Developing and Evaluating a High Resistant Starch Menu and Glycemic Response in Adults with Prediabetes: A Non-Randomized Pilot Study

Abstract

Background The nondigestible fiber, resistant starch (RS), is found in beans, peas, and legumes, bread, cereals and grains, plantains, and potatoes. Here, we determined the feasibility of developing, preparing, and distributing a 7-day menu with a weekly average of ~30 g RS/d, as well as the likability of the foods. Methods First, a menu was formulated using a database, then prepared, stored, and delivered to mimic a future clinical trial. The RS content in each food item was quantified “as consumed” using an assay. Second, adults with prediabetes (n = 15) evaluated the likeability of the food items using a 9-point Likert scale. Likeability was acceptable if the overall score was ≥7 and >75% of the food items were consumed. Anthropometrics (n = 11), and fasting and postprandial (15, 30, 60, and 120 min) blood were collected to determine changes in weight, BMI, glucose, and insulin before and after the intervention. Results The feasibility of preparing, storing, and distributing the menu was verified and a weekly average of ~30 g RS/d at consumption was sustained. The menu provided ~2,000 kcal and 44.1 ± 9.5 g fiber per day. The feasibility of distributing the food items was acceptable where 100% compliance was achieved with the food preparation and participant pick-up schedules. Overall, 78.6% of the food items were consumed with an overall likeability score of 7.1 ± 1.9, meeting likeability targets. Frozen meals were the highest (94.1 ± 5.8%; 8.1 ± 1.4) and soups the lowest (61.4 ± 6.6%; 6 ± 2.4) amount consumed and mean likeability, respectively. Body weight and BMI changed -1.6 kg; 95% CI -2.6 to -0.7 and -0.5 kg/m2; 95% CI -2.8 to 8, respectively. The total area under the curve(0−120 min) for glucose and insulin changed by -655 and -1178 units, respectively, following high RS menu intake. Conclusions It is feasible to formulate, prepare, and distribute a high RS menu that is consumed and liked by adults with prediabetes. Due to small sample size, decreases in body weight, BMI, and glycemic indices should be interpreted with caution and tested using a randomized, cross-over intervention trial. Trial registration: Not applicable.