How Cieotrim® digestion-resistant maltodextrin fiber, can help for lean body, slim waist, BMI, weight control, weight loss, visceral fat loss, metabolic syndrome, adiponectin?
Journal: Journal of Japanese Society for the Study of Obesity, 2007 (13) 34-41(Original paper is in Japanese)
Title: Effect of digestion-resistant maltodextrin fiber on Visceral Fat Accumulation
Authors: Takushi Yamamoto*1, Kunio Yamamoto*1, Yoshinori Fukuhara*1, Toshihiro Fukui*1,
Yuka Kishimoto*2, Kazuhiro Okuma*2, Yasuhiro Matsuoka*3, Koji Isozaki*4, Kazuhiro
Nagao*5, Takae Yamamoto*6 and Katto Tokunaga*7
1 College of Nutrition, Koshien University
2 Matsutani Chemical Industry Co., Ltd.
3 Coca-Cola Tokyo Research and Development Co., Ltd.
4 Medical Corporation Isozaki Clinic
5 Medical Corporation Nagao Clinic
6 Aiei Support Ltd.
7 Takatsuki Social Insurance Health Management Center
Indigestible maltodextrin (also known as digestion-resistant maltodextrin fiber), visceral fat, fat (lipid) metabolism, BMI, weight loss, fiber, slim waist, metabolic syndrome, adiponectin.
(Note: digestion-resistant maltodextrin fiber is also known as indigestible maltodextrin is also known as indigestible dextrin)
Abstract of the research paper:
It has been reported that digestion-resistant maltodextrin regulates the intestinal function, suppresses the rise in blood glucose and the secretion of insulin, and improves lipid metabolism. Digestion-resistant maltodextrin is used as the functional food ingredient for a great number of the foods for specified health use (FOSHU). The authors conducted a non-comparative study to clarify that digestion-resistant maltodextrin fiber significantly decreased triglyceride (triacylglycerol) levels. This study was performed as a double-blind comparative study to examine the effects of indigestible dextrin on visceral fat.
Thirty-eight subjects (23 males and 15 females) were randomized into two groups; a study group of 19 subjects and a control group of 19 subjects. Subjects took tea (containing 9 g indigestible maltodextrin as dietary fiber for the study group) at mealtimes three times a day for three months. Each month, their body measurements were made, blood was collected. CT scans were conducted at the start and the end of the administration to calculate the area of visceral fat. In the group taking digestion-resistant maltodextrin fiber, the area of visceral fat had significantly decreased from 162.4 cm2 to 129.3 cm2 (171 cm2 to 135 cm2 in males; 148 cm2 to 120 cm2 in females) at Week 12. A difference from the control group was observed at Week 12 and the subjects having more visceral fat exhibited a bigger decrease in area. There was a significant difference in triglyceride levels between the study group and the control group at Week 12: the study group showed a significant decrease for both males and females. In addition, the borderline insulin-resistant subjects with HOMAIR from 1.6 to 2.49 exhibited a significant drop in visceral fat and triglyceride levels and a significant elevation of adiponectin in the study group compared with the control group. A postulated mechanism for reduction of visceral fat in this study is that the continued intake of digestion-resistant maltodextrin fiber delayed absorption of glucose and lipid and suppressed a rise in insulin secretion, leading to the prevention of visceral fat accumulation. The continued consumption of tea containing digestion-resistant maltodextrin fiber is expected to prevent metabolic syndrome arising from the accumulation of visceral fat and to reduce multiple risk factors.
As Japanese people increase their daily intake of Western foods, they tend to ingest excessive carbohydrate and lipid, which affects accumulation of visceral fat . In comparison to subcutaneous fat, the accumulation of visceral fat correlates more significantly with obesity, abnormal glucose tolerance, abnormal lipid metabolism and elevated blood pressure [2,3]. It has been reported that a population with borderline diabetes had a higher risk of onset of diabetes when visceral fat was accumulated. It has also been reported that even a population with normal glucose tolerance experienced abnormal glucose tolerance and exacerbated insulin resistance if the risk of high triglyceride levels was added . As a type of water-soluble fiber, digestion-resistant maltodextrin fiber is used as a functional food ingredient for foods for specified health use (FOSHU). Its physiological functions are moderation of digestion and absorption of carbohydrate and suppression of postprandial rise in blood glucose and insulin secretion, that is, improvement of glucose tolerance for a single dose study in humans [5-8], and an improvement in the metabolism of sugar and of fat and visceral fat fora multiple dose study [6,9]. It has been approved as a Standardized FOSHU ingredient for regulating intestinal function. The ED50 value for diarrhea for a single administration is estimated to be 1.4g (as dietary fiber)/kg body weight. Digestion-resistant maltodextrin fiber has a lower risk ofdiarrhea than other indigestible saccharides .
We had found that abnormal glucose/lipid metabolism significantly improved in obese subjects when digestion-resistant maltodextrin fiber was administered at 15 g/day as dietary fiber . However, our study lacked a discussion on the influences of digestion-resistant maltodextrin fiber on an accumulation of visceral fat. To examine a decrease of visceral fat with ingestion of digestion-resistant maltodextrin fiber, we performed a double-blind comparative study. In this present study, we treated subjects having a BMI in excess of 23 with tea containing digestion-resistant maltodextrin fiber at27g/day as dietary fiber to investigate influences on visceral fat and triglyceride levels.
Subjects and Methods
Subjects were male and female volunteers who had not been treated with fibrates, thiazolidines or anion-exchange resin. Based on the past non-comparative study concerning visceral fat , we set the target size of study sample at 40. Among 41 applicants, 40 were participated in this study as subjects. The subjects were grouped by stratified randomization in the way that reduced differences between groups in age, sex, blood sampling, body measurements and fecal properties. We complied with Ethical Guidelines for Epidemiological Research (revised in 2004) and Good Clinical Practice (GCP)  in performing the study. In this study, following the protocol that the ethical review board at Isozaki Clinic judged as appropriate and the
purport of the Declaration of Helsinki, we had physicians give sufficient information to subjects on details, methods, etc. relating to the research and obtained consent in writing. This trial was conducted as a double-blind comparative study of 20 weeks comprising a4-week pre-study observation period, a 12-weektreatment period and a 4-week post-study observation period. The study beverage was a280-ml bottle of tea containing 9 g indigestible dextrin (this ingredient was manufactured by Matsutani Chemical Industry Co., Ltd. and the beverage was manufactured with oolong tea and adlay as the main ingredients at Coca-Cola Tokyo Research & Development Co., Ltd). A control beverage did not contain digestion-resistant maltodextrin fiber. Subjects had three bottles of study or control beverage a day (at mealtimes) during the treatment period.
Body measurements consisted of body height, weight, waist and hip circumferences, blood pressure and pulse rate. Blood tests included hematological tests (WBC, RBC, hemoglobin,hematocrit and platelet counts), lipid component tests (triglyceride, total cholesterol, free fatty acids and RLP), biochemical tests insulin, fasting blood glucose, HbA1c, ketone body fraction, AST, ALT, γ-GPT, ALP, LDH, total protein, albumin, uric acid, urea nitrogen, creatinine, sodium (Na), chlorine (Cl), potassium(K), calcium (Ca), phosphorus (P), magnesium (Mg) and iron (Fe), adiponectin, leptin, high-sensitive CRP. These measurements and tests were carried out during the pre-study observation period, on the first day of treatment as Week 0, at the end of Week 4, 8 and 12 of treatment period and during the post-study observation period. CT was conducted twice: on the day of starting ingestion and 12 weeks after starting ingestion. The area for fat was calculated using Fat Scan (N2 System Co., Ltd.),the software based on the CT measurement method of Tokunaga et al . Repeated measures ANOVA was used to evaluate interactions (groups × weeks). Groups were compared by Mann-Whitney test using the results of an exact test. Dunnett’s multiple comparison was employed for comparing within groups.
Results of an exact test were used for Wilcoxonrank-sum test. χ2 test with Yates correction was done. The correlation was examined using Pearson product-moment correlation coefficient(r). The significant level was P < 0.05(two-tailed test). SPSS13.0 was used for statistical analysis.
Among 40 randomized subjects, two subjects were excluded under the judgment of the withdrawal review board due to non-compliance with the protocol (deviation of overeating and overdrinking), and 38 cases (23 males and 15 females) were analyzed. The average age of the subjects was 59.2 ± 2.1 (male: 56.9 ± 2.6; female:62.7 ± 2.5). Body measurements did not reveal any significant change in body weight and BMI during the administration period within the study group. Waist circumference significantly decreased at Week 12 from Week 0 (P < 0.05).
There was no change in blood pressure. The control group did not show any change in body measurements before and after ingestion (Table2). No gender difference was found in the comparison before and after ingestion within the study group (Table 3).
As for the visceral fat area, interaction was observed (P < 0.05) between the study group and the control group. Within the study group, the area of visceral fat showed a significant fall (P <0.01) on the termination of the ingestion period at Week 12 (129.3 ± 7.3 cm2) compared with that of Week 0 (162.4 ± 11.4 cm2). There was more significant decrease in the area of visceral fat (r =0.8, P < 0.01) observed when the area of visceral fat at Week 0 was larger. The study group did not exhibit any change in subcutaneous fat area.
CT results in the control group did not show any change between before and after treatment. In the study group, there are some cases showed remarkable reduction in the area of visceral fat, for example, one case showed falling from 273 cm2 to 153 cm2. The area of visceral fat in male subjects showed interaction between the study group and the control group (P< 0.05): the area of visceral fat significantly decreased from 171.1 ± 15.3 cm2 at Week 0 to134.8 ± 8.1cm2 at Week 12 (P<0.01) within the study group during the ingestion period. Within female study group, the visceral fat area during the ingestion period decreased significantly (P <0.05) from 147.5 ± 16.8cm2 at Week 0 to 119.7 ±14.4 cm2 at Week 12.
With respect to serum lipid parameters, interaction was observed for triglyceride levels between the study group and the control group during the ingestion period (P < 0.01). Within the study group, triglyceride levels had significantly decreased at Week 8 (P < 0.05) and Week 12 (P < 0.01) compared with Week 0. A significant difference from the control group was found at Week 12 (P < 0.05). VLDL-TG had significantly dropped at Week 8 and Week 12from Week 0 (P < 0.01) with a significant difference from the control group at Week 12 (P <0.05). LDL-TG had significantly dropped at Weeks 8 and 12 from Week 0 (P < 0.01) with a significant difference from the control group at Week 12 (P < 0.05).
Interaction was found for triglyceride levels between the study group and the control group during the ingestion period for both male (P <0.01) and female (P < 0.05) groups. In the comparison within the study group before and after ingestion, the level of triglyceride levels had significantly decreased from Week 0 to Week 8 (P< 0.05) and Week 12 (P < 0.01) in male subjectsand at Week 12 (P<0.01) in females. Male subjects exhibited a significant difference from the control group at Week 12 (P < 0.05). LDL-TG had significantly fallen from Week 0 at Weeks 8 and 12 (P < 0.01) in males and at Week12 (P < 0.01) in females. A significant fall fromWeek 0 was observed for VLDL-TG at Week 8 and Week 12 (P < 0.01) in males and at Week 12(P < 0.01) in females. Female subjects exhibited interaction for leptin when comparing the studygroup and the control group during the ingestion period (P < 0.01) (Table 5). As it is suggested that indigestible maltodextrinshould affect glucose tolerance, we analyzed influences on visceral fat and lipid metabolism through classification based on HOMAIR score, the index of insulin resistance. In the insulin-resistance borderline range (1.6 to 2.49), the study group (n = 10) showed a significant drop in the area of visceral fat (-36.5 cm2: P <0.01), drop in triglyceride levels (-60.5 mg/dl: P<0.01), and elevation in adiponectin (0.6 μg/dl: P < 0.01) at Week 12. The control group (n=6)did not show any significant change in the area of visceral fat (-7.6 cm2: ns), triglyceride (8.0 mg/dl: ns) and adiponectin (-0.3 μg/dl: ns) while giving a significant difference in the levels of triglyceride and adiponectin from the study group(P < 0.01).
Blood tests revealed significant differences between times of measurement and between groups (P < 0.05) in Ca, Fe, Cl, creatinine, MCHC, MCH and platelets within the study group before and after ingestion while all of the changes were within a range of reference values without clinical problems. Male subjects exhibited a significant difference in MCHC in the study group at Week 8 and Week 12 (P < 0.05)and a significant rise in the control group at Week8 (P < 0.05). There was a significant fall in Ca at Week 8. All such changes were within the range of reference values without clinical problems. Female subjects did not show any significant changes.
As for gastrointestinal symptoms, 16 subjects in the study group and 9 subjects of the control group experienced flatulence, and 7 subjects in the study group and 6 subjects in the control group experienced rectal urgency. However the symptoms was mild and no subjects requested discontinuation of the trial or complained of discomfort. There were no significant differences between the study and control groups in terms of nutritional assessment, consumption of alcohol and amount of exercise during the ingestion period.
As previously reported, the group treated with digestion-resistant maltodextrin fiber exhibited a significant decrease in triglyceride levels. By performing anew double-blind comparative study, the authors found that the ingestion of digestion-resistant maltodextrin (as dietary fiber) at 27 g/day significantly reduced visceral fat regardless of gender. The action mechanism of reduction of visceral fat by digestion-resistant maltodextrin fiber may be explained by the possibility of an influence on the absorption of lipids and carbohydrates in the small intestine.
Our recent study in healthy adults with the single administration of a high-fat diet discovered that digestion-resistant maltodextrin fiber significantly suppressed the postprandial rise in triglyceride and insulin secretion . This suggests that digestion-resistant maltodextrin fiber could delay lipid absorption. Serum triglyceride significantly dropped in the study group, compared with the control group, regardless of gender in the present study, which may also be attributable to the delay of lipid absorption by digestion-resistant maltodextrin fiber similarly to the single administration study. It was also reported regarding influences on the absorption of carbohydrates that indigestible maltodextrin delays the speed of digestion and absorption of disaccharides or polysaccharidesbigger than disaccharides [7,8]. Our study found a significant reduction in visceral fat and triglyceride, elevation of adiponectin, and a downward tendency in the HOMAIR score (from2.0 to 1.8) in subjects with borderline insulin resistance and HOMAIR scores from 1.6 to 2.49.
This may be because the long-term ingestion of digestion-resistant maltodextrin fiber delayed the speed of digestion and absorption of saccharides, suppressed excessive secretion of insulin and reduced synthesis and secretion of VLDL-TG and LDL-TG, endogenous lipoproteins, resulting in prevention of accumulation of visceral fat.
Some studies reported that the increased insulin resistance caused by hyper FFA and hyperglycerolemia was observed in the portal vein functioning as a gate from fat cells to the liver in abnormal lipid metabolism accompanied by an accumulation of visceral fat [14,15]. The long-term ingestion of digestion-resistant maltodextrin fiber delayed the speed of digestion and absorption of saccharide and fat and prevented the accumulation of visceral fat.
This reduced FFA and glycerol coming from fat cells to the liver. Consequently, such synergies possibly led to a significant improvements of triglyceride, VLDL-TG and LDL-TG and elevation of adiponectin in subjects with borderline insulin resistance. The ingestion of indigestible maltodextrin may be useful in preventing coronary diseases as the rise in adiponectin is thought to function to suppress development and progress of arteriosclerosis and stabilize plaque [16,17]. With respect to safety, it was reported that a multiple dose study observed abdominal symptoms (sense of fullness, flatulence and rumbling in the abdomen) and a feeling of unsatisfied defecation, although diarrhea was not evident when digestion-resistant maltodextrin fiber in (as dietary fiber) was administered at 27 g/day . Our study also revealed flatulence and rectal urgency, although such adverse events did not prompt any subject to discontinue the trial or a physician to decide to stop the trial. All of the blood test results were found to be within a normal range with no abnormal changes that were medically problematic, including individual changes.
When digestion-resistant maltodextrin fiber was continuously consumed at 27 g/day (as dietary fiber) in tea for12 weeks, it led to a clear reduction in accumulated visceral fat and high triglyceride.
Improvements of accumulation of visceral fat and high triglyceride level, specially in the insulin-resistant borderline range, by long-term use of digestion-resistant maltodextrin fiber are expected to prevent metabolic syndrome, currently regarded as important, and to reduce its multiple risk factors.
1) Yamamoto K, Yagi N, Tokunaga K: Researchon preferences in foods of obese Type 2diabetic patients and obese college students, JJpnSoc Study of Obesity, 2002, 8: 306-310(in Japanese).
2) Fujioka S, Matsuzawa Y, Tokunaga K, et al.:Contribution of intra-abdominal fataccumulation to the impairment of glucoseand lipid metabolism in human obesity,Metabolism, 1987, 36: 54-59.
3) Kanai H, Matsuzawa Y, Kotani K, et al.: Closecorrelation of intra-abdominal fataccumulation to hypertension in obesewomen, Hypertention, 1990, 16: 484-490.
4) Nagaretani H, Nakamura T, Funahashi T, et al.:Visceral Fat is a major contributor formultiple risk factor clustering in Japanesemen with impaired glucose tolerance,Diabetes Care, 2001, 24: 2127-2133.
5) Wakabayashi S: The Effects of indigestibledextrin on sugar tolerance: studies ondigestion-absorption and sugar tolerance,Folia Endocrinol., 1992, 68, 623-635 (inJapanese).
6) Tokunaga K, Matsuoka A: Effects of a Foodfor Specified Health Use (FOSHU) whichcontains indigestible dextrin as an effectiveingredient on glucose and lipid metabolism, J.Japan Diab. Soc., 1999, 42: 120-124 (inJapanese).
7) Ueda Y, Wakabayashi S, Matsuoka A, et al.,Effects of Indigestible Dextrin on BloodGlucose and Urine C-peptide LevelsFollowing Sucrose Loading, J. Japan Diab.Soc., 1993, 36,103-111 (in Japanese).
8) Wakabayashi S, Kishimoto Y, Matsuoka A, etal.: Effects of indigestible dextrin onpostprandial rise in blood glucose levels inman, J. Jpn. Assoc. Dietary Fiber Res., 1999,3: 125-131 (in Japanese).
9) Kishimoto Y, Wakabayashi S, Tokunaga K:Effects of Long-term Administration ofIndigestible Dextrin on Visceral FatAccumulation, J. Jpn. Assoc. Dietary FiberRes., 2000, 4: 59-65 (in Japanese).
10) Satouchi M, Wakabayashi S, Matsuoka A, etal: Effects of Indigestible maltodextrine on Bowel
Movements, Jpn. J. Nutr., 1993, 51: 31-37(in Japanese).
11) Ueda K: Good Clinical Practice (GCPHandbook 3rd Edition), Pharmaceutical andMedical Device Agency ed., Jiho, Tokyo,2005 (in Japanese).
12) Tokunaga K, Matsuzawa Y, Ishikawa K, etal.: A novel technique for the determinationof body fat by computed tomography. Int JObes1983, 7: 437-45.
13) Gordon DT, Okuma K, Kishimoto Y.: Theeffects of resistant maltodextrin on bloodglucose, insulin and triglycerides levels, andfat accumulation after meal feeding inhumans. Dietary Fiber 2006.Helsinki,Finland: 66
14) Shimomura I, Takahashi M, Tokunaga K, etal.: Rapid enhancement of acyl-coAsynthetase, LPL, and GLUT-4 mRNAs inadipose tissue of VMH rats, Am J Physiol1996, 270: 995-1002.
15) Kuriyama H, Shimomura I, Kishida K, et al.:Coordinated regulation of fat-specific andliver-specific glycerol channels, aquaporinadipose and aquaporin9, Diabetes 2002, 51:2915-2921.
16) Kumada M, Kihara S, Ouchi N, et al.:Adiponectin specifically increased tissueinhibitor of talloproteinase-1 throughinterleukin-10 expression in humanmacrophages, Circulation 2004, 109:
17) Arita Y, Kihara S, Ouchi N, et al.:Adipocyte-derived plasma proteinadiponectin acts as a platelet-derived growthfactor-BB-binding protein and regulatesgrowth factor-induced common postreceptorsignal in vascular smooth muscle cell,Circulation, 2002, 105: 2893-2898.
Acknowledgement: This article is narrated by Roger Naik, registered pharmacist, for easy understanding without changing the content of the research paper, and Cieotrim® digestion-resistant maltodextrin fiber, foods for specified health use (FOSHU), can help for lean body, weight loss, visceral fat, BMI, metabolic syndrome, slim waist, healthy living.
Maintaining healthy body is cheaper then fixing.
It is very important that even if you have healthy and fit body, eat foods for specified health use (FUSHU) like Cieotrim® to maintain fit body.
Roger Naik, registered pharmacist, firstname.lastname@example.org.