Endocrine Abstracts

Introduction: Resistant starch (RS) has beneficial effects on postprandial glucose metabolism in both animals and adults. Hitherto, it has not been studied in children. The long-term effects of RS in reducing obesity and improving metabolic profiles need to be investigated in children.

Objectives: Our objective was to compare serial plasma glucose, insulin, gut hormone profiles and satiety scores in obese children after meals, containing increasing amounts of RS.

Methods: This was a single blind, non-randomised, crossover study. 20 obese children, 10-13 years old and without comorbidities were recruited. Three test meals, (1) rice, (2) rice cooked with coconut oil and (3) rice with lentils, chosen for their increasing RS content, were given to all subjects in sequence after a 12-hour overnight fast. Between studies there was a one-week washout period. Blood samples were collected for glucose, insulin, leptin, glucagon like polypeptide (GLP) 1, ghrelin and PYY at 0, 60,120 and 180 minutes (at selected times for each analyte).

Results: There were 12 males and 8 females recruited to the study. Their median age (IQR) was 12 (10.8,12.5) years, and median BMI (IQR) was 26.2 kg/m² (23.6-27.85). Plasma glucose after meal 3 was significantly higher compared to after meals 2 and 1 respectively [C_max (p=<0.05) and AUC (P=0.001) in both]. Ghrelin after meal 3 was significantly lower compared to meals 1 and 2 (AUC, P=0.004). However, insulin, leptin, PYY and GLP1 were not significantly different between the three meals at 120 min and 180 mins. Median satiety scores were not significantly different between the three meals either.

Discussion: This study shows higher insulin AUC following meal 3 which contain RS and protein compared to meals 1 and 2 as expected. Meal 2 with RS alone has shown reduced insulin and blood glucose profile. There is a tendency to reduce satiety score in meal 3 however reduction in satiety score was not significantly different possibly due to small sample size. Gut hormones were not significantly affected by acutely taking RS in obese children. More frequent sampling and a higher RS content may have given different results and will be studied in a larger investigation.