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HI-MAIZE® resistant starch, a natural dietary fiber has proven benefits for healthy weight, glycemic and energy management as well as digestive health. Our experts can help you replace up to 20% of flour in snacks, cookies and other baked goods without adversely affecting processing. Learn how Ingredion’s expertise and ingredient portfolio can help you add proven nutritional benefits to your baked goods.
HI-MAIZE® resistant starch, a natural dietary fiber has proven benefits for healthy weight, glycemic and energy management as well as digestive health. Our experts can help you replace up to 20% of flour in snacks, cookies and other baked goods without adversely affecting processing. Learn how Ingredion’s expertise and ingredient portfolio can help you add proven nutritional benefits to your baked goods.
HI-MAIZE® resistant starch, a natural dietary fiber has proven benefits for healthy weight, glycemic and energy management as well as digestive health. Our experts can help you replace up to 20% of flour in snacks, cookies and other baked goods without adversely affecting processing. Learn how Ingredion’s expertise and ingredient portfolio can help you add proven nutritional benefits to your baked goods.
Moving Beyond Glycemic Reduction to Glycemic Health
Rhonda Witwer, MBA Senior Business Development Manager of Nutrition
Christine Pelkman, Ph.D. Senior Scientist and Clinical Research Manager
Outline Introduction to glycemic health Definitions and public health importance Consumer perspective Key role of insulin resistance Reversing insulin resistance Key findings from population studies Research findings on glycemic effects of HI-MAIZE
resistant starch Conclusions 2 Glycemic Health = Maintaining Blood Sugar Health 3 Definition: Healthy levels of blood sugar (and insulin) The Problem: 11.3% of Americans (aged 20+ years) have diabetes
35% have prediabetes = 79 million adults
Obesity (BMI 30 kg/m 2 ) Diabetes 1994 1994 2000 2000 2007 2007 No Data <4.5% 4.5-5.9% 6.0-7.4% 7.5-8.9% >9.0% CDCs Division of Diabetes Translation. National Diabetes Surveillance System available at http://www.cdc.gov/diabetes/statistics No Data <14.0% 14.0-17.9% 18.0-21.9% 22.0-25.9% >26.0% The Rising Incidence of Obesity is Closely Followed by a Rising Incidence of Type 2 Diabetes 4 The Role of Insulin in Glycemic Health Insulin is produced by beta cells in the pancreas
It helps move glucose from the blood into muscles and cells
In healthy individuals, insulin levels always rise right after eating Higher levels of insulin prevent fat from being burned
Excess weight and inflammation cause the tissue to resist the action of insulin Higher levels of insulin needed to manage blood glucose
Loss of insulin sensitivity (i.e., insulin resistance) is the beginning of the loss of glycemic health
5 American Consumers Are Concerned About Diabetes and Blood Sugar 42% of shoppers are extremely or very concerned about diabetes; 38% are for high blood sugar
31% of shoppers always or usually maintain a high-protein and low- carbohydrate diet
25% of shoppers had decreased their use of carbohydrates in the past two years
7 43% 42% 40% 38% 2008 2010 Diabetes High Blood Sugar (Extremely/very concerned) Consumers Want Healthy Blood Sugar 8 Extremely Important / Very Important Label Claim All Shoppers Education Household Income Less than College Some College Plus Up to $25K
$25-50K
$50-75K Over $75K High fiber 51% 57% 48% 54% 53% 44% 51% Helps to maintain healthy cholesterol levels 40% 46% 37% 44% 44% 34% 36% Helps to maintain healthy blood sugar levels 36% 42% 34% 44% 43% 29% 30% Bolded numbers are statistically different when compared to the total population numbers. Copyright 2011 HealthFocus International/Ingredion Incorporated proprietary information 36% View Healthy Blood Sugar as an Extremely or Very Important Label Claim 9 Younger, health active shoppers Shoppers monitoring carbohydrates for weight Older, diabetic, retired shoppers Copyright 2011 HealthFocus International/Ingredion Incorporated proprietary information Christine Pelkman, Ph.D. Senior Scientist and Clinical Research Manager Diabesity Concurrent Epidemics 11
Diagnosed diabetes in the U.S. Steep rise in diabetes coincides with steep rise in obesity Key Role of Insulin Resistance 12 Metabolic staging of Type 2 diabetes Saltiel: J Clin Invest, Volume 106(2).July 2000.163-164 What Is Insulin Sensitivity? 13 A measure of how well insulin functions in various tissues Fat Liver Muscle
A key player in the control of blood glucose and triglycerides
Basics of Carbohydrate Metabolism 14 Effects of Diet In population studies Higher intake of whole grains and fiber is associated with lower risk for diabetes
In experimental studies Fibers, especially fermentable fibers, increase insulin sensitivity Large body of evidence for effects of resistant starch Natural high-amylose maize, type 2 RS (HAM-RS2)
15 What is Resistant Starch? 16 Starch that resists digestion in the small intestine Reaches the large intestine Form of fermentable fiber
Found in whole grains, beans, bananas and cooked & cooled starchy foods Americans consume 4.9 grams of resistant starch/day on average*
* Murphy M. et. al.., Journal of the American Dietetic Association, Jan 2008 Eriko Sugita / Reuters (Japan Goes Bananas for a New Diet October 17, 2008 TIME Magazine, WORLD edition) High-Amylose Maize (HAM) - RS2 Natural form of starch from high-amylose maize (70% amylose)
17 Extensive Database of Evidence 18 *through August 2012 Published studies utilizing Ingredions RS2 high-amylose corn resistant starch* Clinical studies 66 Animal studies 124 In vitro studies 57 TOTAL: 247 HI-MAIZE 260 for Glycemic Health 19 Increased insulin sensitivity (Healthy people, type 2 diabetes & metabolic syndrome) Reduced glycemic impact at the subsequent meal (human studies) Reduced glycemic response (human studies) Reduced insulin response (human studies) Glycemic Impact Mechanisms (incretins) (animal studies) Increased beta- cell health (people with metabolic syndrome) Post-Meal Glycemic Benefits of HI-MAIZE 260 When replacing flour in foods, it lowers the blood sugar (glycemic) and insulin impact of that food.
20 4 4.5 5 5.5 6 6.5 7 7.5 8 0 30 60 90 120 Time (min) B l o o d
G l u c o s e
(
m m o l / L )
Control bread HI-MAIZE bread Insulin Sensitivity Key to Sustaining Glycemic Health Many foods lower postprandial glycemia But, the effect is temporary Lower Glycemic Index not a sufficient biomarker
Glycemic health Longer-term state Healthy carbohydrate metabolism Insulin sensitivity is a key biomarker Measured in fasting state Challenge with a standard meal, beverage or infusion Result is not due to differences in the food
21 HI-MAIZE 260 Improved Insulin Sensitivity in Six Clinical Trials 22 Subjects Healthy men and women Dose 100 g HI-MAIZE 260 (one day) Results 69% Insulin sensitivity Breakfast Lunch Dinner Meal Tolerance Test 500 kcal Morning Standard meals on two occasions Each 25 g HM260 or 10 g digestible starch Three Longer-Term Studies 23 25 g HM: 15 g fiber + 10 g digestible starch 2 per day 10 g digestible starch 2 per day 24 Subjects Healthy men and women Dose 50 g HM260 (4 weeks) Results 14% Clamp 34% Meal tolerance test End of Week 3 Meal Tolerance Test 500 kcal End of Week 4 Insulin is maintained at a steady state.
How much glucose can be infused is an indicator of insulin sensitivity. Longer-term study 12 weeks Two groups 60 g HM/day versus 20 g waxy starch/day High fasting insulin (> 60 pmol/L) meets criteria for insulin resistance 25 Subjects Men and women with high fasting insulin Dose 60 g HM260 (12 weeks) Results 19% Clamp European Group for the Study of Insulin Resistance Dose-response crossover study 4 weeks per treatment Low-dose 26 g HM260/day High-dose 50 g HM260/day Control matched to low-dose 11.6 g glycemic starch
26 27 Subjects Men and women with abdominal obesity Dose 26 and 50 g HM260 (4 weeks) Results 56.5% and 72.8% IVGTT (men only) Frequently sampled intravenous glucose tolerance test (IVGTT) 2012 Two Mechanistic Studies in Insulin- Resistant Adults Clamp method used with tracers to measure Endogenous glucose production Glucose disposal rate (R d ) Fasting measures used for insulin sensitivity Glucose uptake in forearm measured during MTT Key findings Changes in gene expression in adipose tissue
28 Subjects Men and women with high fasting insulin Dose 67 g HM260 (8 weeks) Results 21% R d
10%
Insulin sensitivity 65% MTT Twofold increase found for key adipose tissue genes 3 lipases (LPL, ATGL, HSL) adipokines: perilipin, adiponectin 2012 Improved Pancreatic Beta-Cell Function Used IVGTT method to allow for study of beta cell function Not possible with clamp
Increased first-phase insulin secretion, an important early indicator of improved beta cell function
29 Subjects Men and women with high fasting insulin Dose 67 g HM260 (4 weeks) Results 36% First-phase I response
Rhonda Witwer Senior Business Development Manager, Nutrition 31 Consumers Are Learning About Resistant Starch from Leading Health Experts Health magazine launched The CarbLovers Diet in 2010 and The CarbLovers Diet Pocket Guide in 2011 Health magazine has 1.4 million subscribers
Prevention magazine launched The Skinny Carbs Diet in October 2010 Prevention magazine is the #1 consumer health magazine, with 2.9 million subscribers 150 recipes with 125 recipes with food sources and 25 recipes with HI-MAIZE
resistant starch
Featured on Dr. Oz, May 24, 2012 32 HI-MAIZE Resistant Starch White, insoluble starch from a natural hybrid of high-amylose corn Mixture of: 40% slowly digestible starch 60% resistant starch The resistant starch portion = insoluble fiber Does not thicken One tablespoon (~9.5 g) = ~5 g dietary fiber
In contrast with regular cornstarch -- White, insoluble starch Quickly digested - 100% glycemic starch Provides viscosity & thickens with heat Not fiber Formulating With HI-MAIZE Resistant Starch Supplements Insoluble powder Disperses in smoothies & shakes Mix into foods, e.g., oatmeal, yogurt, etc. Substitute for flour in home baking
Food Formulations Replace up to 15-25% of flour in formulation Low water-holding capacity Stable in baking and mild extrusion Excellent dough-handling properties
33 Smoothies & Shakes
Baked Goods & Bakery Mixes Pizza Pasta Cereal Snacks Supplements 34 Recommended HI-MAIZE Labeling Claim for Glycemic Health: Helps maintain healthy blood sugar levels as part of a high-fiber diet Applications and Claims Available Online at www.KingArthurFlour.com HI-MAIZE natural fiber Replace up to one-quarter of the flour in almost any recipe with an equal amount of HI-MAIZE resistant starch Gluten free
High fiber flour King Arthur All-Purpose Flour blended with HI- MAIZE resistant starch Substitute 1:1 for all-purpose flour
Golden Vanilla Cake Mix Good source of fiber with HI-MAIZE resistant starch 35 Conclusion Tremendous public health need to maintain glycemic health Consumers want healthy blood sugar Insulin sensitivity is a critical biomarker HI-MAIZE resistant starch improves insulin sensitivity Emerging evidence shows improvement in fat metabolism and pancreatic function HI-MAIZE resistant starch enables innovative supplements and great-tasting carbohydrate-rich foods with proven glycemic health benefits 36 Additional Information Available Formulation information: www.foodinnovation.com/hi-maize
In-depth information on health benefits: www.ResistantStarch.com