Resistant starch type 4-enriched diet lowered blood cholesterols and improved body composition in a double blind controlled cross-over intervention

Mol Nutr Food Res. 2014 Jun;58(6):1365-9. doi: 10.1002/mnfr.201300829. Epub 2014 Jan 30.


A metabolic health crisis is evident as cardiovascular diseases (CVD) remain the leading cause of mortality in the United States. Effects of resistant starch type 4 (RS4), a prebiotic fiber, in comprehensive management of metabolic syndrome (MetS) remain unknown. This study examined the effects of a blinded exchange of RS4-enriched flour (30% v/v) with regular/control flour (CF) diet on multiple MetS comorbidities. In a double blind (participants-investigators), placebo-controlled, cluster cross-over intervention (n = 86, age≥18, 2-12 week interventions, 2-week washout) in the United States, individuals were classified as having MetS (With-MetS) or not (No-MetS) following International Diabetes Federation (IDF)-criteria. RS4 consumption compared with CF resulted in 7.2% (p = 0.002) lower mean total cholesterol, 5.5% (p = 0.04) lower non-HDL, and a 12.8% (p < 0.001) lower HDL cholesterol in the With-MetS group. No-MetS individuals had a 2.6% (p = 0.02) smaller waist circumference and 1.5% (p = 0.03) lower percent body fat following RS4 intervention compared to CF. A small but significant 1% increase in fat-free mass was observed in all participants combined (p = 0.02). No significant effect of RS4 was observed for glycemic variables and blood pressures. RS4 consumption improved dyslipidemia and body composition. Incorporation of RS4 in routine diets could offer an effective strategy for public cardio-metabolic health promotion.

Keywords: Cardiovascular diseases; Dietary intervention; Metabolic syndrome; Resistant starch type 4.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Glucose / metabolism
  • Body Composition
  • Cardiovascular Diseases / blood*
  • Cardiovascular Diseases / diet therapy
  • Cholesterol, HDL / blood*
  • Cholesterol, LDL / blood*
  • Comorbidity
  • Cross-Over Studies
  • Diet
  • Dietary Fiber / administration & dosage
  • Double-Blind Method
  • Female
  • Flour
  • Humans
  • Male
  • Metabolic Syndrome / blood*
  • Metabolic Syndrome / diet therapy
  • Prebiotics / analysis
  • Starch / administration & dosage*
  • Starch / chemistry
  • United States / epidemiology
  • Waist Circumference


  • Blood Glucose
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Dietary Fiber
  • Prebiotics
  • Starch