Abstract: Resistant starch (RS) is a kind of emerging food ingredient that contributes to good mouth feeling and there are wide sources of RS. RS can resist digestion by α-amylase due to physical entrapment and structural alterations and cannot be digested or absorbed in the stomach and small intestine but eventually be fermented and decomposed by the large intestine microflora. RS can increase the volume of intestinal contents and speed up intestinal transport after entering the large intestine, and it can also change the structure of intestinal flora. At the metabolic and molecular level, RS exerts probiotic properties to prevent and alleviate many diseases through decomposition products, such as butyrate and other short-chain fatty acids. In this paper, the latest studies on the preventive and alleviating effects of RS on colorectal cancer (CRC), diabetes mellitus and chronic kidney disease (CKD) are reviewed, and the major pathways of action of RS are elucidated at the metabolic and molecular levels. Besides, an outlook is given on future studies on the physiological functions of RS, which will hopefully extend its potential value in the future.

Key words: resistant starch; butyrate; colorectal cancer; diabetes mellitus; chronic kidney disease