Effect of Native and Acetylated Dietary Resistant Starches on Intestinal Fermentative Capacity of Normal and Stunted Children in Southern India.

Ramadass Balamurugan,Graeme P Young,Tamilselvan Dharmalingam,Gowri M Balachander,Geetha L Gopalsamy,Rosie Meng,Balakrishnan S Ramakrishna,Srinivasan Pugazhendhi,Richard J Woodman,Elissa K Mortimer,Mark Manary,Henry J Binder,Ian L Brown,David H Alpers

doi:10.3390/ijerph16203922

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.

Highlights

Normal growth and development in infancy and childhood are intimately linked to a functional intestine and absorptive system
Caregivers of study participants were questioned every day to determine if participating children had experienced abdominal pain, alteration of bowel habit, or other digestive symptoms which the caregiver attributed to the dietary supplement
The major finding of this study was that the two sources of resistant starch (RS), high amylose maize starch (HAMS) and HAMSA, were fermented in the bowel of preschool child participants, with substrate-responsive fecal short chain fatty acids (SCFA) levels being lower in stunted compared to healthy children

Summary

Introduction

Normal growth and development in infancy and childhood are intimately linked to a functional intestine and absorptive system. One of the major functions of the colonic microbiota in health is to ferment dietary carbohydrate that has escaped digestion in the small intestine. It may be presumed that the colonic microbiota in children with stunting will be efficient in salvaging the unabsorbed carbohydrate through fermentation to short chain fatty acids (SCFA). Because of its broad effects on the composition of the gut luminal microbiota, RS is considered to be a prebiotic [8,9] It is unclear if children from low-middle income countries ferment RS in the same way as healthy adults

Results

Discussion

Conclusion