Glycemic response, satiety, gastric secretions and emptying after bread consumption with water, tea or lemon juice: a randomized crossover intervention using MRI

Do Mindful Eating and Intuitive Eating Affect Beverage Preferences? A Cross-Sectional Survey

Intuitive eating involves following body signals to guide eating decisions and avoiding restrictive diets. Mindful eating is paying full attention to sensory experiences and fostering nonjudgmental awareness. We aimed to elucidate potential relationships between beverage intake and intuitive and mindful eating scores. This cross-sectional exploratory study (October 2021-December 2022) enrolled adult male and female participants who provided sociodemographic and health-related information and subsequently completed the Beverage Intake Questionnaire, the Mindful Eating Questionnaire (MEQ-30), and the Intuitive Eating Scale (IES-2). Bidirectional relationships were observed between beverage intake and intuitive and mindful eating scores. The total beverage intake of males was double compared with that of females, with the intake being mainly derived from sugar-sweetened beverages (p = 0.000). Increased total water intake was positively correlated with IES-2 and its subscale scores and was negatively correlated with MEQ-30 scores in both sexes (p < 0.05). Alcoholic beverage intake was associated with reductions in IES-2 and MEQ-30 scores, whereas unconditional permission to eat increased by 18.3% in males. In females, the consumption of milk-based beverages decreased the IES-2 scores. Understanding the complex relationships between beverage intake and intuitive and mindful eating may deepen our understanding of individual dietary behaviors and inform dietary interventions.

Abnormal gastrointestinal motility is a major factor in explaining symptoms and a potential therapeutic target in patients with disorders of gut-brain interaction

The objective of this article is to review the evidence of abnormal gastrointestinal (GI) tract motor functions in the context of disorders of gut-brain interaction (DGBI). These include abnormalities of oesophageal motility, gastric emptying, gastric accommodation, colonic transit, colonic motility, colonic volume and rectal evacuation. For each section regarding GI motor dysfunction, the article describes the preferred methods and the documented motor dysfunctions in DGBI based on those methods. The predominantly non-invasive measurements of gut motility as well as therapeutic interventions directed to abnormalities of motility suggest that such measurements are to be considered in patients with DGBI not responding to first-line approaches to behavioural or empirical dietary or pharmacological treatment.

MRI-Based Quantification of Pan-Alimentary Function and Motility in Subjects with Diabetes and Gastrointestinal Symptoms

Background: Diabetes-induced gastrointestinal (GI) symptoms are common but difficult to correctly diagnose and manage. We used multi-segmental magnetic resonance imaging (MRI) to evaluate structural and functional GI parameters in diabetic patients and to study the association with their symptomatic presentation. Methods: Eighty-six participants (46 with diabetes and GI symptoms, 40 healthy controls) underwent baseline and post-meal MRI scans at multiple timepoints. Questionnaires were collected at inclusion and following the scans. Data were collected from the stomach, small bowel, and colon. Associations between symptoms and collected data were explored. Utilizing machine learning, we determined which features differentiated the two groups the most. Key Results: The patient group reported more symptoms at inclusion and during MRI scans. They showed 34% higher stomach volume at baseline, 40% larger small bowel volume, 30% smaller colon volume, and less small bowel motility postprandially. They also showed positive associations between gastric volume and satiety scores, gastric emptying time and reflux scores, and small bowel motility and constipation scores. No differences in gastric emptying were observed. Small bowel volume and motility were used as inputs to a classification tool that separated patients and controls with 76% accuracy. Conclusions: In this work, we studied structural and functional differences between patients with diabetes and GI symptoms and healthy controls and observed differences in stomach, small bowel, and colon volumes, as well as an adynamic small bowel in patients with diabetes and GI symptoms. Associations between recorded parameters and perceived symptoms were also explored and discussed.

Pan-alimentary assessment of motility, luminal content, and structures: an MRI-based framework

BACKGROUND

Gastrointestinal symptoms originating from different segments overlap and complicate diagnosis and treatment. In this study, we aimed to develop and test a pan-alimentary framework for the evaluation of gastrointestinal (GI) motility and different static endpoints based on magnetic resonance imaging (MRI) without contrast agents or bowel preparation.

METHODS

Twenty healthy volunteers (55.6 ± 10.9 years, BMI 30.8 ± 9.2 kg/m2) underwent baseline and post-meal MRI scans at multiple time points. From the scans, the following were obtained: Gastric segmental volumes and motility, emptying half time (T50), small bowel volume and motility, colonic segmental volumes, and fecal water content. Questionnaires to assess GI symptoms were collected between and after MRI scans.

KEY RESULTS

We observed an increase in stomach and small bowel volume immediately after meal intake from baseline values (p<.001 for the stomach and p=.05 for the small bowel). The volume increase of the stomach primarily involved the fundus (p<.001) in the earliest phase of digestion with a T50 of 92.1 ± 35.3 min. The intake of the meal immediately elicited a motility increase in the small bowel (p<.001). No differences in colonic fecal water content between baseline and 105 min were observed.

CONCLUSION & INFERENCES

We developed a framework for a pan-alimentary assessment of GI endpoints and observed how different dynamic and static physiological endpoints responded to meal intake. All endpoints aligned with the current literature for individual gut segments, showing that a comprehensive model may unravel complex and incoherent gastrointestinal symptoms in patients.

Quantitative magnetic resonance imaging of in vitro gastrointestinal digestion of a bread and cheese meal

The monitoring of food degradation during gastrointestinal digestion is essential in understanding food structure impacts on the bioaccessibility and bioavailability of nutrients. Magnetic Resonance Imaging (MRI) has the unique ability to access information on changes in multi-scale structural features of foods in a spatially resolved and non-destructive way. Our objective was to exploit various opportunities offered by MRI for monitoring starch, lipid and protein hydrolysis, as well as food particle breakdown during the semi-dynamic in vitro gastrointestinal digestion of complex foods combined in a meal. The meal consisted of French bread, hard cheese and water (drink), with a realistic distribution of bolus particle sizes. The MRI approach was reinforced by parallel chemical analysis of all macronutrients in the supernatant. By combining different imaging protocols, quantitative MRI provided insights into a number of phenomena at the level of the cheese and bread particles and within the liquid phase that are hard to access through conventional approaches. MRI thus revealed the progressive ingress of fluids into the bread crust and the release of the gas trapped in the crumb, the erosion of cheese particles, the creaming of fat, the disappearance of small food particles and changes in liquid phase composition. Excellent agreement was obtained between the quantitative parameters extracted from the MRI images and the results of the chemical analysis, demonstrating the strong potential of MRI for the monitoring of in vitro gastrointestinal digestion. The present study proposes further improvements to fully exploit the capabilities of MRI and constitutes an important step towards the extension of quantitative MRI to in vivo studies.

Spatial-temporal mapping of the intra-gastric pepsin concentration and proteolysis in pigs fed egg white gels

While there is a consensus that food structure affects food digestion, the underlying mechanisms remain poorly understood. A previous experiment in pigs fed egg white gels of same composition but different structures evidenced such effect on food gastric disintegration. In this study, we detailed the consequences on intra-gastric pH, pepsin concentration and proteolysis by sampling throughout the stomach over 6 h digestion. Subsequent amino acid absorption was investigated as well by blood sampling. While acidification was almost homogeneous after 6 h digestion regardless of the gel, pepsin distribution never became uniform. Pepsin started to accumulate in the pylorus/antrum region before concentrating in the body stomach beyond 4 h, time from which proteolysis really started. Interestingly, the more acidic and soft gel resulted in a soon (60 min) increase in proteolysis, an earlier and more intense peak of plasmatic amino acids, and a final pepsin concentration three times higher than with the other gels.

The contribution of gastric digestion of starch to the glycaemic index of breads with different composition or structure

Breads of higher density exhibit lower glycaemic index (GI) both in vivo and in vitro, a phenomenon generally attributed to a slower intestinal starch digestion. The aim of this work was to gain a better understanding of the relationship between bread density, oral and gastric digestion, and GI. Three breads were studied: industrial-style and traditional-style French baguettes (similar composition, different densities), and whole-wheat baguette. In vitro GI predictions confirmed that, for an identical composition, higher bread density was associated with a lower GI. Subsequent oro-gastric digestions, using the dynamic system DIDGI®, showed extensive starch digestion at the gastric stage by salivary α-amylase, in line with recently published data. They further showed that higher bread density led to a lower hydrolysis rate. The concurrence of these results with those of in vivo studies, suggests a mediating role for gastric digestion in the relationship between bread density and GI, possibly via the repercussions on the starch proportion that remains to be hydrolysed in the small intestine. This study therefore adds to the scientific knowledge of the importance of salivary α-amylase to starch digestion, and draws special attention to the possible role of the gastric phase in determining the GI.