Resistant starch type 4‐enriched diet lowered blood cholesterols and improved body composition in a double blind controlled cross‐over intervention

A metabolic health crisis is evident as cardiovascular diseases ( CVD ) remain the leading cause of mortality in the United States. Effects of resistant starch type 4 ( RS 4), a prebiotic fiber, in comprehensive management of metabolic syndrome ( M et S ) remain unknown. This study examined the effects of a blinded exchange of RS 4‐enriched flour (30% v/v) with regular/control flour ( CF ) diet on multiple M et S comorbidities. In a double blind (participants–investigators), placebo‐controlled, cluster cross‐over intervention ( n = 86, age≥18, 2–12 week interventions, 2‐week washout) in the United States, individuals were classified as having M et S ( W ith‐ M et S ) or not ( N o‐ M et S ) following International Diabetes Federation ( IDF )‐criteria. RS 4 consumption compared with CF resulted in 7.2% ( p = 0.002) lower mean total cholesterol, 5.5% ( p = 0.04) lower non‐ HDL , and a 12.8% ( p < 0.001) lower HDL cholesterol in the W ith‐ M et S group. No‐ M et S individuals had a 2.6% ( p = 0.02) smaller waist circumference and 1.5% ( p = 0.03) lower percent body fat following RS 4 intervention compared to CF . A small but significant 1% increase in fat‐free mass was observed in all participants combined ( p = 0.02). No significant effect of RS 4 was observed for glycemic variables and blood pressures. RS 4 consumption improved dyslipidemia and body composition. Incorporation of RS 4 in routine diets could offer an effective strategy for public cardio‐metabolic health promotion.