Resistant starch supplementation influences blood lipid concentrations and glucose control in overweight subjects. [Effects of resistant starch on insulin resistance of type 2 diabetes mellitus patients]. Prior short-term consumption of resistant starch enhances postprandial insulin sensitivity in healthy subjects Is there any place for resistant starch, as alimentary prebiotic, for patients with type 2 diabetes? The Therapeutic Potential of Resistant Starch in Modulation of Insulin Resistance, Endotoxemia, Oxidative Stress and Antioxidant Biomarkers in Women with Type 2 Diabetes: A Randomized Controlled Clinical Trial Resistant starch intake at breakfast affects postprandial responses in type 2 diabetics and enhances the glucose-dependent insulinotropic polypeptide--insulin relationship following a second meal. Efficacy of increased resistant starch consumption in human type 2 diabetes Dietary Fibre Improves First-phase Insulin Secretion in Overweight Individuals Acute ingestion of resistant starch reduces food intake in healthy adults. Dietary treatment with rice containing resistant starch improves markers of endothelial function with reduction of postprandial blood glucose and oxidative stress in patients with prediabetes or newly diagnosed type 2 diabetes. Baseline insulin sensitivity affects response to high-amylose maize resistant starch in women: a randomized, controlled trial Impact of Resistant Starch on Body Fat Patterning and Central Appetite Regulation Effects of moderate variations in macronutrient composition on weight loss and reduction in cardiovascular disease risk in obese, insulin-resistant adults. Effects of 1-year orlistat treatment compared to placebo on insulin resistance parameters in patients with type 2 diabetes. [Impact of weight loss on adipocytokines, C-reactive protein and insulin sensitivity in hypertensive women with central obesity]. Optimal macronutrient content of the diet for adolescents with prediabetes; RESIST a randomised control trial. Effects of Dietary n-3 Fatty Acids on Hepatic and Peripheral Insulin Sensitivity in Insulin-Resistant Humans
Resistant starch ( RS ) includes the sum of starch and degradation products of starch that resist small intestinal digestion and enter the colon . This study was planned to examine the effect of resistant starch on hypolipidemic actions , blood glucose , insulin levels and humoral immune responses in healthy overweight subjects . Healthy overweight subjects ( over 120 % of their ideal body weights ) were fed either 24 g/d of resistant corn starch ( RS ) or regular corn starch ( CS ) for 21 d with their regular meals . Although this double-blind feeding regiment result ed in no significant changes in their weights or other physical parameters for the relatively acute period of intakes , there were significant lowering effects of serum total cholesterol ( p < 0.05 ) and serum LDL-cholesterol ( p < 0.05 ) in subjects supplemented RS . Compared with the control starch group , the RS supplementation also reduced the mean fasting serum glucose concentrations ( p < 0.05 ) . Resistant starch supplement result ed in the increase in serum immunoglobulin G ( IgG ) concentrations . Serum insulin and complement 3 ( C3 ) were unaffected . Tested resistant starch supplementation was reported to be palatable with minimal bowel discomfort . These results suggest that RS supplementation improves the blood lipid profile and controls the blood glucose levels in healthy overweight subjects without bowel discomfort . Therefore , RS has a potential to be used as one of the promising food ingredients for reducing risk factors involved in the development of atherosclerosis and type 2 diabetes in overweight individuals . However , in order to prove RS as a novel therapeutic agent of cardiovascular diseases and diabetes , controlled trials with larger sample sizes and longer duration are warranted OBJECTIVE To observe the effects of resistant starch ( RS ) on insulin resistance ( IR ) in type 2 diabetes mellitus patients . METHODS All 40 patients with type 2 diabetes mellitus were r and omly divided into two groups : Group A and Group B. Cross- design of two stages ( I , II ) was used during observation . Group A received RS 30 g/d as an intervention group for ahead of 4 weeks ( I stage ) , while group B as a control group . Group B was given RS in late 4 weeks ( II stage ) , while Group A as served control group . Blood was taken the first day and on the latest day in each stage . Fasting blood glucose ( FBG ) , post blood glucose ( PBG ) , fructosamine ( FMN ) , total cholesterol ( TC ) , triglyceridemic ( TG ) , insulin sensitive index ( ISI ) , and body mass index ( BMI ) were measured , respectively . RESULTS As Compared with the control group , ISI was higher and FBG , PBG , TC , TG , FMN and BMI were significantly lower in intervention group ( P < 0.05 ) . CONCLUSION RS should be effective in improving IR of type 2 diabetes mellitus patients Aims /hypothesisDiets rich in insoluble-fibre are linked to a reduced risk of both diabetes and cardiovascular disease ; however , the mechanism of action remains unclear . The aim of this study was to assess whether acute changes in the insoluble-fibre ( resistant starch ) content of the diet would have effects on postpr and ial carbohydrate and lipid h and ling . Methods Ten healthy subjects consumed two identical , low-residue diets on separate occasions for 24 h ( 33 % fat ; < 2 g dietary fibre ) . Of the diets one was supplemented with 60 g resistant starch ( Novelose 260 ) . On the following morning a fibre-free meal tolerance test ( MTT ) was carried out ( 59 g carbohydrate ; 21 g fat ; 2.1 kJ ) and postpr and ial insulin sensitivity ( SIORAL ) assessed using a minimal model approach . Results Prior resistant starch consumption led to lower postpr and ial plasma glucose ( p=0.037 ) and insulin ( p=0.038 ) with a higher insulin sensitivity(44±7.5 vs 26±3.5 × 10−4 dl kg−1 min−1 per µUml−1 ; p=0.028 ) and C-peptide-to-insulin molar ratio ( 18.7±6.5 vs 9.7±0.69 ; p=0.017 ) . There was no effect of resistant starch consumption on plasma triacylglycerol although non-esterified fatty acid and 3-hydroxybutyrate levels were suppressed 5 h after the meal tolerance test . Conclusion Prior acute consumption of a high-dose of resistant starch  enhanced carbohydrate h and ling in the postpr and ial period the following day potentially due to the increased rate of colonic fermentation OBJECTIVE The aim of the present study was to determine effects of Resistant Starch ( RS2 ) on metabolic parameters and inflammation in women with type 2 diabetes ( T2DM ) . METHODS In this r and omized controlled clinical trial , 60 females with T2DM were divided into intervention ( n = 28 ) and placebo groups ( n = 32 ) . They received 10 g/d RS2 or placebo for 8 weeks , respectively . Fasting blood sugar ( FBS ) , glycated hemoglobin ( HbA1c ) , lipid profile , high-sensitive C-reactive protein ( hs-CRP ) , interleukin-6 ( IL-6 ) and tumor necrosis factor-alpha ( TNF-α ) were measured at baseline and at the end of the trial . Paired t test , unpaired t-test and ANCOVA were used to compare the quantitative variables . The data were analyzed using SPSS software version 13.0 . RESULTS RS2  decreased HbA1c ( -0.3 % , -3.6 % ) , TNF-α ( -3.4 pg/mL , -18.9 % ) , triglyceride ( -33.4 mg/dL , -15.4 % ) , and it increased HDL-c ( + 9.4 mg/dL , + 24.6 % ) significantly compared with the placebo group ( p < 0.05 ) . Changes in FBS , total cholesterol , low-density lipoprotein , hs-CRP and IL-6 were not significant in the RS2 group compared with the control group . RS2 can improve glycemic status , inflammatory markers and lipid profile in women with T2DM . CONCLUSIONS Although findings of the present study indicated positive effects of RS2  on inflammation and metabolic parameters , more studies are needed to confirm efficacy of RS2 as an adjunct therapy in diabetes Aims : This trial aims to determine the effects of resistant starch ( RS ) subtype 2 ( RS2 ) on glycemic status , metabolic endotoxemia and markers of oxidative stress . Methods : A r and omized , controlled , parallel-group clinical trial group of 56 females with type 2 diabetes mellitus ( T2DM ) was divided to 2 groups . The intervention group ( n = 28 ) and control group ( n = 28 ) received 10 g/day RS2 or placebo for 8 weeks , respectively . Fasting blood sample s were taken to determine glycemic status , endotoxin , high sensitivity C-reactive protein ( hs-CRP ) , malondialdehyde ( MDA ) , total antioxidant capacity ( TAC ) , antioxidant enzymes concentrations as well as uric acid at baseline and after the intervention . Results : After 8 weeks , RS2 caused a significant decrease in the levels of MDA ( -34.10 % ) , glycosylated hemoglobin ( -9.40 % ) , insulin ( -29.36 % ) , homeostasis model of insulin resistance ( -32.85 % ) and endotoxin ( -25.00 % ) , a significant increase in TAC ( 18.10 % ) and glutathione peroxidase ( 11.60 % ) as compared with control . No significant changes were observed in fasting plasma glucose , quantitative insulin sensitivity check index , hs-CRP , superoxide dismutase , catalase and uric acid in the RS2 group as compared with the control group . Conclusion : Supplementation with RS2 may be improved glycemic status , endotoxemia and markers of oxidative stress in patients with T2DM Resistant starch ( RS ) consumption can modulate postpr and ial metabolic responses , but its effects on carbohydrate ( CHO ) h and ling in type 2 diabetics ( T2D ) are unclear . It was hypothesized that a bagel high in RS would improve glucose and insulin homeostasis following the 1st meal , regardless of the amount of available CHO , and that in association with incretins , the effects would carry over to a 2nd meal . Using a r and omized crossover design , 12 T2D ingested four different bagel treatments ( their 1st meal ) determined by available CHO and the weight or amount of bagel consumed : treatment A , without RS ( 50 g of available CHO ) ; treatment B , with RS ( same total CHO as in A ) ; treatment C , with RS ( same available CHO as in A ) ; and treatment D , with the same RS as in B and available CHO as in A and C. A st and ard 2nd meal was ingested 3 h later . Following the first meal , B elicited a lower glucose incremental area under the curve ( iAUC ) than C ( P < 0.05 ) , D ( P < 0.05 ) , and A ( trend ; P = 0.07 ) , lower insulin iAUC than A ( P < 0.05 ) and C ( P < 0.05 ) , and lower glucose-dependent insulinotropic polypeptide ( GIP ) iAUC than A ( P < 0.05 ) . There was a positive correlation ( P < 0.05 ) between GIP and insulin iAUCs after the 2nd meal , and C had a 3 times greater slope than the other treatments ( r = 0.91 , P < 0.001 ) , yet lacked a significant concomitant improvement in glucose disposal . These results show that for the 1st meal , RS was effective when it replaced a portion of the available CHO , while ingesting more RS influenced the GIP-insulin axis following the 2nd meal Resistant starch ( RS ) has been shown to beneficially affect insulin sensitivity in healthy individuals and those with metabolic syndrome , but its effects on human type 2 diabetes ( T2DM ) are unknown . This study aim ed to determine the effects of increased RS consumption on insulin sensitivity and glucose control and changes in postpr and ial metabolites and body fat in T2DM . Seventeen individuals with well-controlled T2DM ( HbA1c 46.6±2 mmol/mol ) consumed , in a r and om order , either 40 g of type 2 RS ( HAM-RS2 ) or a placebo  , daily for 12 weeks with a 12-week washout period in between . At the end of each intervention period , participants attended for three metabolic investigations : a two-step euglycemic – hyperinsulinemic clamp combined with an infusion of [ 6,6 - 2H2 ] glucose , a meal tolerance test ( MTT ) with arterio-venous sampling across the forearm , and whole-body imaging . HAM-RS2 result ed in significantly lower postpr and ial glucose concentrations ( P=0.045 ) and a trend for greater glucose uptake across the forearm muscle ( P=0.077 ) ; however , there was no effect of HAM-RS2 on hepatic or peripheral insulin sensitivity , or on HbA1c . Fasting non-esterified fatty acid ( NEFA ) concentrations were significantly lower ( P=0.004 ) and NEFA suppression was greater during the clamp with HAM-RS2 ( P=0.001 ) . Fasting triglyceride ( TG ) concentrations and soleus intramuscular TG concentrations were significantly higher following the consumption of HAM-RS2 ( P=0.039 and P=0.027 respectively ) . Although fasting GLP1 concentrations were significantly lower following HAM-RS2 consumption ( P=0.049 ) , postpr and ial GLP1 excursions during the MTT were significantly greater ( P=0.009 ) . HAM-RS2 did not improve tissue insulin sensitivity in well-controlled T2DM , but demonstrated beneficial effects on meal h and ling , possibly due to higher postpr and ial GLP1 Previous work has shown increased insulin sensitivity , increased hepatic insulin clearance and lower postpr and ial insulin responses following treatment with resistant starch , a type of dietary fibre . The objective of this study was to further explore the effects of resistant starch on insulin secretion . Twelve overweight ( BMI 28.2±0.4 kg/m2 ) individuals participated in this r and omized , subject-blind crossover study . Participants consumed either 40 g type 2 resistant starch or the energy and carbohydrate-matched placebo daily for four weeks . Assessment of the effect on insulin secretion was made at the end of each intervention using an insulin-modified frequently sample d intravenous glucose tolerance test ( FSIVGTT ) . Insulin and C-peptide concentrations were significantly higher during the FSIVGTT following the resistant starch compared with the placebo . Modelling of the data showed significantly improved first-phase insulin secretion  with resistant starch . These effects were observed without any changes to either body weight or habitual food intake . This study showed that just four weeks of resistant starch intake significantly increased the first-phase insulin secretion in individuals at risk of developing type 2 diabetes . Further studies exploring this effect in individuals with type 2 diabetes are required Resistant starch ( RS ) , a non-viscous dietary fibre , may have postpr and ial effects on appetite regulation and metabolism , although the exact effects and mechanisms are unknown . An acute r and omised , single-blind crossover study , aim ed to determine the effects of consumption of 48 g RS on appetite compared to energy and available carbohydrate-matched placebo .  Twenty young healthy adult males consumed either 48 g RS or the placebo divided equally between two mixed meals on two separate occasions . Effects on appetite were assessed , using an ad libitum test meal and 24-h diet diaries for energy intake , and using visual analogue scales for subjective measures . Changes to postpr and ial glucose , insulin and C-peptide were also assessed . There was a significantly lower energy intake following the RS supplement compared to the placebo supplement at both the ad libitum test meal ( 5241 ( sem 313 ) v. 5606 ( sem 345 ) kJ , P = 0.033 ) and over the 24 h ( 12 603 ( sem 519 ) v. 13 949 ( sem 755 ) kJ , P = 0.044 ) . However , there was no associated effect on subjective appetite measures . Postpr and ial plasma glucose concentrations were not significantly different between supplements , but there was a significantly lower postpr and ial insulin response following the RS supplement ( P = 0.029 ) . The corresponding C-peptide concentrations were not significantly different , although the ratio of C-peptide to insulin was higher following the RS supplement compared to placebo ( P = 0.059 ) . These results suggest that consumption of 48 g RS , over a 24-h period , may be useful in the management of the metabolic syndrome and appetite . Further studies are required to determine the exact mechanisms OBJECTIVE We aim ed to evaluate whether 4-week of dietary treatment with rice containing resistant starch reduces blood glucose and oxidative stress as well as improves endothelial function . METHODS Patients with impaired fasting glucose ( IFG ) , impaired glucose tolerance ( IGT ) or newly diagnosed type 2 diabetes ( n = 90 ) were r and omly assigned to either a group ingesting rice containing 6.51 g resistant starch daily or a control rice group for 4-weeks . We assessed fasting and postpr and ial levels of glucose and insulin , oxidative stress markers and endothelial function using reactive hyperemia peripheral arterial tonometry  ( RH-PAT ) . RESULTS The diet containing rice with resistant starch  reduced fasting insulin and insulin resistance , postpr and ial glucose ( P = 0.010 ) and insulin levels at 30 min , and glucose and insulin areas under the response curve after the st and ard meal . Rice with resistant starch also decreased urinary 8-epi-PGF(2α ) and plasma malondialdehyde ( MDA ) and increased the RH-PAT index ( P < 0.001 ) and total nitric oxide ( NO ) . Postpr and ial changes in glucose at 60 and 120 min and areas under the glucose response curve , MDA , RH-PAT , and total NO of the test group differed significantly from those in the control even after adjusting for baseline values . Overall , changes in the RH-PAT index correlated positively with changes in total NO ( r = 0.336 , P = 0.003 ) and superoxide dismutase activity ( r = 0.381 , P = 0.001 ) and negatively with changes in MDA ( r = -0.358 , P = 0.002 ) and 8-epi-PGF(2α ) . CONCLUSIONS In patients with IFG , IGT or newly diagnosed type 2 diabetes , 4-weeks of dietary treatment with rice containing resistant starch was associated with improved endothelial function with reduction of postpr and ial glucose and oxidative stress compared with control Background Resistant starch ( RS ) is a type of dietary fiber that can improve glucose metabolism , but its effects may be modulated by sex or baseline insulin sensitivity . This study was design ed to examine the effect of high-amylose maize resistant starch ( HAM-RS2 ) on insulin sensitivity ( SI ) in women , and to determine if SI status affects the response to RS . Methods This was a r and omized , placebo-controlled , double-blind , cross-over study . Participants were 40 healthy , non-diabetic women aged 22–67 years in the normal-weight to obese BMI range ( 20.6–47.4 kg/m2 ) . Two doses of HAM-RS2 were tested , 15 and 30 g per day , administered in the form of cookies . Participants were r and omized to the order in which they received the experimental and placebo product . Each arm was 4 weeks , with a 4-week wash-out period in between . SI was assessed at the end of each 4-week arm of product consumption by frequently- sample d , insulin-modified , intravenous glucose tolerance test and minimal modeling . Participants were categorized as being insulin resistant ( IR ; SI < 7.8 ) or insulin sensitive ( IS ; SI ≥ 7.8 ) based on Gaussian analysis . The effect of treatment arm on SI was examined by mixed-model analysis within IR and IS sub-groups , using all available data . In addition , SI was examined by ANOVA among just those women who completed all three arms of the study with valid SI results . Results Among IR participants , SI was on average ~16 % higher after the 30 g arm when compared to the control arm by mixed-model analysis ( n = 40 , P < 0.05 ) , and tended to be 23 % higher by ANOVA among women who completed all arms ( n = 23 , P = 0.06 ) . HAM-RS2 did not affect SI in IS women . Conclusion Consumption of HAM-RS2 at 30 g/day in the form of a snack food item was associated with improved insulin sensitivity in women with insulin resistance . Clinical trials registry numberNCT01521806 Background Adipose tissue patterning has a major influence on the risk of developing chronic disease . Environmental influences on both body fat patterning and appetite regulation are not fully understood . This study was performed to investigate the impact of resistant starch ( RS ) on adipose tissue deposition and central regulation of appetite in mice . Methodology and Principle Findings Forty mice were r and omised to a diet supplemented with either the high resistant starch ( HRS ) , or the readily digestible starch ( LRS ) . Using 1H magnetic resonance ( MR ) methods , whole body adiposity , intrahepatocellular lipids ( IHCL ) and intramyocellular lipids ( IMCL ) were measured . Manganese-enhanced MRI ( MEMRI ) was used to investigate neuronal activity in hypothalamic regions involved in appetite control when fed ad libitum . At the end of the interventional period , adipocytes were isolated from epididymal adipose tissue and fasting plasma collected for hormonal and adipokine measurement . Mice on the HRS and LRS diet had similar body weights although total body adiposity , subcutaneous and visceral fat , IHCL , plasma leptin , plasma adiponectin plasma insulin/glucose ratios was significantly greater in the latter group . Adipocytes isolated from the LRS group were significantly larger and had lower insulin-stimulated glucose uptake . MEMRI data obtained from the ventromedial and paraventricular hypothalamic nuclei suggests a satiating effect of the HRS diet despite a lower energy intake . Conclusion and Significance Dietary RS significantly impacts on adipose tissue patterning , adipocyte morphology and metabolism , glucose and insulin metabolism , as well as affecting appetite regulation , supported by changes in neuronal activity in hypothalamic appetite regulation centres which are suggestive of satiation BACKGROUND Obese , insulin-resistant persons are at risk of cardiovascular disease . How best to achieve both weight loss and clinical benefit in these persons is controversial , and recent reports question ed the superiority of low-fat diets . OBJECTIVE We aim ed to ascertain the effects of moderate variations in the carbohydrate and fat content of calorie-restricted diets on weight loss and cardiovascular disease risk in obese , insulin-resistant persons . DESIGN Fifty-seven r and omly assigned , insulin-resistant , obese persons completed a 16-wk calorie-restricted diet with 15 % of energy as protein and either 60 % and 25 % or 40 % and 45 % of energy as carbohydrate and fat , respectively . Baseline and postweight-loss insulin resistance ; daylong glucose , insulin , and triacylglycerol concentrations ; fasting lipid and lipoprotein concentrations ; and markers of endothelial function were quantified . RESULTS Weight loss with 60 % or 40 % of energy as carbohydrate ( 5.7 + /- 0.7 or 6.9 + /- 0.7 kg , respectively ) did not differ significantly , and improvement in insulin sensitivity correlated with the amount of weight lost ( r = 0.50 , P < 0.001 ) . Subjects following the diet with 40 % of energy as carbohydrate had greater reductions in daylong insulin and triacylglycerol ( P < 0.05 ) and fasting triacylglycerol ( 0.53 mmol/L ; P = 0.04 ) concentrations , greater increases in HDL-cholesterol concentrations ( 0.12 mmol/L ; P < 0.01 ) and LDL particle size ( 1.82 s ; P < 0.05 ) , and a greater decrease in plasma E-selectin ( 5.6 ng/L ; P = 0.02 ) than did subjects following the diet with 60 % of energy as carbohydrate . CONCLUSIONS In obese , insulin-resistant persons , a calorie-restricted diet , moderately lower in carbohydrate and higher in unsaturated fat , is as efficacious as the traditional low-fat diet in producing weight loss and may be more beneficial in reducing markers for cardiovascular disease risk WHAT IS KNOWN AND OBJECTIVE The behavioural approach is usually slow and not always sufficient to achieve optimal targets in weight and metabolic control in obese diabetic patients , and a pharmacological treatment is often necessary . The aim of this study was to compare the effects of orlistat and placebo on body weight , glycaemic and lipid profile and insulin resistance in patients with type 2 diabetes . METHODS Two hundred and fifty-four obese , diabetic patients were enrolled in this study and r and omized to take orlistat 360 mg or placebo for 1year . We evaluated at baseline and after 3 , 6 , 9 and 12months body weight , waist circumference ( WC ) , body mass index ( BMI ) , glycated haemoglobin ( HbA(1c ) ) , fasting plasma glucose ( FPG ) , post-pr and ial plasma glucose ( PPG ) , fasting plasma insulin ( FPI ) , homeostasis model assessment insulin resistance index ( HOMA-IR ) , lipid profile , retinol-binding protein-4 ( RBP-4 ) , resistin , visfatin and high-sensitivity C-reactive protein ( Hs-CRP ) . RESULTS AND DISCUSSION We observed a significant reduction in body weight , WC , BMI , lipid profile , RBP-4 and visfatin in the orlistat group but not in control group . Faster improvements in HbA(1c ) , PPG , FPI , HOMA-IR , resistin and Hs-CRP were recorded with orlistat than with placebo . A similar decrease in FPG was seen in the two groups . Significant predictors of change in insulin resistance ( HOMA-IR ) were RBP-4 and resistin concentration in the orlistat group ( r=-0·53 , P<0·05 , and r=-0·59 , P<0·01 , respectively ) . WHAT IS NEW AND CONCLUSION To the best of our knowledge , this is the first study investigating the effect of orlistat on insulin resistance and markers of inflammation . Orlistat improved lipid profile and led to faster glycaemic control and insulin resistance parameters than the control , without any serious adverse event . Orlistat also improved RBP-4 and visfatin , effects not observed with placebo OBJECTIVE To assess the impact of weight reduction on serum adipocytokines , C-reactive protein ( CRP ) , and insulin sensitivity in hypertensive female patients with central obesity . METHODS This study was performed using the data base and stored serum sample s of female patients who had participated in an intervention study focused on weight loss . Thirty hypertensive women aged 18 to 65 , body mass index ( BMI ) > 27 kg/m2 , and central obesity were selected . They were r and omly assigned to receive either a low-calorie diet plus orlistat 120 mg three times daily or a low-calorie diet alone for 16 weeks . Patients who experienced weight loss greater than 5 % ( n = 24 ) were assessed for blood pressure , anthropometric parameters , visceral fat , insulin resistance ( HOMA-R - homeostasis model assessment of insulin resistance ) and sensitivity ( ISI - Insulin Sensitivity Index ) indices , plus serum lipids , adipocytokines ( adiponectin , leptin , IL-6 , and TNF-alpha ) and CRP levels . RESULTS After BMI had been reduced by approximately 5 % in both groups , visceral fat , fasting glucose , triglycerides , and TNF-alpha decreased . Only the orlistat group , which was more insulin resistant at baseline , showed a significant reduction in blood glucose after oral glucose load , in addition to increased insulin sensitivity . CONCLUSION This study 's findings indicate that a weight loss greater than 5 % is associated with improved inflammatory status and decreased insulin resistance , regardless of changes in adiponectin and TNF-a levels . The greatest improvements in insulin sensitivity experienced by the orlistat-treated patients could not be attributed to the use of this drug because of the higher number of insulin-resistant subjects in this group CONTEXT Prediabetes and clinical insulin resistance in adolescents are rapidly emerging clinical problems with serious health outcomes . OBJECTIVE The objective of this study was to determine the efficacy of 2 structured lifestyle interventions , both differing in diet macronutrient composition , on insulin sensitivity . DESIGN This study was a r and omized controlled trial , known as Research ing Effective Strategies to Improve Insulin Sensitivity in Children and Teenagers , in 2 hospitals in Sydney , Australia . PARTICIPANTS Participants included overweight or obese 10- to 17-year-olds with either prediabetes and /or clinical features of insulin resistance . INTERVENTION At baseline adolescents were prescribed metformin and r and omized to a structured diet , which was either high carbohydrate or moderate carbohydrate with increased protein . The program commenced with a 3-month dietary intervention , with the addition of an exercise intervention in the next 3 months . OUTCOMES The outcomes included an insulin sensitivity , anthropometry , and cardiometabolic profile at 6 months . RESULTS One hundred eleven subjects ( 66 girls ) were recruited and 98 subjects ( 58 girls ) completed the 6-month intervention . After 3 months the mean insulin sensitivity index increased by 0.3 [ 95 % confidence interval ( CI ) 0.2 - 0.4 ] . After 6 months the mean insulin ( picomoles per liter ) to glucose ratio ( millimoles per liter ) decreased by 7.2 [ 95%CI -12.0 to -2.3 ] , body mass index , expressed as a percentage of the 95th centile , decreased by 9 % ( 95 % CI -3 to -15 ) , but there was no significant change in the lipids . There were no significant differences in outcomes between the diet groups at any time point . CONCLUSIONS These results are in contrast with our hypothesis that adolescents r and omized to the increased protein diet would have better outcomes . Further strategies are required to better address prediabetes and clinical features of insulin resistance in adolescents OBJECTIVE Dietary n-3 polyunsaturated fatty acids , including eicosapentaenoic acid ( EPA ) and docosahexaenoic acid ( DHA ) , prevent insulin resistance and stimulate mitochondrial biogenesis in rodents , but the findings of translational studies in humans are thus far ambiguous . The aim of this study was to evaluate the influence of EPA and DHA on insulin sensitivity , insulin secretion , and muscle mitochondrial function in insulin-resistant , nondiabetic humans using a robust study design and gold-st and ard measurements . RESEARCH DESIGN AND METHODS Thirty-one insulin-resistant adults received 3.9 g/day  EPA+DHA or placebo for 6 months in a r and omized double-blind study . Hyperinsulinemic-euglycemic clamp with somatostatin was used to assess hepatic and peripheral insulin sensitivity . Postpr and ial glucose disposal and insulin secretion were measured after a meal . Measurements were performed at baseline and after 6 months of treatment . Abdominal fat distribution was evaluated by MRI . Muscle oxidative capacity was measured in isolated mitochondria using high-resolution respirometry and noninvasively by magnetic resonance spectroscopy . RESULTS Compared with placebo , EPA+DHA did not alter peripheral insulin sensitivity , postpr and ial glucose disposal , or insulin secretion . Hepatic insulin sensitivity , determined from the suppression of endogenous glucose production by insulin , exhibited a small but significant improvement with EPA+DHA compared with placebo .  Muscle mitochondrial function was unchanged by EPA+DHA or placebo . CONCLUSIONS This study demonstrates that dietary EPA+DHA does not improve peripheral glucose disposal , insulin secretion , or skeletal muscle mitochondrial function in insulin-resistant nondiabetic humans . There was a modest improvement in hepatic insulin sensitivity with EPA+DHA , but this was not associated with any improvements in clinical ly meaningful outcomes
Conclusions This meta- analysis has provided evidence that RS supplementation can improve fasting glucose , fasting insulin , insulin resistance and sensitivity , especially for diabetic with overweight or obesity .
Background The role of resistant starch ( RS ) in glucose , insulin , insulin resistance or sensitivity , and lipid parameters have been reported in several studies and remained controversial .
A pooled analysis which assessed these parameters has not been performed .
Thus , we conducted a meta- analysis to sum up existing evidence about the issue .