Digestion and metabolic fates of starch, and its relation to major nutrition-related health problems: A review

摘要

Starch is the most abundant nutrient in the global diet, providing energy to a rapidly growing population. Due to the hydro-thermal treatments commonly used, the granular structure disintegrates, leading to a rapid digestion of starch and thus a swift absorption of glucose in the small intestine. However, this highly digestible major source of energy may also contribute to nutrition-related health problems. When part of an energy-affluent meal, starch will contribute to obesity either through hepatic de novo lipogenesis, or by replacing fat as an energy source for cells. Typical starch-rich foods have not been found to have a particularly high satiating effect, further contributing to an obesity-inducing effect. As a major source of glucose entering the circulation, starch is central both for the pathogenesis and the management of diabetes mellitus type 2. Common starch-rich foods generally produce a rather large glycaemic response, further contributing to this health problem. Starch may contribute to cardiovascular disease through stimulation of hepatic de novo lipogenesis, which triggers triglyceride transport from the liver to adipose tissue, producing atherogenic low-density lipoprotein. In addition to discussing the relationship between starch and nutrition-related health problems, the potential to reduce rate of digestion and absorption through altered processing conditions will be discussed in this review. A coarser structure, altered hydro-thermal treatments and/or chemical modification may increase the resistance of starch to digestion, resulting in lower digestibility, an increased satiety and a lower glycaemic response. More research and development is needed in this exciting and very important area of nutrition.