Resistant Starch: Gut Health Support for ME/CFS, Fibromyalgia, and Long COVID
Managing chronic fatigue syndrome (ME/CFS), fibromyalgia, or long COVID often involves tackling multisystem challenges, including gut issues like irritable bowel syndrome (IBS). Supporting gut health is crucial for symptom management but can be incredibly challenging.
Enter resistant starch—a unique carbohydrate that nourishes gut bacteria, balances energy levels, and reduces inflammation. Let’s explore what resistant starch is, its benefits for chronic conditions, and how to include it in your diet.
What Is Resistant Starch?
Resistant starch is a type of carbohydrate that "resists" digestion in the small intestine. Unlike regular starches that break down into glucose, resistant starch passes through the stomach intact and ferments in the colon, acting as food for beneficial gut bacteria.
There are 4 main types of resistant starch:
RS1: Found in whole grains, seeds, legumes, raw nuts (almonds, pistachios, cashews, & walnuts)
RS2: Found in raw foods like green bananas
RS3: Created when starch-rich foods like rice or potatoes are cooked and cooled. Microwaving these foods enhances their RS3 content.
RS4: A chemically modified version found in some processed foods promoted to be high in fiber. The label will state ingredients like modified starch, tapioca, high-amylose maize, or simply resistant starch.
The Role of Butyrate: A Key Player in Gut Health
One of the most significant benefits of resistant starch is its ability to promote the production of butyrate, a short-chain fatty acid (SCFA) with powerful health-supporting properties. Butyrate is produced when beneficial gut bacteria ferment resistant starch in the colon, and it serves as a critical molecule for maintaining gut and overall health. About 95% of short-chain fatty acids, like butyrate, are taken up by the cells lining the gut where they can have body-wide effects and brain effects.
How Butyrate Supports Health
Butyrate is recognized as a key contributor to host health by maintaining immune homeostasis, gut barrier integrity, and metabolism. Here’s a closer look at how it works:
Immune Regulation:
Butyrate helps modulate the immune system by reducing excessive inflammation and promoting tolerance, which can be especially beneficial for those with chronic conditions involving immune dysregulation (e.g. gut autoimmunity).
Gut Barrier Integrity:
It supports the integrity of the gut lining by nourishing intestinal cells and improving gut barrier function. This can prevent harmful substances from entering the bloodstream and triggering systemic inflammation.
Metabolic Benefits:
Butyrate plays a role in energy metabolism by acting as a fuel source for colon cells and influencing how the body uses and stores energy. This can contribute to improved energy levels and metabolic health.
Anti-Inflammatory Effects:
Chronic low-grade inflammation is a hallmark of many conditions like ME/CFS, fibromyalgia, and long COVID. By reducing inflammatory markers in the gut and bloodstream, butyrate may help alleviate some symptoms associated with these conditions.
Butyrate and ME/CFS: Research Highlights
Abnormal gut microbiome patterns have been observed in ME/CFS, fibromyalgia, and long COVID patients. Key butyrate-producing bacteria are often reduced, including:
Faecalibacterium prausnitzii: Major producer of butyrate, reduced in multiple ME/CFS and fibromyalgia studies.
Bifidobacterium spp.: Supports gut barrier integrity and SCFA production.
Bacteroides spp.: Produces SCFAs like acetate and propionate, which benefit energy metabolism.
Coprococcus spp.: Associated with anti-inflammatory properties.
Eubacterium spp.: Includes butyrate-producing bacteria like Eubacterium rectale.
The benefits of resistant starch vary based on an individual’s unique gut microbiome. For example, Ruminococcus bromii (R. bromii) is essential for breaking down resistant starch. A lack of this species—though rare—can hinder butyrate production.
Resistant Starch and Inflammation
In clinical trials for other chronic diseases, RS2 (at doses ranging from 6g–28g per day) reduced inflammatory markers like C-reactive protein (CRP), interleukin-6, and TNF-α. These findings make resistant starch a promising dietary addition for chronic conditions.
Tips for Incorporating Resistant Starch Safely
Here are some tips for incorporating RS into your diet. Aim for RS1 or RS2 choices and 15-20g per day, as these are easier to digest and have been shown to reduce inflammation in clinical trials.
Start Low and Go Slow:
Begin with small amounts (e.g., 1 teaspoon of raw potato starch, ½ a green banana, or a few tablespoons of cooled rice) and gradually increase as tolerated.
Pair with a Low-FODMAP Diet:
If you’re following a low-FODMAP diet for IBS, choose low-FODMAP sources of resistant starch, such as cooked and cooled rice or potatoes.
Monitor Symptoms:
Keep a symptom journal to track how your body responds to resistant starch. If symptoms worsen, consider pausing or consulting a healthcare provider.
Combine with Soluble Fiber:
Pair resistant starch with soluble fiber (e.g., oats, chia seeds) to support digestion and minimize discomfort.
Conclusion
Resistant starch is more than a carbohydrate—it’s a powerful tool for gut health, energy stabilization, and inflammation reduction. For individuals with ME/CFS, fibromyalgia, or long COVID, it offers a practical and beneficial dietary strategy.
With its potential to improve microbiome balance, boost butyrate production, and support overall health, resistant starch could be a simple yet transformative addition to your wellness journey.
References
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König RS, Albrich WC, Kahlert CR, Bahr LS, Löber U, Vernazza P, Scheibenbogen C, Forslund SK. The Gut Microbiome in Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS). Front Immunol. 2022 Jan 3;12:628741. doi: 10.3389/fimmu.2021.628741. Erratum in: Front Immunol. 2022 Mar 30;13:878196. doi: 10.3389/fimmu.2022.878196. PMID: 35046929; PMCID: PMC8761622.
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