Rhonda Witwer is the senior business development manager of nutrition for National Starch Food Innovation, based in Bridgewater, NJ. She manages Hi-maize resistant starch and Hi-maize whole grain flour for the North American market for National Starch and was responsible for building recognition for natural resistant starch’s important health benefits in glycemic health and weight control within the food industry and health professional communities. She has also effectively translated more than 360 published studies supporting Hi-maize resistant starch into understandable, credible marketing messages being used by numerous Hi-maize co-branding partners. Ms. Witwer has more than two decades of experience in marketing bioactive ingredients and has written numerous articles and expert market reports on the market opportunities for bioactive ingredients. A graduate of Butler University with a BS in Chemistry, she received her MBA in marketing from The Wharton School of the University of Pennsylvania.

Health E-Insights: What is resistant starch and why are we hearing about it so much recently in the media?
 
Ms. Witwer: Hi-maize resistant starch is a natural bioactive ingredient isolated from a special corn that is high in amylose content. Hi-maize contains approximately 40% slowly digestible starch, which is digested within the small intestine and slowly absorbed as glucose. Hi-maize also contains approximately 60% resistant starch, which reaches the large intestine. The resistant starch portion is fermented by the beneficial bacteria in the large intestine and produces short-chain fatty acids. Both components of Hi-maize resistant starch shift the production of hormones known to be connected to satiety and insulin sensitivity. Recently, resistant starch has been featured in several widely promoted new weight loss programs. Prevention and Health magazines are promoting resistant starch as a key healthy carb for weight control. The most prominent examples are the Carb Lovers Diet. (www.CarbLovers.com) and the Skinny Carbs diet (www.SkinnyCarbsDietBook.com/UOF/SkinnyCarbsDietBook). The editors from Health magazine, writers of the CarbLovers Diet and the CarbLovers Diet Pocket Guide, have promoted resistant starch around the country, including appearances on “The Today Show,” “The Rachael Ray Show,” “The Talk” on CBS-TV, and many local broadcast news shows. Recipes including Hi-maize resistant starch have even been included in an article in The Washington Post. This type of publicity is driving consumer interest in resistant starch. We are also seeing increased interest in resistant starch in the area of blood glucose (blood sugar) control, with a handful of products on the market already and more on the way. The claims they typically make in this area include ‘helps maintain healthy blood sugar levels’ because it is a simple, easy way to put a positive benefit on a food that many consumers may be worried about consuming. Consumers are just beginning to learn about the health benefits of resistant starch. Prevention declared it one of the Top Medical Breakthroughs of 2008 for Women. The National Institutes of Health is also conducting a trial with Hi-maize resistant starch. Awareness is growing because numerous groups are starting to talk about resistant starch after reviewing the scientific evidence, which is readily available on www.ResistantStarch.com. For instance, recent news articles appeared in The Huffington Post, Woman’s World, Web MD, The Los Angeles Times, First for Women, Women’s Health, as well as Health and Prevention. The data supporting Hi-maize resistant starch’s insulin sensitivity benefits is clear and compelling. Improving insulin sensitivity is essential to maintaining glycemic health and Hi-maize resistant starch clearly and significantly improves this critical biomarker.
 
Health E-Insights: What does the natural products marketplace for healthy blood sugar support look like today?
 
Ms. Witwer: From a market opportunity standpoint, addressing blood sugar health as a preventive measure is a big opportunity for product manufacturers and retailers. Recent consumer studies show that around 11% of consumers are personally affected by diabetes. On the other hand, 42% of consumers are either very or extremely concerned about blood sugar levels. Another study stated that more than 50% of the U.S. population could have pre-diabetes or diabetes by the year 2020. In vitamin and health food stores, most of the products/ingredients that are currently on the market to address the fallout from unhealthy blood sugar levels deal with either weight management or with conditions that develop as a result of poor blood sugar health, such as eye health products and heart health products. Most weight management products are focused on people who have a small amount of weight to lose—in other words, a cosmetic situation, rather than those with the greatest need: very over weight or the obese. In the context of today’s discussions of healthcare, the insurance community is increasingly being held accountable for cost control. As they examine the options, prevention is becoming a strong and viable approach. The top four killers of American adults are smoking, obesity, high blood pressure and high blood sugar. (Danaei, PLOS Medicine, April 2009, 6(4): e1000058).  As dietary approaches to managing high blood sugar become available and are credible, the insurance community will drive their adoption for the cost savings alone. It is far cheaper to prevent type 2 diabetes than to treat it. With regard to developing, specifically, ingredient solutions to address the management of blood sugar levels, or glycemic health, the industry and consumers need to focus on the issues they can actually address. While weight loss and exercise is considered the primary approach improving blood sugar health, as a society, we don’t seem to be able to do this quickly or well enough. Put another way, given the severity of the problem, we can’t wait to lose the weight.
 
Health E-Insights: What can we focus on in addition to weight loss in supporting blood sugar health?
 
Ms. Witwer: The medical and health professional communities are focusing on losing weight and exercise as recommended actions to maintain glycemic health. It is becoming obvious that we also need to consider the biomarker insulin resistance (insulin sensitivity). Insulin resistance is a physiological condition where the natural hormone insulin, becomes less effective at lowering blood sugar. It develops when the receptors on the muscle cells and tissues become less sensitive to the effects of insulin, so in effect, insulin resistance and insulin sensitivity are two sides of the same coin. When insulin resistance increases, glucose (blood sugar) transport into cells becomes less efficient and blood glucose levels rise, triggering the production of more insulin. Higher levels of circulating insulin are needed to keep blood glucose levels under control. With ongoing inflammation and increasing insulin resistance, the body may not be able keep up with the demand for insulin to control blood glucose. When this happens, blood glucose levels rise above healthy levels and a person is considered to have impaired glycemic control. High levels of insulin inhibit the use of fat as energy. It also increases the production of fatty acids. Thus, high levels of circulating insulin promote fat storage and prevent fat from being utilized as energy. This helps to explain the fact that approximately 80% of people with type 2 diabetes are also overweight. Lowering the levels of circulating insulin will help to increase fat burning and decrease fat storage. Thus, reducing insulin resistance may lead to improvements in weight control as well as blood glucose control. In normal blood glucose levels, it has traditionally been assumed that insulin levels are also normal. However, insulin levels are the first to change in when glycemic health is impaired. People with healthy blood glucose levels may already have the beginnings of insulin resistance without knowing it and may have elevated insulin levels.

Health E-Insights: How does Hi-maize affect insulin resistance?

Ms. Witwer: Hi-maize resistant starch occupies a unique position in the market. It is one of the most studied ingredients in the space, with more than 20 human clinical trials, the most recent of which showed over a 50% decrease in the critical biomarker insulin resistance when fed as a supplement at moderate levels to overweight and/or obese men. In total, six randomized clinical studies have been completed showing that Hi-maize resistant starch significantly increases insulin sensitivity in adults. Five out of six of these studies included healthy individuals, while one study included individuals with type 2 diabetes. In contrast to the previous studies in which Hi-maize replaced glycemic carbohydrates, these studies added Hi-maize in addition to participants’ normal diet and an equal amount of digestible starch was added to the control condition. Thus, the benefit was found independent of a glycemic reduction of food or the diet. Hi-maize is a natural ingredient that has been commercially available for a decade, which means it has a track record for safety, consumer acceptance and its ability to be incorporated into a variety of delivery systems, from supplement powders and specialty flours to fully formulated functional foods. With an ingredient like Hi-maize resistant starch, we have a set of clear targets that can be affected through nutritional and supplemental means—insulin resistance and insulin sensitivity. It is clear from the outset that the terms insulin resistance and insulin sensitivity must become a part of an average person’s vocabulary, much in the same way cholesterol is today, if people are going to be able to start to manage their own glycemic health.

Health E-Insights: What are recommended supplement levels of Hi-maize and what product forms is it delivered in?

Ms. Witwer: Current research suggests that from 5-15 grams per day of Hi-maize resistant starch can support healthy blood sugar levels. Some scientific studies have shown health benefits at even higher levels (30 grams). Supplementation could be considered as a once-a-day (breakfast), in which 5 grams of resistant starch (1 tablespoon) to 15 grams of resistant starch (3 tsp.) would be recommended based on the needs of the individual. For home use, we have seen Hi-maize used in a dry powder form, sachets and specialty flours. In functional foods, formulated products can include shakes and smoothies, baked goods, pastas, snacks and potentially bars. In products that contained Hi-maize resistant starch, we recommend a structure/function claim stating—‘Helps maintain healthy blood sugar levels.’

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