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Cited by 3Food composition and propertiesNatural Antidiabetic Agents StudiesMicrobial Metabolites in Food Biotechnology

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The Effect of Alpha-Cyclodextrin on Postprandial Glucose Excursions: a Systematic Meta-Analysis

Open access
Wittkowski, Knut M·2022·Cureus
DOI 10.7759/cureus.31160PMC PMC9637372

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Abstract

Alpha-cyclodextrin (αCD) is a bacterial product that is widely used as a food ingredient. In the European Union (EU), αCD is regulated as a dietary fiber with an authorized health claim "for contributing to the reduction of postprandial glycemic responses." In the US, αCD is generally recognized as save (GRAS), but on April 25, 2022, the U.S. Food and Drug Administration (FDA) rejected the inclusion of αCD in the list of dietary fibers because "the strength of the scientific evidence does not support a finding of a beneficial effect of αCD on postprandial blood glucose …" To evaluate the strength of this scientific evidence, this meta-analysis reviews clinical trials conducted to test the effect of αCD on the rise of blood glucose and insulin levels during three hours after consumption of a meal comprising carbohydrates, fats, and proteins. Several issues related to the standardization of the outcomes, the choice of the statistical methods in the cross-over studies conducted, and the choice of methods for the aggregation of P-values are discussed. It is concluded that the administration of αCD not only reduces the postprandial glycemic responses, but the absence of an increase in insulin levels suggests that αCD acts independently of increasing insulin production and, thus, the beneficial effect of αCD is not affected by insulin resistance.

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Crossref · 10.7759/cureus.31160

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Figure 1 PRISMA flow diagram Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 [7]
Figure 1 PRISMA flow diagram Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 [7]CC BY · PubMed Central
Figure 2 Data extraction summary: effects of different doses of αCD on blood glucose profiles. In all studies, each of >8 patients was administered all doses (cross-over). Legend: ***: P < .001; *: P < .05; °: P < .37, Figures were derived (excerpted) under 17 U.S.C. § 107 (fair use in scholarship and research) from Buckley, et al. (2006, permission granted) [14], Sugahara, Inoue, et al. (2016) [21], Bär, Diamantis, et al. (2020, CC BY 4.0) [5] Fletcher, et al. (2014, dissertation) [17], Lytle, et al. (2018, redrawn) [11], Binou, et al. (2022, permission granted) [22,23], Gentilcore, et al. (2011, permission granted) [4]: To serve the purpose of scholarly criticism, figures have been scaled to have similar axes, scales were cropped at 180 min [4,11], colors and some misleading indicators of “significance” were removed, and information was added to their sub-legends. αCD: alpha-cyclodextrin
Figure 2 Data extraction summary: effects of different doses of αCD on blood glucose profiles. In all studies, each of >8 patients was administered all doses (cross-over). Legend: ***: P < .001; *: P < .05; °: P < .37, Figures were derived (excerpted) under 17 U.S.C. § 107 (fair use in scholarship and research) from Buckley, et al. (2006, permission granted) [14], Sugahara, Inoue, et al. (2016) [21], Bär, Diamantis, et al. (2020, CC BY 4.0) [5] Fletcher, et al. (2014, dissertation) [17], Lytle, et al. (2018, redrawn) [11], Binou, et al. (2022, permission granted) [22,23], Gentilcore, et al. (2011, permission granted) [4]: To serve the purpose of scholarly criticism, figures have been scaled to have similar axes, scales were cropped at 180 min [4,11], colors and some misleading indicators of “significance” were removed, and information was added to their sub-legends. αCD: alpha-cyclodextrinCC BY · PubMed Central
Figure 3 Data extraction summary: effects of different doses of αCD on serum insulin and TG Legend: ***: P < .001; *: P < .05; °: P < .37, figures were derived (excerpted) under 17 U.S.C. § 107 (fair use in scholarship and research) from Buckley, et al. (2006, permission granted) [14], Sugahara, Inoue, et al. (2016) [21], Bär, Diamantis, et al. (2020, CC BY 4.0) [5] Fletcher, et al. (2014, dissertation) [17], Lytle, et al. (2018, redrawn) [11], Binou, et al. (2022, permission granted) [22,23], Gentilcore, et al. (2011, permission granted) [4]: To serve the purpose of scholarly criticism, figures have been scaled to have similar axes, scales were cropped at 180 min [4,11], colors and some misleading indicators of “significance” were removed, and information was added to their sub-legends. αCD: alpha-cyclodextrin; TG: triglyceride
Figure 3 Data extraction summary: effects of different doses of αCD on serum insulin and TG Legend: ***: P < .001; *: P < .05; °: P < .37, figures were derived (excerpted) under 17 U.S.C. § 107 (fair use in scholarship and research) from Buckley, et al. (2006, permission granted) [14], Sugahara, Inoue, et al. (2016) [21], Bär, Diamantis, et al. (2020, CC BY 4.0) [5] Fletcher, et al. (2014, dissertation) [17], Lytle, et al. (2018, redrawn) [11], Binou, et al. (2022, permission granted) [22,23], Gentilcore, et al. (2011, permission granted) [4]: To serve the purpose of scholarly criticism, figures have been scaled to have similar axes, scales were cropped at 180 min [4,11], colors and some misleading indicators of “significance” were removed, and information was added to their sub-legends. αCD: alpha-cyclodextrin; TG: triglycerideCC BY · PubMed Central

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  1. Effect of cyclodextrin on postprandial blood glucose and triglycerides. (2022). Accessed. 2022-09-01: https://www.semanticscholar.org/paper/Effect-of-cyclodextrin-on-postprandial-blood-and-Sugahara-Inoue/a8f2e5365a72faa....

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Metadata

Authors
Wittkowski, K. M.
Corresponding author
Wittkowski, Knut M
ORCID
Wittkowski, Knut M
Venue
Cureus
Publisher
Springer Science and Business Media LLC
Published
2022-11-06
Volume
14
Issue
11
Pages
e31160-e31160
ISSN
2168-8184 (ISSN-L)
DOI
10.7759/cureus.31160
PMC
PMC9637372
OpenAlex
W4308317698
Cited by
3
References
22
Citations by year
2025: 1 · 2024: 1 · 2022: 1
FWCI
0.46
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Cureus (publishedVersion, cc-by)
  • medRxiv (acceptedVersion, cc-by-nd)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Food composition and properties
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Natural Antidiabetic Agents Studies
  • Health Sciences › Nursing › Nutrition and Dietetics › Microbial Metabolites in Food Biotechnology
Keywords
α-cyclodextrin, postprandial glycemic response, blood glucose, insulin, dietary fiber, health claims, insulin resistance, carbohydrate digestion

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