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Am J Clin Nutr 89: 114-125, 2009. First published December 3, 2008; doi:10.3945/ajcn.26842
American Journal of Clinical Nutrition, doi:10.3945/ajcn.26842
Vol. 89, No. 1, 114-125, January 2009

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© 2009 American Society for Clinical Nutrition

ORIGINAL RESEARCH COMMUNICATION

Interventions to lower the glycemic response to carbohydrate foods with a low-viscosity fiber (resistant maltodextrin): meta-analysis of randomized controlled trials1,2,3,4

Geoffrey Livesey and Hiroyuki Tagami

1 From Independent Nutrition Logic, Pealerswell House, Wymondham, Norfolk, United Kingdom (GL), and Matsutani Chemical Industry Co, Ltd, Itami City, Japan (HT).

2 The opinions expressed herein are those of the authors and do not necessarily represent the views of the Matsutani Chemical Industry Co, Ltd.

3 The review was both commissioned from Independent Nutrition Logic Ltd and funded by the Matsutani Chemical Industry Co, Ltd, Itami City, Japan.

4 Address reprint requests and correspondence to G Livesey, Independent Nutrition Logic, Pealerswell House, 21 Bellrope Lane, Wymondham, Norfolk NR18 0QX, United Kingdom. E-mail: glivesey{at}inlogic.co.uk.

Background: The glycemic response to diet has been linked with noncommunicable diseases and is reduced by low-palatable, viscous, soluble fiber (1). Whether a palatable, low-viscous, soluble fiber such as resistant maltodextrin (RMD) has the same effect is unclear.

Objective: The objective was to assess evidence on the attenuation of the blood glucose response to foods by ≤10 g RMD in healthy adults.

Design: We conducted a systematic review of randomized, placebo-controlled trials with the use of fixed- and random-effects meta-analyses and meta-regression models.

Results: We found data from 37 relevant trials to April 2007. These trials investigated the attenuation of the glycemic response to rice, noodles, pastry, bread, and refined carbohydrates that included 30–173 g available carbohydrate. RMD was administered in drinks or liquid foods or solid foods. Placebo drinks and foods excluded RMD. Percentage attenuation was significant, dose-dependent, and independent of the amount of available carbohydrate coingested. Attenuation of the glycemic response to starchy foods by 6 g RMD in drinks approached {approx}20%, but when placed directly into foods was {approx}10%—significant (P < 0.001) by both modes of administration. Study quality analyses, funnel plots, and trim-and-fill analyses uncovered no cause of significant systematic bias. Studies from authors affiliated with organizations for-profit were symmetrical without heterogeneity, whereas marginal asymmetry and significant heterogeneity arose among studies involving authors from nonprofit organizations because of some imprecise studies.

Conclusions: A nonviscous palatable soluble polysaccharide can attenuate the glycemic response to carbohydrate foods. Evidence of an effect was stronger for RMD in drinks than in foods.




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