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Nutritional Methodology
Research Communication

A Combined ¹³CO₂/H₂ Breath Test Can Be Used to Assess Starch Digestion and Fermentation in Humans¹

Erin L. Symonds^*,,2, Stamatiki Kritas^*,**, Taher I. Omari^*,** and Ross N. Butler^*,**

^* Gastroenterology Unit, Women’s and Children’s Hospital, North Adelaide, South Australia; Department of Physiology, University of Adelaide, Adelaide, South Australia; ^** Department of Paediatrics, University of Adelaide, Adelaide, South Australia

²To whom correspondence should be addressed. E-mail: erinsymonds{at}yahoo.com.

Ingestion of starch from corn (naturally enriched with ¹³C) should produce ¹³CO₂ after small intestinal digestion and ¹³CO₂ and H₂ from colonic fermentation. This study used a combined ¹³CO₂/H₂ breath test to assess the digestion and fermentation of resistant starch and to show that the test could detect changes in digestibility due to cooking. Volunteers consumed 40 g digestible cornstarch with water (n = 8), or 40 g resistant cornstarch in liquid (n = 12) or cooked into a pancake (n = 4). Interval breath sampling was performed and analyzed for ¹³CO₂ and H₂. Ingestion of resistant starch produced a double-peaked ¹³CO₂ excretion curve. The first increase in ¹³CO₂ occurred at the same time as excretion from digestible starch (55 ± 9 and 68 ± 9 min, respectively), which was due to small intestinal digestion. The second increase in ¹³CO₂ was accompanied by an increase in H₂ excretion (432 ± 15 and 428 ± 48 min, respectively), which was indicative of colonic bacterial fermentation. Cooking resistant starch increased its degree of digestion from 36 to 72%. The ¹³CO₂/H₂ breath test can be used to estimate digestion and fermentation of starches in different physiologic and pathologic conditions.

KEY WORDS: • resistant starch • breath testing • fermentation • ¹³CO₂

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