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


METHODS
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.
Livesey
Geoffrey
G
Independent Nutrition Logic, Pealerswell House, Wymondham, Norfolk, UK. glivesey@inlogic.co.uk
Tagami
Hiroyuki
H
D019540:Area Under Curve; D001682:Biological Availability; D001786:Blood Glucose / Q000378:metabolism*; D004040:Dietary Carbohydrates / Q000378:metabolism / Q000493:pharmacokinetics*; D004043:Dietary Fiber / Q000378:metabolism / Q000494:pharmacology*; D004305:Dose-Response Relationship, Drug; D038321:Glycemic Index; D006801:Humans; D007328:Insulin / Q000097:blood; D016013:Likelihood Functions; D009753:Nutritive Value; D011134:Polysaccharides / Q000378:metabolism / Q000493:pharmacokinetics; D016032:Randomized Controlled Trials as Topic; D012044:Regression Analysis; D012307:Risk Factors; D012995:Solubility; D014783:Viscosity
D001786:Blood Glucose; D004040:Dietary Carbohydrates; D004043:Dietary Fiber; D007328:Insulin; D011134:Polysaccharides; C008315:maltodextrin