Objectives: Colorectal disturbances encompass a variety of disorders that impact the colon and rectum, such as colitis and colon cancer. Butyrate provides an energy source for colonocytes and supports optimal colon health. Butylated high-amylose maize starch (HAMSB) delivers short-chain fatty acids (SCFA) directly to the colon. This work summarizes clinical trials and animal studies that reported the role of HAMSB in relieving colorectal disturbances and its association with microbiota changes.
Methods: We conducted a MEDLINE search and identified additional relevant studies through manual searching on Google Scholar. Key search terms included "SCFA," "esterified," and "starch", as well as variations of the terms. Relevant clinical trials and animal studies that reported quantitative data were selected for analysis and review. Studies on companion animals were excluded.
Results: Out of 1,293 studies identified in the literature searches, four clinical trials on healthy human individuals and ten animal studies were selected for review. The relevant literature showed that HAMSB consumption increased butyrate levels in both animals and humans. Two publications showed that HAMSB significantly reduced rectal O6-methyl-guanine adducts and epithelial proliferation induced by the high protein diet (HPD). Fecal microbiota were assessed in all clinical trials, consistently showing that HAMSB supplementation increased abundance of Parabacteroides distasonis. In seven animal studies, HAMSB significantly reduced the risk of HPD- or azoxymethane-induced colon cancer by reducing genetic damage, but the effects were attributed to different mechanisms. HAMSB functioned through affecting cecal ammonia levels by modulating colon pH in diet-induced cancer, while it ameliorated chemical-induced colon cancer by downregulating miR19b and miR92a expressions and subsequently activating caspase-dependent apoptosis. Furthermore, two studies found that HAMSB improved colitis via regulating T cell differentiation and activities by inhibiting histone deacetylase, but its role in bacteria-induced colon colitis requires further investigation.
Conclusions: HAMSB may offer a dietary approach to promote optimal colon health, particularly in the context of mitigating colorectal disturbances associated with high protein diets.
