to assess the digestion and fermentation of resistant starch and to show that the test could detect changes in digestibility due to cooking. Volunteers consumed 40 g digestible cornstarch with water (n = 8), or 40 g resistant cornstarch in liquid (n = 12) or cooked into a pancake (n = 4). Interval breath sampling was performed and analyzed for (13)CO(2) and H(2). Ingestion of resistant starch produced a double-peaked (13)CO(2) excretion curve. The first increase in (13)CO(2) occurred at the same time as excretion from digestible starch (55 +/- 9 and 68 +/- 9 min, respectively), which was due to small intestinal digestion. The second increase in (13)CO(2) was accompanied by an increase in H(2) excretion (432 +/- 15 and 428 +/- 48 min, respectively), which was indicative of colonic bacterial fermentation. Cooking resistant starch increased its degree of digestion from 36 to 72%. The (13)CO(2)/H(2) breath test can be used to estimate digestion and fermentation of starches in different physiologic and pathologic conditions.
-
6.
Influence of the physical form of processed rice products on the enzymatic hydrolysis of rice starch in vitro and on the postprandial glucose and insulin responses in patients with type 2 diabetes mellitus.
Kim, JC, Kim, JI, Kong, BW, Kang, MJ, Kim, MJ, Cha, IJ
Bioscience, biotechnology, and biochemistry. 2004;(9):1831-6
-
-
Free full text
-
Abstract
The manufacturing processes used determined the physicochemical properties of the three kinds of rice food, garaeduk, bagsulgi, and cooked rice. The initial rate of hydrolysis by porcine pancreatic alpha-amylase (PPA) was affected by the food form. The firmer structure of garaeduk was apparently responsible for the difficulty in maceration, resulting in less digestion than with easily digestible food for the same maceration time. The initial rate of hydrolysis of each rice product by PPA increased with increasing maceration time in a Waring Blender for all of the processed rice products. The postprandial glucose and insulin responses to the three processed rice products were also studied in ten patients with type 2 diabetes mellitus (4 men and 6 women aged 56.8 +/- 2.3 yr; duration of diabetes, 3.6 +/- 1.2 yr; body mass index (BMI), 23.7 +/- 2.6 kg/m2; fasting serum glucose, 143.9 +/- 5.1 mg/dl; serum insulin, 20.8 +/- 2.2 microU/ml). Each subject ingested of the three rice foods after a 12-h overnight fast, and the serum glucose and insulin levels were measured over a 0-240 min period. The postprandial serum glucose and insulin levels at 90 min after ingesting bagsulgi and cooked rice were less than those at 60 min, while the levels at 90 min after ingesting garaeduk were higher than those at 60 min. Garaeduk also significantly decreased the incremental responses of glucose and insulin when compared with bagsulgi and cooked rice. The results suggest that garaeduk would be the most unlikely to increase the postprandial serum glucose and insulin levels among the three rice foods. The food form, which eventually differentiated each food by its specific surface area with the same degree of maceration because of the characteristic physical strength, therefore affected the rate of rice starch hydrolysis both in vitro and in vivo.
-
7.
Wheat-starch-based gluten-free products in the treatment of newly detected coeliac disease: prospective and randomized study.
Peräaho, M, Kaukinen, K, Paasikivi, K, Sievänen, H, Lohiniemi, S, Mäki, M, Collin, P
Alimentary pharmacology & therapeutics. 2003;(4):587-94
-
-
Free full text
-
Abstract
BACKGROUND The safety of wheat-starch-based gluten-free products in the treatment of coeliac disease is debatable. Prospective studies are lacking. AIM: : To compare the clinical, histological and serological response to a wheat-starch-based or natural gluten-free diet in patients with newly detected coeliac disease. METHODS Fifty-seven consecutive adults with untreated coeliac disease were randomized to a wheat-starch-based or natural gluten-free diet. Clinical response, small bowel mucosal morphology, CD3+, alphabeta+ and gammadelta+ intra-epithelial lymphocytes, mucosal human leucocyte antigen-DR expression and serum endomysial, transglutaminase and gliadin antibodies were investigated before and 12 months after the introduction of the gluten-free diet. Quality of life measurements were performed by standardized questionnaires and the bone mineral density was analysed. RESULTS In both groups, abdominal symptoms were alleviated equally by a strict diet. There were no differences between the groups in mucosal morphology, the density of intra-epithelial lymphocytes, serum antibodies, bone mineral density or quality of life tests at the end of the study. Four patients on a natural gluten-free diet and two on a wheat-starch-based gluten-free diet had dietary lapses; as a result, inadequate mucosal, serological and clinical recovery was observed. CONCLUSIONS The dietary response to a wheat-starch-based gluten-free diet was as good as that to a natural gluten-free diet in patients with newly detected coeliac disease.