Effect of native and acetylated dietary resistant starches on intestinal fermentative capacity of normal and stunted children in Southern India

Authors: BALAMURUGAN, RAMADASS - Christian Medical College Vellore; PUGAZHENDHI, SRINIVASAN - Christian Medical College Vellore; BALACHANDER, GOWRI - Christian Medical College Vellore; DHARMALINGAM, TAMILSELVAN - Christian Medical College Vellore; MORTIMER, ELISSA - Flinders University; GOPALSAMY, GEETHA - Flinders University; WOODMAN, RICHARD - Flinders University; MENG, ROSIE - Flinders University; ALPERS, DAVID - Washington University School Of Medicine; MANARY, MARK - Children'S Nutrition Research Center (CNRC); BINDER, HENRY - Yale School Of Medicine; BROWN, IAN - Australian Cancer Research Foundation; YOUNG, GRAEME - Flinders University; RAMAKRISHNA, BALAKRISHNAN - Christian Medical College Vellore

Submitted to: International Journal of Environmental Research and Public Health
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 10/12/2019
Publication Date: 10/15/2019
Citation: Balamurugan, R., Pugazhendhi, S., Balachander, G.M., Dharmalingam, T., Mortimer, E.K., Gopalsamy, G.L., Woodman, R.J., Meng, R., Alpers, D.H., Manary, M., Binder, H.J., Brown, I.L., Young, G.P., Ramakrishna, B.S. 2019. Effect of native and acetylated dietary resistant starches on intestinal fermentative capacity of normal and stunted children in Southern India. International Journal of Environmental Research and Public Health. 16(20):3922. https://doi.org/10.3390/ijerph16203922.
DOI: https://doi.org/10.3390/ijerph16203922

Interpretive Summary: Dietary resistant starch (RS) affects the microbe populations in the human gut and some of these microbes make small fats that are healthy. This study fed Indian children biscuits containing either high amylose maize starch (HAMS) or acetylated HAMS and measured these small healthy fats in their stools. HAMS caused more small healthy fats than acetylated HAMS, suggesting there may be a health benefit, especially for children who are already poorly grown.

Technical Abstract: The health benefits of dietary amylase resistant starch (RS) arise from intestinal microbial fermentation and generation of short chain fatty acids (SCFA). We compared the intestinal fermentative capability of stunted and nonstunted ('healthy') children in southern India using two types of RS: high amylose maize starch (HAMS) and acetylated HAMS (HAMSA). Twenty children (10 stunted and 10 healthy) aged 2 to 5 years were fed biscuits containing HAMS (10 g/day) for two weeks followed by a 2-week washout and then HAMSA biscuits (10 g/day) for 2 weeks. Fecal samples were collected at 3-4 day intervals and pH and SCFA analyzed. At entry, stunted children had lower SCFA concentrations compared to healthy children. Both types of RS led to a significant decrease in fecal pH and increase in fecal acetate and propionate in both healthy and stunted children. However, while HAMS increased fecal butyrate in both groups of children, HAMSA increased butyrate in healthy but not stunted children. Furthermore, healthy children showed a significantly greater increase than stunted children in both acetate and butyrate when fed either RS. No adverse effects were reported with either RS. Stunted children have impaired capacity to ferment certain types of RS which has implications for choice of RS in formulations aimed at improving microbial function in stunted children.