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

Am J Clin Nutr. 2009 Jan;89(1):114-25. doi: 10.3945/ajcn.2008.26842.

Abstract

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 < or = 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 approximately 20%, but when placed directly into foods was approximately 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.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Area Under Curve
  • Biological Availability
  • Blood Glucose / metabolism*
  • Dietary Carbohydrates / metabolism
  • Dietary Carbohydrates / pharmacokinetics*
  • Dietary Fiber / metabolism
  • Dietary Fiber / pharmacology*
  • Dose-Response Relationship, Drug
  • Glycemic Index*
  • Humans
  • Insulin / blood
  • Likelihood Functions
  • Nutritive Value
  • Polysaccharides / metabolism
  • Polysaccharides / pharmacokinetics
  • Randomized Controlled Trials as Topic
  • Regression Analysis
  • Risk Factors
  • Solubility
  • Viscosity

Substances

  • Blood Glucose
  • Dietary Carbohydrates
  • Dietary Fiber
  • Insulin
  • Polysaccharides
  • maltodextrin