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Tao T, Shu Q, Zhao Y, Guo W, Wang J, Shi Y, Jia S, Zhai H, Chen H, Wang C, Xu G. Mechanical regulation of lipid and sugar absorption by Piezo1 in enterocytes. Acta Pharm Sin B 2024; 14:3576-3590. [PMID: 39220873 PMCID: PMC11365390 DOI: 10.1016/j.apsb.2024.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 03/22/2024] [Accepted: 03/27/2024] [Indexed: 09/04/2024] Open
Abstract
Obesity is primarily caused by excessive intake as well as absorption of sugar and lipid. Postprandial surge in distention pressure and intestinal motility accelerates the absorption of nutrients. The response of intestinal epithelial cells to mechanical stimulation is not fully understood. Piezo1, a mechanosensitive ion channel, is widely expressed throughout the digestive tract. However, its function in intestinal nutrient absorption is not yet clear. In our study, excessive lipid deposition was observed in the duodenum of obese patients, while duodenal Piezo1-CaMKK2-AMPKα was decreased when compared to normal-weight individuals. Under high-fat diet condition, the Piezo1 iKO mice exhibited abnormally elevated sugar and lipid absorption as well as severe lipid deposition in the duodenum and liver. These phenotypes were mainly caused by the inhibition of duodenal CaMKK2-AMPKα and the upregulation of SGLT1 and DGAT2. In contrast, Yoda1, a Piezo1 agonist, was found to reduce intestinal lipid absorption in diet induced obese mice. Overexpression of Piezo1, stretch and Yoda1 inhibited lipid accumulation and the expression of DGAT2 and SGLT1, whereas knockdown of Piezo1 stimulated lipid accumulation and DGAT2 in Caco-2 cells. Our study reveals a previously unexplored mechanical regulation of nutrient absorption in intestinal epithelial cells, which may shed new light on the therapy of obesity.
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Affiliation(s)
- Tian Tao
- Department of Physiology, School of Medicine, Jinan University, Guangzhou 510632, China
- Department of Metabolic and Bariatric Surgery, the First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Qing Shu
- Department of Physiology, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Yawen Zhao
- Department of Physiology, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Wenying Guo
- Department of Physiology, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Jinting Wang
- Department of Physiology, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Yuhao Shi
- Department of Physiology, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Shiqi Jia
- Department of Metabolic and Bariatric Surgery, the First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Hening Zhai
- Endoscopy Center, the First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Hui Chen
- Biotherapy Center; Cell-gene Therapy Translational Medicine Research Center, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China
| | - Cunchuan Wang
- Department of Metabolic and Bariatric Surgery, the First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Geyang Xu
- Department of Physiology, School of Medicine, Jinan University, Guangzhou 510632, China
- Key Laboratory of Viral Pathogenesis & Infection Prevention and Control (Jinan University), Ministry of Education, Guangzhou 510632, China
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Steenackers N, Eksteen G, Wauters L, Augustijns P, Van der Schueren B, Vanuytsel T, Matthys C. Understanding the gastrointestinal tract in obesity: From gut motility patterns to enzyme secretion. Neurogastroenterol Motil 2024; 36:e14758. [PMID: 38342973 DOI: 10.1111/nmo.14758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 01/15/2024] [Accepted: 01/25/2024] [Indexed: 02/13/2024]
Abstract
BACKGROUND AND PURPOSE The pathophysiology of obesity has been the product of extensive research, revealing multiple interconnected mechanisms contributing to body weight regulation. The regulation of energy balance involves an intricate network, including the gut-neuroendocrine interplay. As a consequence, research on the gut-brain-microbiota axis in obesity has grown extensively. The physiology of the gastrointestinal tract, far from being underexplored, has significant implications for the development of specific complications in people living with obesity across the fields of gastroenterology, nutrition, and pharmacology. Clinical research indicates higher fasting bile acids serum levels, and blunted postprandial increases in bilious secretions in people living with obesity. Findings are less straightforward for the impact of obesity on gastric emptying with various studies reporting accelerated, normal, or delayed gastric emptying rates. Conversely, the effect of obesity on gastrointestinal pH, gastrointestinal transit, and gastric and pancreatic enzyme secretion is largely unknown. In this review, we explore the current evidence on the gastrointestinal physiology of obesity.
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Affiliation(s)
- Nele Steenackers
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Gabriel Eksteen
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Lucas Wauters
- Translational Research Center for Gastrointestinal Disorders, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
| | - Patrick Augustijns
- Drug Delivery and Disposition, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - Bart Van der Schueren
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
- Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium
| | - Tim Vanuytsel
- Translational Research Center for Gastrointestinal Disorders, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
| | - Christophe Matthys
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
- Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium
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3
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Masood M, Low D, Deal SB, Kozarek RA. Gastroesophageal Reflux Disease in Obesity: Bariatric Surgery as Both the Cause and the Cure in the Morbidly Obese Population. J Clin Med 2023; 12:5543. [PMID: 37685616 PMCID: PMC10488124 DOI: 10.3390/jcm12175543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 08/11/2023] [Accepted: 08/18/2023] [Indexed: 09/10/2023] Open
Abstract
Gastrointestinal reflux disease (GERD) is a chronic, highly prevalent condition in the United States. GERD can significantly impact quality of life and lead to complications including aspiration pneumonia, esophageal stricture, Barrett's esophagus (BE) and esophageal cancer. Obesity is a risk factor for GERD, which often improves with weight loss and bariatric surgery. Though the incidence of bariatric surgery, in particular, minimally invasive sleeve gastrectomy, has risen in recent years, emerging data has revealed that the severity or new onset of GERD may follow bariatric surgery. We performed a literature review to provide a detailed analysis of GERD with an emphasis on bariatric surgery as both the cure and the cause for GERD in the morbidly obese population. We also describe the pathophysiological mechanisms, management approach and treatment strategies of GERD following bariatric surgery.
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Affiliation(s)
- Muaaz Masood
- Division of Gastroenterology and Hepatology, Center for Digestive Health, Virginia Mason Franciscan Health, Seattle, WA 98101, USA
| | - Donald Low
- Division of Thoracic Surgery, Center for Digestive Health, Virginia Mason Franciscan Health, Seattle, WA 98101, USA
| | - Shanley B. Deal
- Division of General Surgery, Center for Weight Management, Virginia Mason Franciscan Health, Seattle, WA 98101, USA
| | - Richard A. Kozarek
- Division of Gastroenterology and Hepatology, Center for Digestive Health, Virginia Mason Franciscan Health, Seattle, WA 98101, USA
- Center for Interventional Immunology, Benaroya Research Institute, Virginia Mason Franciscan Health, Seattle, WA 98101, USA
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Fiorentino TV, De Vito F, Suraci E, Marasco R, Hribal ML, Luzza F, Sesti G. Obesity and overweight are linked to increased sodium-glucose cotransporter 1 and glucose transporter 5 levels in duodenum. Obesity (Silver Spring) 2023; 31:724-731. [PMID: 36746764 DOI: 10.1002/oby.23653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/03/2022] [Accepted: 10/23/2022] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Prior evidence indicates that individuals with obesity have an accelerated intestinal glucose absorption. This cross-sectional study evaluated whether those with overweight or obesity display higher duodenal protein levels of the glucose carriers sodium-glucose cotransporter 1 (SGLT-1), glucose transporter 2 (GLUT-2), and glucose transporter 5 (GLUT-5). METHODS SGLT-1, GLUT-2, and GLUT-5 protein levels were assessed on duodenal mucosa biopsies of 52 individuals without diabetes categorized on the basis of their BMI as lean, with overweight, or with obesity. RESULTS Individuals with overweight and obesity exhibited progressively increased duodenal protein levels of SGLT-1 and GLUT-5 as compared with the lean group. Conversely, no differences in duodenal GLUT-2 abundance were found among the three groups. Univariate analysis showed that SGLT-1 and GLUT-5 protein levels were positively correlated with BMI, waist circumference, 1-hour post-load glucose, fasting and post-load insulin, and insulin secretion and resistance levels. Furthermore, a positive relationship was detected between intestinal GLUT-5 levels and serum uric acid concentrations, a product of fructose metabolism known to be involved in the pathogenesis of obesity and its complications. CONCLUSIONS Individuals with overweight and obesity display enhanced duodenal SGLT-1 and GLUT-5 abundance, which correlates with increased postprandial glucose concentrations, insulin resistance, and hyperinsulinemia.
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Affiliation(s)
- Teresa Vanessa Fiorentino
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Francesca De Vito
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Evelina Suraci
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Raffaella Marasco
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Marta Letizia Hribal
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Francesco Luzza
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Giorgio Sesti
- Department of Clinical and Molecular Medicine, University of Rome-Sapienza, Rome, Italy
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Obesity-associated mesenteric lymph leakage impairs the trafficking of lipids, lipophilic drugs and antigens from the intestine to mesenteric lymph nodes. Eur J Pharm Biopharm 2022; 180:319-331. [DOI: 10.1016/j.ejpb.2022.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/06/2022] [Accepted: 10/19/2022] [Indexed: 11/23/2022]
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Berton M, Bettonte S, Stader F, Battegay M, Marzolini C. Repository Describing the Anatomical, Physiological, and Biological Changes in an Obese Population to Inform Physiologically Based Pharmacokinetic Models. Clin Pharmacokinet 2022; 61:1251-1270. [PMID: 35699913 PMCID: PMC9439993 DOI: 10.1007/s40262-022-01132-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2022] [Indexed: 11/24/2022]
Abstract
Background Obesity is associated with physiological changes that can affect drug pharmacokinetics. Obese individuals are underrepresented in clinical trials, leading to a lack of evidence-based dosing recommendations for many drugs. Physiologically based pharmacokinetic (PBPK) modelling can overcome this limitation but necessitates a detailed description of the population characteristics under investigation. Objective The purpose of this study was to develop and verify a repository of the current anatomical, physiological, and biological data of obese individuals, including population variability, to inform a PBPK framework. Methods A systematic literature search was performed to collate anatomical, physiological, and biological parameters for obese individuals. Multiple regression analyses were used to derive mathematical equations describing the continuous effect of body mass index (BMI) within the range 18.5–60 kg/m2 on system parameters. Results In total, 209 studies were included in the database. The literature reported mostly BMI-related changes in organ weight, whereas data on blood flow and biological parameters (i.e. enzyme abundance) were sparse, and hence physiologically plausible assumptions were made when needed. The developed obese population was implemented in Matlab® and the predicted system parameters obtained from 1000 virtual individuals were in agreement with observed data from an independent validation obese population. Our analysis indicates that a threefold increase in BMI, from 20 to 60 kg/m2, leads to an increase in cardiac output (50%), liver weight (100%), kidney weight (60%), both the kidney and liver absolute blood flows (50%), and in total adipose blood flow (160%). Conclusion The developed repository provides an updated description of a population with a BMI from 18.5 to 60 kg/m2 using continuous physiological changes and their variability for each system parameter. It is a tool that can be implemented in PBPK models to simulate drug pharmacokinetics in obese individuals.
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Affiliation(s)
- Mattia Berton
- Division of Infectious Diseases and Hospital Epidemiology, Departments of Medicine and Clinical Research, University Hospital Basel, Basel, Switzerland. .,University of Basel, Basel, Switzerland.
| | - Sara Bettonte
- Division of Infectious Diseases and Hospital Epidemiology, Departments of Medicine and Clinical Research, University Hospital Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | | | - Manuel Battegay
- Division of Infectious Diseases and Hospital Epidemiology, Departments of Medicine and Clinical Research, University Hospital Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Catia Marzolini
- Division of Infectious Diseases and Hospital Epidemiology, Departments of Medicine and Clinical Research, University Hospital Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland
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7
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The Influence of Obesity on Small Bowel Capsule Endoscopy. Gastroenterol Res Pract 2022; 2022:6396651. [PMID: 35591896 PMCID: PMC9112179 DOI: 10.1155/2022/6396651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 04/25/2022] [Indexed: 12/03/2022] Open
Abstract
Objective Intestinal motility may be different in obese and nonobese patients, but this has not been determined. Here, we sought to evaluate the effect of obesity on small bowel capsule endoscopy (SBCE). Patients and Methods. We retrospectively analyzed the cases of the 340 patients who underwent SBCE for small intestinal disease (excluding cases of unobservable total small bowel, small bowel stenosis, and bowel resection) at our hospital during the period January 2014 to December 2020 to extract patient background factors and the bowel transit times of SBCE according to the presence/absence of obesity (defined as a body mass index (BMI) ≥ 25 kg/m2). Results The obese group was 54 patients (nonobese, n = 286). The small bowel transit time (SBTT) was significantly shorter in the obese patients compared to the nonobese patients (p = 0.0026), and when we divided the patients by their short/long SBTTs using 216.5 min as the cutoff, we observed significant between-group differences in the patients' age (≥60 years) and in the patients' hospitalization status at the time of the SBCE examination. A multivariate analysis revealed that hospitalized status at the examination is a factor contributing significantly to a long SBTT (OR 0.25, 95% CI: 0.15–0.42, p < 0.0001). An analysis using the outpatient/inpatient conditions showed that obesity was an independent factor in the inpatient status at the SBCE examination with a significant short SBTT (OR 2.91, 95% CI: 1.06–7.97, p = 0.0380). Constipation at the examination was also a factor contributing to a long SBTT (OR 0.26, 95% CI: 0.07–0.99, p = 0.0493). Conclusion The SBTT of the SBCE was significantly shorter in the obese patients. This tendency was especially evident in the hospitalized state.
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8
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Bordier V, Teysseire F, Schlotterbeck G, Senner F, Beglinger C, Meyer-Gerspach AC, Wölnerhanssen BK. Effect of a Chronic Intake of the Natural Sweeteners Xylitol and Erythritol on Glucose Absorption in Humans with Obesity. Nutrients 2021; 13:nu13113950. [PMID: 34836205 PMCID: PMC8618859 DOI: 10.3390/nu13113950] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 11/01/2021] [Accepted: 11/02/2021] [Indexed: 02/07/2023] Open
Abstract
In patients with obesity, accelerated nutrients absorption is observed. Xylitol and erythritol are of interest as alternative sweeteners, and it has been shown in rodent models that their acute ingestion reduces intestinal glucose absorption. This study aims to investigate whether a chronic intake of xylitol and erythritol impacts glucose absorption in humans with obesity. Forty-six participants were randomized to take either 8 g of xylitol or 12 g of erythritol three times a day for five to seven weeks, or to be part of the control group (no substance). Before and after the intervention, intestinal glucose absorption was assessed during an oral glucose tolerance test with 3-Ortho-methyl-glucose (3-OMG). The effect of xylitol or erythritol intake on the area under the curve for 3-OMG concentration was not significant. Neither the time (pre or post intervention), nor the group (control, xylitol, or erythritol), nor the time-by-group interaction effects were significant (p = 0.829, p = 0.821, and p = 0.572, respectively). Therefore, our results show that a chronic intake of the natural sweeteners xylitol and erythritol does not affect intestinal glucose absorption in humans with obesity.
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Affiliation(s)
- Valentine Bordier
- St. Clara Research Ltd. at St. Claraspital, 4002 Basel, Switzerland; (V.B.); (F.T.); (C.B.)
- Faculty of Medicine, University of Basel, 4001 Basel, Switzerland
| | - Fabienne Teysseire
- St. Clara Research Ltd. at St. Claraspital, 4002 Basel, Switzerland; (V.B.); (F.T.); (C.B.)
- Faculty of Medicine, University of Basel, 4001 Basel, Switzerland
| | - Götz Schlotterbeck
- Institute for Chemistry and Bioanalytics, School of Life Science, FHNW University of Applied Sciences and Arts Northwestern Switzerland, 4132 Muttenz, Switzerland; (G.S.); (F.S.)
| | - Frank Senner
- Institute for Chemistry and Bioanalytics, School of Life Science, FHNW University of Applied Sciences and Arts Northwestern Switzerland, 4132 Muttenz, Switzerland; (G.S.); (F.S.)
| | - Christoph Beglinger
- St. Clara Research Ltd. at St. Claraspital, 4002 Basel, Switzerland; (V.B.); (F.T.); (C.B.)
- Faculty of Medicine, University of Basel, 4001 Basel, Switzerland
| | - Anne Christin Meyer-Gerspach
- St. Clara Research Ltd. at St. Claraspital, 4002 Basel, Switzerland; (V.B.); (F.T.); (C.B.)
- Faculty of Medicine, University of Basel, 4001 Basel, Switzerland
- Correspondence: (A.C.M.-G.); (B.K.W.); Tel.: +41-61-685-85-85 (A.C.M.-G. & B.K.W.)
| | - Bettina K. Wölnerhanssen
- St. Clara Research Ltd. at St. Claraspital, 4002 Basel, Switzerland; (V.B.); (F.T.); (C.B.)
- Faculty of Medicine, University of Basel, 4001 Basel, Switzerland
- Correspondence: (A.C.M.-G.); (B.K.W.); Tel.: +41-61-685-85-85 (A.C.M.-G. & B.K.W.)
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Steenackers N, Wauters L, Van der Schueren B, Augustijns P, Falony G, Koziolek M, Lannoo M, Mertens A, Meulemans A, Raes J, Vangoitsenhoven R, Vieira-Silva S, Weitschies W, Matthys C, Vanuytsel T. Effect of obesity on gastrointestinal transit, pressure and pH using a wireless motility capsule. Eur J Pharm Biopharm 2021; 167:1-8. [PMID: 34273543 DOI: 10.1016/j.ejpb.2021.07.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 06/22/2021] [Accepted: 07/07/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Despite the increasing prevalence and medical burden of obesity, the understanding of gastrointestinal physiology in obesity is scarce, which hampers drug development. AIM To investigate the effect of obesity and food intake on gastrointestinal transit, pressure and pH. MATERIAL AND METHODS An exploratory cross-sectional study using a wireless motility capsule (SmartPill©) was performed in 11 participants with obesity and 11 age- and gender-matched participants with normal weight (group) in fasted and fed state (visit). During the first visit, the capsule was ingested after an overnight fast. During a second visit, the capsule was ingested after a nutritional drink to simulate fed state. Linear mixed models were constructed to compare segmental gastrointestinal transit, pressure and pH between groups (obesity or control) and within every group (fasted or fed). RESULTS Food intake slowed gastric emptying in both groups (both P < 0.0001), though food-induced gastric contractility was higher in participants with obesity compared to controls (P = 0.02). In the small intestine, a higher contractility (P = 0.001), shorter transit (P = 0.04) and lower median pH (P = 0.002) was observed in participants with obesity compared to controls. No differences were observed for colonic measurements. CONCLUSION Obesity has a profound impact on gastrointestinal physiology, which should be taken into account for drug development.
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Affiliation(s)
- N Steenackers
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium.
| | - L Wauters
- Translational Research Center for Gastrointestinal Disorders, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium.
| | - B Van der Schueren
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium; Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium.
| | - P Augustijns
- Drug Delivery and Disposition, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium.
| | - G Falony
- Rega Institute, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium; Center for Microbiology, VIB, Leuven, Belgium.
| | - M Koziolek
- Institute of Pharmacy, Center of Drug Absorption and Transport, University of Greifswald, Greifswald, Germany.
| | - M Lannoo
- Department of Abdominal Surgery, University Hospitals Leuven, Leuven, Belgium.
| | - A Mertens
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium; Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium.
| | - A Meulemans
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium; Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium.
| | - J Raes
- Rega Institute, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium; Center for Microbiology, VIB, Leuven, Belgium.
| | - R Vangoitsenhoven
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium; Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium.
| | - S Vieira-Silva
- Rega Institute, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium; Center for Microbiology, VIB, Leuven, Belgium.
| | - W Weitschies
- Institute of Pharmacy, Center of Drug Absorption and Transport, University of Greifswald, Greifswald, Germany.
| | - C Matthys
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium; Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium.
| | - T Vanuytsel
- Translational Research Center for Gastrointestinal Disorders, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium; Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium.
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10
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Roy D, Ye A, Moughan PJ, Singh H. Impact of gastric coagulation on the kinetics of release of fat globules from milk of different species. Food Funct 2021; 12:1783-1802. [PMID: 33514994 DOI: 10.1039/d0fo02870c] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The behavior of fat globules during the gastric digestion of raw and pasteurized cow, goat, and sheep whole milks was studied using a human gastric simulator. Microstructural and physicochemical analysis revealed that, initially, the coagulation of the milks in the human gastric simulator resulted in the majority of the milk fat globules being entrapped within the curd. As the digestion progressed, the proportion of fat globules entrapped within the aggregated protein matrix (curd) decreased; there was also some flocculation as well as coalescence of the fat globules within the curd. The liberation of the entrapped fat globules from the curd to the liquid phase of the chyme was strongly dependent on the disintegration and hydrolysis of the structured casein network. Surprisingly, the fat globules released (or already present) into the liquid phase of the chyme were not as extensively coalesced as those remaining within the curd. These phenomena were observed to be similar for the raw and pasteurized whole milk of all species. The pasteurized whole milks from all species formed relatively less structured coagula compared with their raw milk counterparts, leading to a greater extent of protein breakdown and, thus, higher proportions of fat release from the pasteurized milk curds. This study provides a deeper understanding of how the curd-forming properties of different mammalian milks in the gastric environment provide controlled delivery of nutrients (such as protein and fat).
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Affiliation(s)
- Debashree Roy
- Riddet Institute, Massey University, Private Bag 11 222, Palmerston North 4442, New Zealand.
| | - Aiqian Ye
- Riddet Institute, Massey University, Private Bag 11 222, Palmerston North 4442, New Zealand.
| | - Paul J Moughan
- Riddet Institute, Massey University, Private Bag 11 222, Palmerston North 4442, New Zealand.
| | - Harjinder Singh
- Riddet Institute, Massey University, Private Bag 11 222, Palmerston North 4442, New Zealand.
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11
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Panza SB, Vargas R, Balbo SL, Bonfleur ML, Granzotto DCT, Sant'Ana DMG, Nogueira-Melo GA. Perinatal exposure to low doses of glyphosate-based herbicide combined with a high-fat diet in adulthood causes changes in the jejunums of mice. Life Sci 2021; 275:119350. [PMID: 33737081 DOI: 10.1016/j.lfs.2021.119350] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 03/05/2021] [Accepted: 03/08/2021] [Indexed: 12/12/2022]
Abstract
AIM Exposure to pesticides and consumption of high-fat diets are widespread in society. Reports have shown that exposure to glyphosate and a high-fat diet can cause gastrointestinal disorders and increase susceptibility to obesity. Thus, this study evaluated the impacts of perinatal exposure to glyphosate followed by consumption of a high-fat diet in adulthood on the histology and morphometry of jejunums and enteric nervous system of C57BL/6 mice. MATERIAL AND METHODS After mating, 20 C57BL/6 female mice were separated into a control group (CG) and a glyphosate group (GLY) that received water with 0.5% glyphosate. After the lactation period, some male offspring were randomly separated into CG-SD and GLY-SD (standard diet) groups or CG-HD and GLY-HD (high-fat diet) groups. After 12 weeks, jejunum samples were collected and submitted to histological analysis. KEY FINDINGS Indirect exposure to glyphosate changed the morphometry of the intestinal wall, increased the proportion of intraepithelial lymphocytes (IELs) and goblet cells, and altered the area occupied by collagen fibers. The hyperlipidemic diet hypertrophied the jejunal total wall, total muscular and submucosal layers, decreased IELs, and increased the proportion of goblet cells. GLY-HD mice had shallower crypts, shorter villi, and less goblet cells and IELs than mice from GLY-SD group. GLY-HD also showed an increased number of neurons in myenteric and submucosal plexuses. Groups exposed to glyphosate and/or fed a high-fat diet had atrophied submucosal neurons. SIGNIFICANCE This study suggests that perinatal glyphosate exposure combined with a high-fat diet in adulthood increases the risk of jejunum inflammation and dysfunction.
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Affiliation(s)
- S B Panza
- Biosciences and Physiopathology Program, Universidade Estadual de Maringá, Maringá, Brazil
| | - R Vargas
- Laboratory of Cellular and Molecular Biology, Universidade Estadual de Maringá, Maringá, Brazil
| | - S L Balbo
- Laboratory of Biophysics and Human Physiology, Universidade Estadual do Oeste do Paraná, Cascavel, Brazil
| | - M L Bonfleur
- Laboratory of Biophysics and Human Physiology, Universidade Estadual do Oeste do Paraná, Cascavel, Brazil
| | - D C T Granzotto
- Department of Statistics, Universidade Estadual de Maringá, Maringá, Brazil
| | - D M G Sant'Ana
- Biosciences and Physiopathology Program, Universidade Estadual de Maringá, Maringá, Brazil; Department of Morphological Sciences, Universidade Estadual de Maringá, Maringá, Brazil
| | - G A Nogueira-Melo
- Biosciences and Physiopathology Program, Universidade Estadual de Maringá, Maringá, Brazil.
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12
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Altered intestinal epithelial nutrient transport: an underappreciated factor in obesity modulated by diet and microbiota. Biochem J 2021; 478:975-995. [PMID: 33661278 DOI: 10.1042/bcj20200902] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 02/03/2021] [Accepted: 02/05/2021] [Indexed: 12/31/2022]
Abstract
Dietary nutrients absorbed in the proximal small intestine and assimilated in different tissues have a profound effect on overall energy homeostasis, determined by a balance between body's energy intake and expenditure. In obesity, altered intestinal absorption and consequently tissue assimilation of nutrients may disturb the energy balance leading to metabolic abnormalities at the cellular level. The absorption of nutrients such as sugars, amino acids and fatty acids released from food digestion require high-capacity transporter proteins expressed in the intestinal epithelial absorptive cells. Furthermore, nutrient sensing by specific transporters/receptors expressed in the epithelial enteroendocrine cells triggers release of gut hormones involved in regulating energy homeostasis via their effects on appetite and food intake. Therefore, the intestinal epithelial cells play a pivotal role in the pathophysiology of obesity and associated complications. Over the past decade, gut microbiota has emerged as a key factor contributing to obesity via its effects on digestion and absorption of nutrients in the small intestine, and energy harvest from dietary fiber, undigested component of food, in the large intestine. Various mechanisms of microbiota effects on obesity have been implicated. However, the impact of obesity-associated microbiota on the intestinal nutrient transporters needs extensive investigation. This review marshals the limited studies addressing the altered structure and function of the gut epithelium in obesity with special emphasis on nutrient transporters and role of diet and microbiota. The review also discusses the thoughts and controversies and research gaps in this field.
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13
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Roy D, Ye A, Moughan PJ, Singh H. Structural changes in cow, goat, and sheep skim milk during dynamic in vitro gastric digestion. J Dairy Sci 2020; 104:1394-1411. [PMID: 33309366 DOI: 10.3168/jds.2020-18779] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 09/18/2020] [Indexed: 11/19/2022]
Abstract
Coagulation of milk in the stomach is the first crucial step in its digestion. Using a human gastric simulator, the dynamic gastric digestion of goat and sheep skim milk were compared with that of cow skim milk, focusing particularly on their physical characteristics. The gastric contents were analyzed for changes in dry matter and microstructure, and the extent of protein digestion. The study revealed that the skim milk from all species formed a curd within the first 15 min of gastric digestion, at which time the pH was ~6.1 to 6.3. Compared with cow skim milk, the dry matter contents of the clots formed from goat and sheep skim milk were lower and higher, respectively, which was due to the differences in their total solids and protein contents. Microstructural analysis showed that, as digestion progressed, the clot structure became more cohesive, along with a decrease in moisture content, which in turn affected the breakdown and hydrolysis of caseins by pepsin; this phenomenon was similar for milk from all species. However, the extent of moisture retained in the sheep skim milk clot appeared to be lower than those of the cow and goat skim milk clots. In addition, the relative firmness of the sheep milk clot was higher than those of the cow and goat milk clots at the end of gastric digestion. The pattern of protein hydrolysis by pepsin was similar for the milk of all species, despite the differences in the proportions of different proteins. The study provided insight into the coagulation kinetics of goat and sheep skim milk under in vitro gastric digestion conditions.
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Affiliation(s)
- Debashree Roy
- Riddet Institute, Massey University, Private Bag 11 222, Palmerston North 4442, New Zealand
| | - Aiqian Ye
- Riddet Institute, Massey University, Private Bag 11 222, Palmerston North 4442, New Zealand
| | - Paul J Moughan
- Riddet Institute, Massey University, Private Bag 11 222, Palmerston North 4442, New Zealand
| | - Harjinder Singh
- Riddet Institute, Massey University, Private Bag 11 222, Palmerston North 4442, New Zealand.
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14
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Dupont G, Bordes SJ, Lachkar S, Wahl L, Iwanaga J, Loukas M, Tubbs RS. The effects of obesity on the human body part III: Cardiovascular, digestive, excretory, endocrine, and reproductive. Clin Anat 2020; 34:307-311. [PMID: 33170983 DOI: 10.1002/ca.23700] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 10/15/2020] [Accepted: 11/02/2020] [Indexed: 11/06/2022]
Abstract
This third installment of The Effects of Obesity on the Human Body discusses the endocrine, digestive, reproductive, cardiovascular, and excretory systems. Obesity is known to upset hormonal balance, leading to widespread metabolic disorders involving organs such as the liver and pancreas. Furthermore, the hypersecretion of leptin from adipose tissue triggers various responses from the cardiovascular and gastrointestinal systems, with implications for energy and nutrient balance and uptake.
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Affiliation(s)
- Graham Dupont
- Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Stephen J Bordes
- Department of Anatomical Sciences, St. George's University School of Medicine, St. George's, Grenada
| | | | - Lauren Wahl
- Department of Cell and Developmental Biology, University of Colorado, Boulder, Colorado, USA
| | - Joe Iwanaga
- Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Fukuoka, Japan.,Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Marios Loukas
- Department of Anatomical Sciences, St. George's University School of Medicine, St. George's, Grenada.,Department of Anatomy, University of Warmia and Mazury, Olsztyn, Poland
| | - R Shane Tubbs
- Department of Anatomical Sciences, St. George's University School of Medicine, St. George's, Grenada.,Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA.,Department of Neurology, Tulane University School of Medicine, New Orleans, Louisiana, USA.,Department of Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, Louisiana, USA
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15
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Ramanadhan S, Jusko WJ, Edelman A. Pharmacokinetics of Hormonal Contraception in Individuals with Obesity: a Review. CURRENT OBSTETRICS AND GYNECOLOGY REPORTS 2020; 9:72-78. [PMID: 33117601 DOI: 10.1007/s13669-020-00284-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose of Review Obesity continues to affect many women globally. In the USA, almost 40% of all women are obese and many of these women use hormonal contraception for pregnancy prevention. How well hormonal contraceptive works for these individuals has been an area of ongoing research. Pharmacokinetics (PK), the study of drug passage through the body, can shed light on how differences in physiology between obese and non-obese populations can impact drug disposition and subsequent efficacy. This review aims to reflect on these types of studies and empower clinicians with information to help tackle the challenges of the obesity epidemic and help them provide the best contraceptive options to their patients. Here, we present the basics of the mechanisms of action of hormonal contraception, fundamental pharmacokinetic principles, and the latest research into pharmacokinetics, obesity, and hormonal contraception. Recent Findings New studies focused on the PK of hormonal contraception in women with obesity have shown that while there are distinct differences in how steroid hormones are processed in women with different body mass indices, contraceptive efficacy is likely the same. This is replicated in studies involving a variety of hormonal contraceptive methods. Summary PK studies allow for a detailed analysis of steroid hormone processing in individuals with obesity. Observing PK parameters at each stage of the passage of these hormones through the body, researchers have drilled down on physiologic differences that accompany obesity. In reviewing these PK parameter differences, however, it appears that while processes are different, the end result of pregnancy prevention is likely not compromised in the setting of obesity. Emergency contraception, which functions by a different mechanism from that of continuous hormonal contraception, is the one area in which obesity has been demonstrated to impact efficacy.
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Affiliation(s)
| | - William J Jusko
- WJJ Department of Pharmaceutical Sciences, University at Buffalo, Buffalo, NY 14214, USA
| | - Alison Edelman
- Oregon Health & Science University, Portland, OR 97239, USA
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16
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Ramne S, Gray N, Hellstrand S, Brunkwall L, Enhörning S, Nilsson PM, Engström G, Orho-Melander M, Ericson U, Kuhnle GGC, Sonestedt E. Comparing Self-Reported Sugar Intake With the Sucrose and Fructose Biomarker From Overnight Urine Samples in Relation to Cardiometabolic Risk Factors. Front Nutr 2020; 7:62. [PMID: 32435652 PMCID: PMC7218081 DOI: 10.3389/fnut.2020.00062] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 04/17/2020] [Indexed: 11/17/2022] Open
Abstract
Studies on sugar intake and its link to cardiometabolic risk show inconsistent results, partly due to dietary misreporting. Cost-effective and easily measured nutritional biomarkers that can complement dietary data are warranted. Measurement of 24-h urinary sugars is a biomarker of sugar intake, but there are knowledge gaps regarding the use of overnight urine samples. We aim to compare (1) overnight urinary sucrose and fructose measured with liquid chromatography-tandem mass spectrometry, (2) self-reported sugar intake measured with web-based 4-day food records, (3) their composite measure, and (4) these different measures' (1–3) cross-sectional associations with cardiometabolic risk factors in 991 adults in the Malmö Offspring Study (18–69 years, 54% women). The correlations between the reported intakes of total sugar, added sugar and sucrose was higher for urinary sucrose than fructose, and the correlations for the sum or urinary sucrose and fructose (U-sugars) varied between r≈0.2–0.3 (P < 0.01) in men and women. Differences in the direction of associations were observed for some cardiometabolic risk factors between U-sugars and reported added sugar intake, as well as between the sexes. In women, U-sugars, but not reported added sugar intake, were positively associated with systolic and diastolic blood pressure and fasting glucose. Both U-sugars and added sugar were positively associated with BMI and waist circumference in women, whereas among men, U-sugars were negatively associated with BMI and waist circumference, and no association was observed for added sugar. The composite measure of added sugars and U-sugars was positively associated with BMI, waist circumference and systolic blood pressure and negatively associated with HDL cholesterol in women (P < 0.05). Conclusively, we demonstrate statistically significant, but not very high, correlations between reported sugar intakes and U-sugars. Results indicate that overnight urinary sugars may be used as a complement to self-reported dietary data when investigating associations between sugar exposure and cardiometabolic risk. However, future studies are highly needed to validate the overnight urinary sugars as a biomarker because its use, instead of 24-h urine, facilitates data collection.
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Affiliation(s)
- Stina Ramne
- Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Malmö, Sweden
| | - Nicola Gray
- Department of Food and Nutritional Sciences, School of Chemistry, Food and Pharmacy, University of Reading, Reading, United Kingdom
| | - Sophie Hellstrand
- Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Malmö, Sweden
| | - Louise Brunkwall
- Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Malmö, Sweden
| | - Sofia Enhörning
- Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Malmö, Sweden.,Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden
| | - Peter M Nilsson
- Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Malmö, Sweden
| | - Gunnar Engström
- Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Malmö, Sweden
| | - Marju Orho-Melander
- Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Malmö, Sweden
| | - Ulrika Ericson
- Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Malmö, Sweden
| | - Gunter G C Kuhnle
- Department of Food and Nutritional Sciences, School of Chemistry, Food and Pharmacy, University of Reading, Reading, United Kingdom
| | - Emily Sonestedt
- Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Malmö, Sweden
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17
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Stillhart C, Vučićević K, Augustijns P, Basit AW, Batchelor H, Flanagan TR, Gesquiere I, Greupink R, Keszthelyi D, Koskinen M, Madla CM, Matthys C, Miljuš G, Mooij MG, Parrott N, Ungell AL, de Wildt SN, Orlu M, Klein S, Müllertz A. Impact of gastrointestinal physiology on drug absorption in special populations––An UNGAP review. Eur J Pharm Sci 2020; 147:105280. [DOI: 10.1016/j.ejps.2020.105280] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 02/10/2020] [Accepted: 02/24/2020] [Indexed: 02/07/2023]
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18
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Mulet-Cabero AI, Egger L, Portmann R, Ménard O, Marze S, Minekus M, Le Feunteun S, Sarkar A, Grundy MML, Carrière F, Golding M, Dupont D, Recio I, Brodkorb A, Mackie A. A standardised semi-dynamic in vitro digestion method suitable for food – an international consensus. Food Funct 2020; 11:1702-1720. [DOI: 10.1039/c9fo01293a] [Citation(s) in RCA: 134] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Standardised recommendations for a physiologically relevant, semi-dynamic in vitro simulation of upper GI tract digestion.
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Affiliation(s)
| | | | | | | | | | | | | | - Anwesha Sarkar
- School of Food Science & Nutrition
- University of Leeds
- Leeds
- UK
| | - Myriam M.-L. Grundy
- University of Reading
- School of Agriculture
- Policy and Development
- Reading RG6 6AR
- UK
| | - Frédéric Carrière
- Aix-Marseille Université
- CNRS
- UMR7281 Bioénergétique et Ingénierie des Protéines
- 13402 Marseille cedex 09
- France
| | - Matt Golding
- School of Food and Nutrition
- Massey University
- Palmerston North
- New Zealand
| | | | - Isidra Recio
- Instituto de Investigación en Ciencias de la Alimentación (CIAL
- CSIC-UAM)
- 28049 Madrid
- Spain
| | | | - Alan Mackie
- School of Food Science & Nutrition
- University of Leeds
- Leeds
- UK
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19
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Effects of Sucralose Ingestion versus Sucralose Taste on Metabolic Responses to an Oral Glucose Tolerance Test in Participants with Normal Weight and Obesity: A Randomized Crossover Trial. Nutrients 2019; 12:nu12010029. [PMID: 31877631 PMCID: PMC7019725 DOI: 10.3390/nu12010029] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 12/16/2019] [Accepted: 12/18/2019] [Indexed: 11/17/2022] Open
Abstract
Here, we tested the hypothesis that sucralose differentially affects metabolic responses to labeled oral glucose tolerance tests (OGTTs) in participants with normal weight and obesity. Participants (10 with normal weight and 11 with obesity) without diabetes underwent three dual-tracer OGTTs preceded, in a randomized order, by consuming sucralose or water, or by tasting and expectorating sucralose (e.g., sham-fed; sweetness control). Indices of β-cell function and insulin sensitivity (SI) were estimated using oral minimal models of glucose, insulin, and C-peptide kinetics. Compared with water, sucralose ingested (but not sham-fed) resulted in a 30 ± 10% increased glucose area under the curve in both weight groups. In contrast, the insulin response to sucralose ingestion differed depending on the presence of obesity: decreased within 20–40 min of the OGTT in normal-weight participants but increased within 90–120 min in participants with obesity. Sham-fed sucralose similarly decreased insulin concentrations within 60 min of the OGTT in both weight groups. Sucralose ingested (but not sham-fed) increased SI in normal-weight participants by 52 ± 20% but did not affect SI in participants with obesity. Sucralose did not affect glucose rates of appearance or β-cell function in either weight group. Our data underscore a physiological role for taste perception in postprandial glucose responses, suggesting sweeteners should be consumed in moderation.
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20
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Gastrointestinal Sensing of Meal-Related Signals in Humans, and Dysregulations in Eating-Related Disorders. Nutrients 2019; 11:nu11061298. [PMID: 31181734 PMCID: PMC6627312 DOI: 10.3390/nu11061298] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 05/29/2019] [Accepted: 06/05/2019] [Indexed: 12/13/2022] Open
Abstract
The upper gastrointestinal (GI) tract plays a critical role in sensing the arrival of a meal, including its volume as well as nutrient and non-nutrient contents. The presence of the meal in the stomach generates a mechanical distension signal, and, as gastric emptying progresses, nutrients increasingly interact with receptors on enteroendocrine cells, triggering the release of gut hormones, with lipid and protein being particularly potent. Collectively, these signals are transmitted to the brain to regulate appetite and energy intake, or in a feedback loop relayed back to the upper GI tract to further adjust GI functions, including gastric emptying. The research in this area to date has provided important insights into how sensing of intraluminal meal-related stimuli acutely regulates appetite and energy intake in humans. However, disturbances in the detection of these stimuli have been described in a number of eating-related disorders. This paper will review the GI sensing of meal-related stimuli and the relationship with appetite and energy intake, and examine changes in GI responses to luminal stimuli in obesity, functional dyspepsia and anorexia of ageing, as examples of eating-related disorders. A much better understanding of the mechanisms underlying these dysregulations is still required to assist in the development of effective management and treatment strategies in the future.
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21
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Wan X, Yin J, Chen J. Characteristics of Intestinal Myoelectrical and Motor Activities in Diet-Induced Obese Rats: Obesity and Motility. Dig Dis Sci 2019; 64:1478-1485. [PMID: 30659469 DOI: 10.1007/s10620-019-5458-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Accepted: 01/08/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Gastrointestinal motility has been reported to be altered in obesity. However, it is unknown whether intestinal myoelectrical activity (IMA) is also changed in obesity. AIMS The aim of this study was to characterize intestinal myoelectrical and motility activities in the fasting state, during feeding, and postprandial state after various test meals in diet-induced obese (DIO) rats in comparison with regular rats. METHODS IMA was recorded in the fasting, feeding, and postprandial states in DIO and regular rats. Regular laboratory chow, high-fat solid food, and high-fat liquid food were used to test IMA responses to different meals. RESULTS (1) The intestinal slow waves in the DIO rats were not different from those in normal rats in the fasting or postprandial state. Neither intestinal transit nor the number of intestinal contractions per minute was altered in DIO rats although gastric emptying was accelerated. (2) Both DIO rats and normal rats showed altered IMA during the first minute of feeding (cephalic stimulation). (3) The intestinal slow waves in both DIO rats and regular rats were impaired slightly but significantly after intake of a high-fat meal. CONCLUSIONS Our study demonstrates that intestinal myoelectrical activity is not altered in DIO rats and its postprandial responses to various meals are not altered either. High-fat meals induce intestinal dysrhythmia but do not have a chronic impact on intestinal slow waves in DIO rats.
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Affiliation(s)
- Xinyue Wan
- Veterans Research and Education Foundation, VA Medical Center, Oklahoma City, OK, USA.,Division of Gastroenterology, Wuhan University, Renmin Hospital, Wuhan, China
| | - Jieyun Yin
- Veterans Research and Education Foundation, VA Medical Center, Oklahoma City, OK, USA.,Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD, 21224, USA
| | - Jiande Chen
- Veterans Research and Education Foundation, VA Medical Center, Oklahoma City, OK, USA. .,Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD, 21224, USA.
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22
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van der Beek CM, Canfora EE, Kip AM, Gorissen SHM, Olde Damink SWM, van Eijk HM, Holst JJ, Blaak EE, Dejong CHC, Lenaerts K. The prebiotic inulin improves substrate metabolism and promotes short-chain fatty acid production in overweight to obese men. Metabolism 2018; 87:25-35. [PMID: 29953876 DOI: 10.1016/j.metabol.2018.06.009] [Citation(s) in RCA: 138] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 06/07/2018] [Accepted: 06/24/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND AIMS Human gut microbiota play an important role in maintaining human health. Dietary fibers, i.e. prebiotics, are fermented by human gut microbiota into the short-chain fatty acids (SCFAs) acetate, propionate, and butyrate. SCFAs promote fat oxidation and improve metabolic health. Therefore, the prebiotic inulin might be an effective dietary strategy to improve human metabolism. We aimed to investigate the acute metabolic effects of ingesting inulin compared with digestible carbohydrates and to trace inulin-derived SCFAs using stable isotope tracer methodology. METHODS In a double-blind, randomized, placebo-controlled crossover design, 14 healthy, overweight to obese men consumed a high-fat milkshake containing A) 24 g inulin of which 0.5 g was U-13C-inulin (INU) or B) 24 g maltodextrin placebo (PLA), with a wash-out period of at least five days. Fat oxidation was measured via an open-circuit ventilated hood and blood samples were collected up to 7 h after ingestion. Plasma, breath, and fecal samples were collected, and appetite and satiety scores were assessed. RESULTS Fat oxidation increased in the early postprandial phase (0-3 h), and both plasma glucose and insulin were lower after INU ingestion compared with PLA (all P < 0.05). Plasma free fatty acids were higher in the early, and lower in the late postprandial period after INU ingestion. Inulin was fermented into SCFAs as indicated by higher plasma acetate concentrations after INU compared with PLA (P < 0.05). In addition, we found continuous increases in plasma 13C-SCFA enrichments (P < 0.05 from t = 120 onwards) and breath 13CO2 enrichments after INU intake. There were no effects on plasma triglycerides, free glycerol, satiety hormones GLP-1 and PYY, and appetite and satiety scores. CONCLUSIONS Ingestion of the prebiotic inulin improves fat oxidation and promotes SCFA production in overweight to obese men. Overall, replacing digestible carbohydrates with the fermentable inulin may favor human substrate metabolism. CLINICAL TRIAL REGISTRY The trial was registered at clinicaltrials.gov under number NCT02009670.
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Affiliation(s)
- Christina M van der Beek
- Top Institute Food and Nutrition, Wageningen, the Netherlands; Department of Surgery, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Universiteitssingel 50, 6229 ER Maastricht, the Netherlands.
| | - Emanuel E Canfora
- Top Institute Food and Nutrition, Wageningen, the Netherlands; Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Universiteitssingel 50, 6229 ER Maastricht, the Netherlands.
| | - Anna M Kip
- Department of Surgery, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Universiteitssingel 50, 6229 ER Maastricht, the Netherlands.
| | - Stefan H M Gorissen
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Universiteitssingel 50, 6229 ER Maastricht, the Netherlands.
| | - Steven W M Olde Damink
- Department of Surgery, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Universiteitssingel 50, 6229 ER Maastricht, the Netherlands; Department of HPB Surgery and Liver Transplantation, Institute of Liver and Digestive Health, University College London, Rowland Hill Street, London NW3 2PF, United Kingdom.
| | - Hans M van Eijk
- Department of Surgery, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Universiteitssingel 50, 6229 ER Maastricht, the Netherlands.
| | - Jens J Holst
- NNF Center for Basic Metabolic Research, Copenhagen, Blegdamsvej 3A, Copenhagen 2200, Denmark; Department of Biomedical Sciences, University of Copenhagen, Nørregade 10, 1165 Copenhagen, Denmark.
| | - Ellen E Blaak
- Top Institute Food and Nutrition, Wageningen, the Netherlands; Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Universiteitssingel 50, 6229 ER Maastricht, the Netherlands.
| | - Cornelis H C Dejong
- Top Institute Food and Nutrition, Wageningen, the Netherlands; Department of Surgery, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Universiteitssingel 50, 6229 ER Maastricht, the Netherlands; Department of Surgery, Universitätsklinikum Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.
| | - Kaatje Lenaerts
- Top Institute Food and Nutrition, Wageningen, the Netherlands; Department of Surgery, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Universiteitssingel 50, 6229 ER Maastricht, the Netherlands.
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Nguyen NQ, Debreceni TL, Burgess JE, Bellon M, Wishart J, Standfield S, Malbert CH, Horowitz M. Impact of gastric emptying and small intestinal transit on blood glucose, intestinal hormones, glucose absorption in the morbidly obese. Int J Obes (Lond) 2018; 42:1556-1564. [PMID: 29453463 DOI: 10.1038/s41366-018-0012-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 11/06/2017] [Accepted: 11/27/2017] [Indexed: 02/07/2023]
Abstract
This study evaluated gastric emptying (GE) and small intestinal (SI) transit in people with morbid obesity and their relationships to glycaemia, incretin hormones, and glucose absorption METHODS: GE and caecal arrival time (CAT) of a mixed meal were assessed in 22 morbidly obese (50.2 ± 2.5 years; 13 F:9 M; BMI: 48.6 ± 1.8 kg/m2) and 10 lean (38.6 ± 8.4 years; 5 F:5 M; BMI: 23.9 ± 0.7 kg/m2) subjects, using scintigraphy. Blood glucose, plasma 3-O-methylglucose, insulin, glucagon, glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) were measured. Insulin sensitivity and resistance were also quantified RESULTS: When compared with lean subjects, GE (t50: 60.7 ± 6.5 vs. 41.1 ± 7.3 min; P = 0.04) and CAT (221.5 ± 9.8 vs. 148.0 ± 7.1 min; P = 0.001) of solids were prolonged in morbid obesity. Postprandial rises in GIP (P = 0.001), insulin (P = 0.02), glucose (P = 0.03) and 3-O-methylglucose (P = 0.001) were less. Whereas GLP-1 increased at 45 mins post-prandially in lean subjects, there was no increase in the obese (P = 0.04). Both fasting (P = 0.045) and postprandial (P = 0.012) plasma glucagon concentrations were higher in the obese CONCLUSIONS: GE and SI transit are slower in the morbidly obese, and associated with reductions in postprandial glucose absorption, and glycaemic excursions, as well as plasma GIP and GLP-1.
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Affiliation(s)
- Nam Q Nguyen
- Department of Gastroenterology and Hepatology, Level 7, Royal Adelaide Hospital, North Terrace, Adelaide, SA, 5000, Australia.
- Discipline of Medicine, University of Adelaide, Royal Adelaide Hospital, Level 6 Eleanor Harrold Building, North Terrace, Adelaide, SA, 5000, Australia.
| | - Tamara L Debreceni
- Department of Gastroenterology and Hepatology, Level 7, Royal Adelaide Hospital, North Terrace, Adelaide, SA, 5000, Australia
| | - Jenna E Burgess
- Department of Gastroenterology and Hepatology, Level 7, Royal Adelaide Hospital, North Terrace, Adelaide, SA, 5000, Australia
| | - Max Bellon
- Nuclear Medicine, PET and Bone Densitometry, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Judith Wishart
- Discipline of Medicine, University of Adelaide, Royal Adelaide Hospital, Level 6 Eleanor Harrold Building, North Terrace, Adelaide, SA, 5000, Australia
| | - Scott Standfield
- Discipline of Medicine, University of Adelaide, Royal Adelaide Hospital, Level 6 Eleanor Harrold Building, North Terrace, Adelaide, SA, 5000, Australia
| | | | - Michael Horowitz
- Discipline of Medicine, University of Adelaide, Royal Adelaide Hospital, Level 6 Eleanor Harrold Building, North Terrace, Adelaide, SA, 5000, Australia
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Müller M, Canfora EE, Blaak EE. Gastrointestinal Transit Time, Glucose Homeostasis and Metabolic Health: Modulation by Dietary Fibers. Nutrients 2018; 10:nu10030275. [PMID: 29495569 PMCID: PMC5872693 DOI: 10.3390/nu10030275] [Citation(s) in RCA: 160] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 02/16/2018] [Accepted: 02/26/2018] [Indexed: 12/19/2022] Open
Abstract
Gastrointestinal transit time may be an important determinant of glucose homeostasis and metabolic health through effects on nutrient absorption and microbial composition, among other mechanisms. Modulation of gastrointestinal transit may be one of the mechanisms underlying the beneficial health effects of dietary fibers. These effects include improved glucose homeostasis and a reduced risk of developing metabolic diseases such as obesity and type 2 diabetes mellitus. In this review, we first discuss the regulation of gastric emptying rate, small intestinal transit and colonic transit as well as their relation to glucose homeostasis and metabolic health. Subsequently, we briefly address the reported health effects of different dietary fibers and discuss to what extent the fiber-induced health benefits may be mediated through modulation of gastrointestinal transit.
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Affiliation(s)
- Mattea Müller
- Department of Human Biology, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Universiteitssingel 50, 6229 ER, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
| | - Emanuel E Canfora
- Department of Human Biology, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Universiteitssingel 50, 6229 ER, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
| | - Ellen E Blaak
- Department of Human Biology, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Universiteitssingel 50, 6229 ER, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
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Schacht S, Masood F, Catmull S, Dolan R, Altabtabaee R, Grow W, Al-Nakkash L. Dietary Genistein Influences Number of Acetylcholine Receptors in Female Diabetic Jejunum. J Diabetes Res 2017; 2017:3568146. [PMID: 28835900 PMCID: PMC5556993 DOI: 10.1155/2017/3568146] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Accepted: 07/17/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Intestinal dysfunction in the ob/ob mouse model of diabetes mimics that seen clinically. METHODS We determined the effects of a 4-week genistein diet (600 mg genistein/kg food) on intestinal function (contractility, morphology, AChR, and motility) in female ob/ob and lean mice. RESULTS Contractility of the jejunum in response to incrementally increasing concentrations of KCl was comparable in ob/ob females and lean controls regardless of a genistein-diet. There were no changes in the wall thickness measured. We assessed the number of clusters of AChR in the jejunum wall; AChR were decreased by 48% in ob/ob mice versus leans, and the genistein diet reversed this. In utilizing a video-imaging system to evaluate gastrointestinal motility, we determined that the distance between consecutive contractile events was significantly increased by 1.87-fold in ob/ob mice versus leans, and the genistein diet was without effect. CONCLUSIONS These data suggest that slowed intestinal transit in the diabetic ob/ob mouse may be due in part to decreased AChR and decreased contraction events occurring per unit time. A genistein diet rescues the number of AChR to levels of leans yet did not change the number of contractile events. Feeding ob/ob mice a genistein-rich diet has potential therapeutic benefits towards improving the debilitating diabetes-related gastrointestinal dysfunction.
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Affiliation(s)
- Sydney Schacht
- Department of Physiology, Midwestern University, 19555 N. 59th Avenue, Glendale, AZ 85308, USA
| | - Faisal Masood
- Department of Physiology, Midwestern University, 19555 N. 59th Avenue, Glendale, AZ 85308, USA
| | - Shawn Catmull
- Department of Physiology, Midwestern University, 19555 N. 59th Avenue, Glendale, AZ 85308, USA
| | - Robert Dolan
- Department of Physiology, Midwestern University, 19555 N. 59th Avenue, Glendale, AZ 85308, USA
| | - RussL Altabtabaee
- Department of Physiology, Midwestern University, 19555 N. 59th Avenue, Glendale, AZ 85308, USA
| | - Wade Grow
- Department of Anatomy, Arizona College of Osteopathic Medicine, Midwestern University, 19555 N. 59th Avenue, Glendale, AZ 85308, USA
| | - Layla Al-Nakkash
- Department of Physiology, Midwestern University, 19555 N. 59th Avenue, Glendale, AZ 85308, USA
- *Layla Al-Nakkash:
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Shearer J, Swithers SE. Artificial sweeteners and metabolic dysregulation: Lessons learned from agriculture and the laboratory. Rev Endocr Metab Disord 2016; 17:179-86. [PMID: 27387506 DOI: 10.1007/s11154-016-9372-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Escalating rates of obesity and public health messages to reduce excessive sugar intake have fuelled the consumption of artificial sweeteners in a wide range of products from breakfast cereals to snack foods and beverages. Artificial sweeteners impart a sweet taste without the associated energy and have been widely recommended by medical professionals since they are considered safe. However, associations observed in long-term prospective studies raise the concern that regular consumption of artificial sweeteners might actually contribute to development of metabolic derangements that lead to obesity, type 2 diabetes and cardiovascular disease. Obtaining mechanistic data on artificial sweetener use in humans in relation to metabolic dysfunction is difficult due to the long time frames over which dietary factors might exert their effects on health and the large number of confounding variables that need to be considered. Thus, mechanistic data from animal models can be highly useful because they permit greater experimental control. Results from animal studies in both the agricultural sector and the laboratory indicate that artificial sweeteners may not only promote food intake and weight gain but can also induce metabolic alterations in a wide range of animal species. As a result, simple substitution of artificial sweeteners for sugars in humans may not produce the intended consequences. Instead consumption of artificial sweeteners might contribute to increases in risks for obesity or its attendant negative health outcomes. As a result, it is critical that the impacts of artificial sweeteners on health and disease continue to be more thoroughly evaluated in humans.
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Affiliation(s)
- Jane Shearer
- Faculty of Kinesiology, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada
| | - Susan E Swithers
- Department of Psychological Sciences, Purdue University, 703 Third Street, West Lafayette, IN, 47907, USA.
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France M, Skorich E, Kadrofske M, Swain GM, Galligan JJ. Sex-related differences in small intestinal transit and serotonin dynamics in high-fat-diet-induced obesity in mice. Exp Physiol 2015; 101:81-99. [PMID: 26381722 DOI: 10.1113/ep085427] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Accepted: 09/15/2015] [Indexed: 12/17/2022]
Abstract
Obesity alters gastrointestinal (GI) motility and 5-HT signalling. Altered 5-HT signalling disrupts control of GI motility. Levels of extracellular 5-HT depend on enterochromaffin (EC) cell release and serotonin transporter (SERT) uptake. We assessed GI transit and 5-HT signalling in the jejunum of normal and obese mice. Male and female mice were fed a control diet (CD; 10% of kilocalories as fat) or a high-fat diet (HFD; 60% of kilocalories as fat). Gastrointestinal transit was increased in male HFD-fed and female CD-fed compared with male CD-fed mice. The 5-HT3 receptor blocker, alosetron, increased gastric emptying in male CD-fed mice, but decreased transit in female CD-fed mice. The 5-HT-induced jejunal longitudinal muscle contractions in vitro were similar in all mice. In contrast to male CD-fed mice, 5-HT uptake (measured using continuous amperometry in vitro) in male HFD-fed mice was fluoxetine insensitive, yet sensitive to cocaine and the dopamine transporter (DAT) blocker GBR 12909. Immunoreactivity for DAT was present in the mucosa, and protein levels were greater in male HFD-fed compared with CD-fed mice. Extracellular 5-HT and mucosal 5-hydroxyindolacetic acid (5-HT metabolite) were similar in male HFD-fed compared with CD-fed mice. 5-Hydroxytryptamine uptake was fluoxetine sensitive in all females. Greater SERT protein, decreased extracellular 5-HT and greater mucosal 5-hydroxyindolacetic acid were observed in female HFD-fed compared with CD-fed mice. Mucosal 5-HT and EC cell numbers were similar in CD-fed and HFD-fed mice of both sexes; female 5-HT and EC cell numbers were increased compared with males. The HFD did not alter plasma sex hormone levels in any mice. Overall, obesity alters GI transit and 5-HT signalling in a sex-dependent manner.
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Affiliation(s)
- Marion France
- Neuroscience Program, Michigan State University, East Lansing, MI, USA
| | - Emmalee Skorich
- Neuroscience Program, Michigan State University, East Lansing, MI, USA
| | - Mark Kadrofske
- Department of Pediatrics and Human Development, Michigan State University, East Lansing, MI, USA
| | - Greg M Swain
- Neuroscience Program, Michigan State University, East Lansing, MI, USA.,Department of Chemistry, Michigan State University, East Lansing, MI, USA
| | - James J Galligan
- Neuroscience Program, Michigan State University, East Lansing, MI, USA.,Department of Pharmacology & Toxicology, Michigan State University, East Lansing, MI, USA
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Knibbe CAJ, Brill MJE, van Rongen A, Diepstraten J, van der Graaf PH, Danhof M. Drug disposition in obesity: toward evidence-based dosing. Annu Rev Pharmacol Toxicol 2015; 55:149-67. [PMID: 25340929 DOI: 10.1146/annurev-pharmtox-010814-124354] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Obesity and morbid obesity are associated with many physiological changes affecting pharmacokinetics, such as increased blood volume, cardiac output, splanchnic blood flow, and hepatic blood flow. In obesity, drug absorption appears unaltered, although recent evidence suggests that this conclusion may be premature. Volume of distribution may vary largely, but the magnitude and direction of changes seem difficult to predict, with extrapolation on the basis of total body weight being the best approach to date. Changes in clearance may be smaller than in distribution, whereas there is growing evidence that the influence of obesity on clearance can be predicted on the basis of reported changes in the metabolic or elimination pathways involved. For obese children, we propose two methods to distinguish between developmental and obesity-related changes. Future research should focus on the characterization of physiological concepts to predict the optimal dose for each drug in the obese population.
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Affiliation(s)
- Catherijne A J Knibbe
- Division of Pharmacology, Leiden Academic Centre for Drug Research, Leiden University, 2333 CC Leiden, The Netherlands;
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Blaslov K, Bulum T, Zibar K, Duvnjak L. Relationship between metabolic syndrome and meal-induced glucagon like peptide-1 response in type 1 diabetic patients1-1. J Diabetes 2015; 7:340-6. [PMID: 25042812 DOI: 10.1111/1753-0407.12194] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Revised: 06/03/2014] [Accepted: 06/25/2014] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Metabolic syndrome (MS) is found in approximately% 30-40% of patients with type 1 diabetes mellitus (T1DM). Meal-induced glucagon-like peptide-1 (GLP-1) secretion in T1DM patients with MS is yet to be clarified. The aim of the present study was to analyse the relationship between total fasting GLP-1 concentrations and the meal-induced GLP-1 response with MS prevalence in T1DM patients compared with lean, normal glucose tolerance (NGT), control subjects. METHODS The study included 77 T1DM patients (61% male), 26 (34%) with MS, who had a mean age of 45.08 years, mean body mass index (BMI) of 25.42 kg/m(2) , and median diabetes duration of 21 years. Ten age-, gender, and BMI-matched NGT control subjects were also included in the study. Circulating GLP-1 concentrations ere measured before and 30 min after a meal by ELISA. The difference between the 30-min postprandial and fasting GLP-1 concentration (ΔGLP-1) was calculated by subtracting fasting GLP-1 concentrations from postprandial GLP-1 concentrations. RESULTS The NGT group had significantly higher total fasting, postprandial, and meal-induced GLP-1 concentrations than the T1DM groups. The T1DM patients without MS had a higher increase in circulating GLP-1 concentrations compared with the T1DM group with MS. After adjustment for age, gender, disease duration, and meal caloric value, GLP-1 response levels were inversely correlated with MS prevalence in binary logistic regression analysis. CONCLUSION A higher meal-induced GLP-1 response is associated with lower MS prevalence, but whether GLP-1 has a protective role in MS development is yet to be determined. This may provide further insight into the implementation of GLP-1-based therapies in the T1DM population.
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Affiliation(s)
- Kristina Blaslov
- Vuk Vrhovac Clinic for Diabetes, Endocrinology and Metabolic Diseases, University Hospital Merkur, University of Zagreb, School of Medicine, Zagreb, Croatia
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Janssens PLHR, Hursel R, Westerterp-Plantenga MS. Long-term green tea extract supplementation does not affect fat absorption, resting energy expenditure, and body composition in adults. J Nutr 2015; 145:864-70. [PMID: 25740906 DOI: 10.3945/jn.114.207829] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 02/12/2015] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Green tea (GT) extract may play a role in body weight regulation. Suggested mechanisms are decreased fat absorption and increased energy expenditure. OBJECTIVE We examined whether GT supplementation for 12 wk has beneficial effects on weight control via a reduction in dietary lipid absorption as well as an increase in resting energy expenditure (REE). METHODS Sixty Caucasian men and women [BMI (in kg/m²): 18-25 or >25; age: 18-50 y] were included in a randomized placebo-controlled study in which fecal energy content (FEC), fecal fat content (FFC), resting energy expenditure, respiratory quotient (RQ), body composition, and physical activity were measured twice (baseline vs. week 12). For 12 wk, subjects consumed either GT (>0.56 g/d epigallocatechin gallate + 0.28-0.45 g/d caffeine) or placebo capsules. Before the measurements, subjects recorded energy intake for 4 consecutive days and collected feces for 3 consecutive days. RESULTS No significant differences between groups and no significant changes over time were observed for the measured variables. Overall means ± SDs were 7.2 ± 3.8 g/d, 6.1 ± 1.2 MJ/d, 67.3 ± 14.3 kg, and 29.8 ± 8.6% for FFC, REE, body weight, and body fat percentage, respectively. CONCLUSION GT supplementation for 12 wk in 60 men and women did not have a significant effect on FEC, FFC, REE, RQ, and body composition.
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Affiliation(s)
- Pilou L H R Janssens
- Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
| | - Rick Hursel
- Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
| | - Margriet S Westerterp-Plantenga
- Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
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Soares A, Beraldi EJ, Ferreira PEB, Bazotte RB, Buttow NC. Intestinal and neuronal myenteric adaptations in the small intestine induced by a high-fat diet in mice. BMC Gastroenterol 2015; 15:3. [PMID: 25609418 PMCID: PMC4316644 DOI: 10.1186/s12876-015-0228-z] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 01/05/2015] [Indexed: 12/18/2022] Open
Abstract
Background The prevalence of obesity has increased at alarming rates, particularly because of the increased consumption of high-fat diets (HFDs). The influence of HFDs on intrinsic innervation and the intestinal wall has not been fully characterized. The aim of this study was to investigate the morpho-quantitative aspects of myenteric neurons and the wall of the small intestine in mice fed a HFD. Methods Swiss mice were fed a HFD (59% kcal from fat) or standard chow (9% Kcal from fat) for 8 weeks. Segments of the duodenum, jejunum, and ileum were subjected to histological processing for morpho-quantitative examination of the intestinal wall and mucosal cells, and immunohistochemistry was performed to evaluate myenteric neurons. The data for each segment were compared between the groups using an unpaired Student’s t-test or an equivalent nonparametric test. Results The HFD increased body weight and visceral fat and decreased the length of the small intestine and the circumference of the ileum. In the duodenum, the HFD increased the density of the nitrergic subpopulation and decreased the area of nitrergic neurons and vasoactive intestinal peptide (VIP) varicosities. In the jejunum, the density of the nitrergic subpopulation was increased and the neuronal areas of the general population, nitrergic subpopulation and (VIP) varicosities were reduced. In the ileum, the density of the general population and nitrergic subpopulation were increased and the neuronal areas of the general population, nitrergic subpopulation and (VIP) varicosities were reduced. The morphometric parameters of the villi, crypts, muscular layer and total wall generally increased in the duodenum and jejunum and decreased in the ileum. In the duodenum and jejunum, the HFD promoted a decreased in the proportion of intraepithelial lymphocytes. In the ileum, the proportion of intraepithelial lymphocytes and goblet cells reduced, and the enteroendocrine cells increased. Conclusions The high-fat diet induces changes in the myenteric innervation of the small intestine, intestinal wall and mucosal cells responsible for the secretion of hormones and maintenance of the protective intestinal barrier. The morpho-quantitative data provide a basis for further studies to clarify the influence of HFD in the motility, digestive and absorptive capacity, and intestinal barrier.
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Affiliation(s)
- Angelica Soares
- Center of Medical and Pharmaceutical Sciences, State University of the West of Paraná, R. Universitária, 1619, Cascavel, PR, CEP 85819-110, Brazil.
| | - Evandro José Beraldi
- Department of Morphological Sciences, State University of Maringá, Av. Colombo, 5790, Maringá, PR, CEP 87020-900, Brazil.
| | - Paulo Emílio Botura Ferreira
- Department of Morphological Sciences, State University of Maringá, Av. Colombo, 5790, Maringá, PR, CEP 87020-900, Brazil.
| | - Roberto Barbosa Bazotte
- Department of Pharmacology and Therapeutics, State University of Maringá, Av. Colombo, 5790, Maringá, PR, CEP 87020-900, Brazil.
| | - Nilza Cristina Buttow
- Department of Morphological Sciences, State University of Maringá, Av. Colombo, 5790, Maringá, PR, CEP 87020-900, Brazil.
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Nguyen NQ, Debreceni TL, Bambrick JE, Bellon M, Wishart J, Standfield S, Rayner CK, Horowitz M. Rapid gastric and intestinal transit is a major determinant of changes in blood glucose, intestinal hormones, glucose absorption and postprandial symptoms after gastric bypass. Obesity (Silver Spring) 2014; 22:2003-9. [PMID: 24829088 DOI: 10.1002/oby.20791] [Citation(s) in RCA: 87] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 04/10/2014] [Accepted: 05/02/2014] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To evaluate the effect of modulating pouch emptying (PE) and SI transit of glucose after Roux-en-Y gastric bypass (RYGB) on blood glucose, incretin hormones, glucose absorption and gastrointestinal (GI) symptoms. METHODS Ten RYGB patients were studied twice in random order, receiving either a 150 ml glucose drink (200 kcal) or the same solution infused into the proximal Roux-limb at 4 kcal/min. Data were compared with 10 healthy volunteers who received a 4 kcal/min duodenal infusion. PE, cecal arrival time (CAT), blood glucose, plasma 3-O-methylglucose (3-OMG), insulin, glucose-dependent insulinotropic polypeptide (GIP), and glucagon-like peptide-1 (GLP-1), and GI symptoms were measured. RESULTS In RYGB subjects, the glucose drink emptied very rapidly (PE t50 = 3 ± 1 min) and intestinal glucose infusion was associated with higher blood glucose and plasma 3-OMG, but lower plasma GLP-1, GIP, insulin, and GI symptoms than oral glucose (all P < 0.001), and comparable to volunteers. In RYGB subjects, CAT correlated inversely with peak GLP-1 (r = -0.73, P = 0.01), and plasma 3-OMG correlated tightly blood glucose (r = 0.94, P < 0.0001). CONCLUSIONS After RYGB, reducing intestinal glucose delivery to 4 kcal/min is associated with higher blood glucose, greater glucose absorption, lower incretin responses, and less GI symptoms, supporting rapid transit contribution to the exaggerated incretin responses and "dumping symptoms".
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Affiliation(s)
- Nam Q Nguyen
- Department of Gastroenterology and Hepatology, Level 7, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia, 5000, Australia; Discipline of Medicine, University of Adelaide, Royal Adelaide Hospital, Level 6 Eleanor Harrold Building, North Terrace, Adelaide, South Australia, 5000, Australia
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Alminger M, Aura AM, Bohn T, Dufour C, El S, Gomes A, Karakaya S, Martínez-Cuesta M, McDougall G, Requena T, Santos C. In VitroModels for Studying Secondary Plant Metabolite Digestion and Bioaccessibility. Compr Rev Food Sci Food Saf 2014; 13:413-436. [DOI: 10.1111/1541-4337.12081] [Citation(s) in RCA: 218] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Accepted: 02/28/2014] [Indexed: 12/18/2022]
Affiliation(s)
- M. Alminger
- Dept. of Chemical and Biological Engineering; Chalmers Univ. of Technology; SE 412 96 Gothenburg Sweden
| | - A.-M. Aura
- VTT Technical Research Centre of Finland; P.O.Box 1000 Tietotie 2 Espoo FI-02044 VTT Finland
| | - T. Bohn
- Environment and Agro-biotechnologies Dept; Centre de Recherche Public - Gabriel Lippmann; 4422 Belvaux Luxembourg
| | - C. Dufour
- INRA, UMR408 Safety and Quality of Plant Products F-84000 Avignon; France
- Univ. of Avignon; UMR408 Safety and Quality of Plant Products F-84000 Avignon; France
| | - S.N. El
- Engineering Faculty Dept. of Food Engineering; Ege Univ. 35100 Izmir Turkey
| | - A. Gomes
- Inst. de Biologia Experimental e Tecnológica; Apartado 12, 2781-901 Oeiras Portugal
- Inst. de Tecnologia Química e Biológica; Univ. Nova de Lisboa; Av. da República, EAN, 2781-901 Oeiras Portugal
| | - S. Karakaya
- Engineering Faculty Dept. of Food Engineering; Ege Univ. 35100 Izmir Turkey
| | - M.C. Martínez-Cuesta
- Inst. de Investigación en Ciencias de la Alimentación CIAL (CSIC-UAM); Nicolás Cabrera 9, 28049 Madrid Spain
| | - G.J. McDougall
- The James Hutton Inst., Invergowrie; DD2 5DA; Dundee United Kingdom
| | - T. Requena
- Inst. de Investigación en Ciencias de la Alimentación CIAL (CSIC-UAM); Nicolás Cabrera 9, 28049 Madrid Spain
| | - C.N. Santos
- Inst. de Biologia Experimental e Tecnológica; Apartado 12, 2781-901 Oeiras Portugal
- Inst. de Tecnologia Química e Biológica; Univ. Nova de Lisboa; Av. da República, EAN, 2781-901 Oeiras Portugal
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Minekus M, Alminger M, Alvito P, Ballance S, Bohn T, Bourlieu C, Carrière F, Boutrou R, Corredig M, Dupont D, Dufour C, Egger L, Golding M, Karakaya S, Kirkhus B, Le Feunteun S, Lesmes U, Macierzanka A, Mackie A, Marze S, McClements DJ, Ménard O, Recio I, Santos CN, Singh RP, Vegarud GE, Wickham MSJ, Weitschies W, Brodkorb A. A standardised static in vitro digestion method suitable for food - an international consensus. Food Funct 2014; 5:1113-24. [PMID: 24803111 DOI: 10.1039/c3fo60702j] [Citation(s) in RCA: 3335] [Impact Index Per Article: 333.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Simulated gastro-intestinal digestion is widely employed in many fields of food and nutritional sciences, as conducting human trials are often costly, resource intensive, and ethically disputable. As a consequence, in vitro alternatives that determine endpoints such as the bioaccessibility of nutrients and non-nutrients or the digestibility of macronutrients (e.g. lipids, proteins and carbohydrates) are used for screening and building new hypotheses. Various digestion models have been proposed, often impeding the possibility to compare results across research teams. For example, a large variety of enzymes from different sources such as of porcine, rabbit or human origin have been used, differing in their activity and characterization. Differences in pH, mineral type, ionic strength and digestion time, which alter enzyme activity and other phenomena, may also considerably alter results. Other parameters such as the presence of phospholipids, individual enzymes such as gastric lipase and digestive emulsifiers vs. their mixtures (e.g. pancreatin and bile salts), and the ratio of food bolus to digestive fluids, have also been discussed at length. In the present consensus paper, within the COST Infogest network, we propose a general standardised and practical static digestion method based on physiologically relevant conditions that can be applied for various endpoints, which may be amended to accommodate further specific requirements. A frameset of parameters including the oral, gastric and small intestinal digestion are outlined and their relevance discussed in relation to available in vivo data and enzymes. This consensus paper will give a detailed protocol and a line-by-line, guidance, recommendations and justifications but also limitation of the proposed model. This harmonised static, in vitro digestion method for food should aid the production of more comparable data in the future.
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Affiliation(s)
- M Minekus
- TNO, PO BOX 360, 3700AJ Zeist, The Netherlands.
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Abstract
OBJECTIVES To evaluate the role of sleeve gastrectomy (SG) in gastrointestinal motility. BACKGROUND SG is a widely used bariatric operation leading to weight loss and early improvement of patient's metabolic profile. Current data indicate faster postoperative gastric emptying, but detailed studies on alterations in small bowel motility are missing. DESIGN We evaluated 21 morbidly obese patients who underwent laparoscopic SG before and 4 months after the procedure. After consumption of a semisolid radiolabeled meal, their gastric and intestinal transit times were studied with a gamma camera. Particularly the times of 10% gastric emptying, 50% gastric emptying, maximal intestinal filling, 10% terminal ileum filling, duodenal to terminal ileum transit, cecal filling initiation, and ileocecal valve transit (T ICVt) were studied pre- and postoperatively. RESULTS Ten percent gastric emptying and 50% gastric emptying were decreased postoperatively as well as maximal intestinal filling, indicating faster gastric emptying and intestinal filling. Duodenal to terminal ileum transit and 10% terminal ileum filling also decreased as small bowel transit time accelerated and the meal reached the terminal ileum more rapidly. Contrary opening of the ileocecal valve and food transit through it were delayed, with postoperative increase in cecal filling initiation and T ICVt, respectively. CONCLUSIONS SG accelerates gastric emptying and small bowel transit of semisolids. In addition, it delays the initiation of cecal filling and T ICVt. This early and prolonged contact of food with the distal small bowel mucosa may explain the metabolic effects of SG occurring before substantial weight loss.
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Fu XY, Li Z, Zhang N, Yu HT, Wang SR, Liu JR. Effects of gastrointestinal motility on obesity. Nutr Metab (Lond) 2014; 11:3. [PMID: 24398016 PMCID: PMC3891996 DOI: 10.1186/1743-7075-11-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Accepted: 12/31/2013] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Changes of gastrointestinal motility, which are important related to the food digestion and absorption in the gastrointestinal tract, may be one of the factors in obesity-formation. AIMS The changes of gastrointestinal motility were explored in the rats from diet-induced obesity (DIO), diet-induced obese resistant (DR) or control (CON) by diet intervention. METHODS After fed with a high fat diet (HFD), 100 male Sprague-Dawley rats were divided into DIO, DR and CON groups. The rats from DIO and DR groups were fed with HFD, and CON with a basic diet (BD) for 6 weeks. Body weight, energy intake, gastric emptying, intestinal transit, motility of isolated small intestine segments and colon's function were measured in this study. Expression of interstitial cells of Cajal (ICCs) and enteric nervous system (ENS) - choline acetyltransferase (ChAT), vasoactive intestinal peptides (VIP), substance P (SP) and NADPH-d histochemistry of nitric oxide synthase (NOS) were determined by immunohistochemistry. RESULTS Body weight and intake energy in the DIO group were higher than those in the DR group (p < 0.05). Gastric emptying of DIO group rats (78.33 ± 4.95%) was significantly faster than that of DR group (51.79 ± 10.72%) (p < 0.01). The peak value of motility in rat's duodenum from the DR group was significantly higher than that in the DIO group (p < 0.05). In addition, the expression of interstitial cells of Cajal (ICC), choline acetyltransferase (ChAT), substance P (SP), vasoactive intestinal peptides (VIP) and neuronal nicotinamide adenine dinucleotide phosphate-diaphorase (NADPH-d) in the intestine of rats were significantly increased in the DIO group when compared to the DR group (p < 0.05). CONCLUSION A faster gastric emptying, a weaker contraction of duodenum movement, and a stronger contraction and relaxation of ileum movement were found in the rats from the DIO group. It indicated that there has effect of gastrointestinal motility on obesity induced by HFD.
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Affiliation(s)
- Xiao-Yi Fu
- School of Public Health, JiLin Medical College, 5 JiLin street, JiLin, JiLin Province 132013, The People’s Republic of China
| | - Ze Li
- School of Public Health, Harbin Medical University, 157 BaoJian Road, Harbin, HeiLongJiang Province 150081, The People’s Republic of China
| | - Na Zhang
- School of Public Health, Harbin Medical University, 157 BaoJian Road, Harbin, HeiLongJiang Province 150081, The People’s Republic of China
| | - Hai-Tao Yu
- School of Public Health, JiLin Medical College, 5 JiLin street, JiLin, JiLin Province 132013, The People’s Republic of China
| | - Shu-Ran Wang
- School of Public Health, JiLin Medical College, 5 JiLin street, JiLin, JiLin Province 132013, The People’s Republic of China
| | - Jia-Ren Liu
- Boston Children’s Hospital and Harvard Medical School, 300 LongWood Ave, Boston 02115, USA
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Zhang J, Sha W, Zhu H, Chen JDZ. Blunted Peripheral and Central Responses to Gastric Mechanical and Electrical Stimulations in Diet-induced Obese Rats. J Neurogastroenterol Motil 2013; 19:454-66. [PMID: 24199005 PMCID: PMC3816179 DOI: 10.5056/jnm.2013.19.4.454] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2013] [Revised: 07/28/2013] [Accepted: 08/09/2013] [Indexed: 01/26/2023] Open
Abstract
Background/Aims The increase in the prevalence of obesity is attributed to increased food intake and decreased physical activity in addition to genetic factors. Altered gut functions have been reported in obese subjects, whereas, little is known on the possible alterations in brain-gut interactions in obesity. The aim of the study was to explore possible alterations in gastric myoelectrical activity, gastric emptying, autonomic functions and central neuronal responses to gastric stimulations in diet-induced obese rats. Methods Gastric myoelectrical activity, gastric emptying and heart rate variability were recorded in lean and obese rats; extracellular neuronal activity in the ventromedial hypothalamus and its responses to gastric stimulations were also assessed. Results (1) Gastric emptying was significantly accelerated but gastric myoelectrical activity was not altered in obese rats; (2) the normal autonomic responses to feeding were absent in obese rats, suggesting an impairment of postprandial modulation of autonomic functions; and (3) central neuronal responses to gastric stimulations (both balloon distention and electrical stimulation) were blunted in obese rats, suggesting impairment in the brain-gut interaction. Conclusions In diet-induced obese rats, gastric emptying is accelerated, postprandial modulations of autonomic functions is altered and central neuronal responses to gastric stimulations are attenuated. These alterations in peripheral, autonomic and brain-gut interactions may help better understand pathogenesis of obesity and develop novel therapeutic approaches for obesity.
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Affiliation(s)
- Jing Zhang
- Veterans Research and Education Foundation, VA Medical Center, Oklahoma City, OK, USA
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Vors C, Pineau G, Gabert L, Drai J, Louche-Pélissier C, Defoort C, Lairon D, Désage M, Danthine S, Lambert-Porcheron S, Vidal H, Laville M, Michalski MC. Modulating absorption and postprandial handling of dietary fatty acids by structuring fat in the meal: a randomized crossover clinical trial. Am J Clin Nutr 2013; 97:23-36. [PMID: 23235199 DOI: 10.3945/ajcn.112.043976] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Prolonged postprandial hypertriglyceridemia is a potential risk factor for cardiovascular diseases. In the context of obesity, this is associated with a chronic imbalance of lipid partitioning oriented toward storage and not toward β-oxidation. OBJECTIVE We tested the hypothesis that the physical structure of fat in a meal can modify the absorption, chylomicron transport, and further metabolic handling of dietary fatty acids. DESIGN Nine normal-weight and 9 obese subjects were fed 40 g milk fat (+[(13)C]triacylglycerols), either emulsified or nonemulsified, in breakfasts of identical composition. We measured the postprandial triacylglycerol content and size of the chylomicron-rich fraction, plasma kinetics of [(13)C]fatty acids, exogenous lipid oxidation with breath-test/indirect calorimetry, and fecal excretion. RESULTS The emulsified fat resulted in earlier (>1 h) and sharper chylomicron and [(13)C]fatty acid peaks in plasma than in spread fat in both groups (P < 0.0001). After 2 h, the emulsified fat resulted in greater apolipoprotein B-48 concentrations (9.7 ± 0.7 compared with 7.1 ± 0.9 mg/L; P < 0.05) in the normal-weight subjects than did the spread fat. In the obese subjects, emulsified fat resulted in a 3-fold greater chylomicron size (218 ± 24 nm) compared with the spread fat (P < 0.05). The emulsified fat induced higher dietary fatty acid spillover in plasma and a sharper (13)CO(2) appearance, which provoked increased exogenous lipid oxidation in each group: from 45% to 52% in normal-weight subjects (P < 0.05) and from 40% to 57% in obese subjects (P < 0.01). CONCLUSION This study supports a new concept of "slow vs fast fat," whereby intestinal absorption can be modulated by structuring dietary fat to modulate postprandial lipemia and lipid β-oxidation in humans with different BMIs. This trial was registered at clinicaltrials.gov as NCT01249378.
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Affiliation(s)
- Cécile Vors
- From INRA, USC1362, CarMeN, Cardiovascular Metabolism Diabetes and Nutrition laboratory, Villeurbanne, France
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Sleeve gastrectomy with transit bipartition: a potent intervention for metabolic syndrome and obesity. Ann Surg 2012; 256:104-10. [PMID: 22609843 DOI: 10.1097/sla.0b013e31825370c0] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To present 5-year results of sleeve gastrectomy (SG) with transit bipartition (TB) as a metabolic intervention for obesity. BACKGROUND Recent data suggest that high glycemic index foods may lead to a hormonally hyperactive proximal gut and a hypoactivate distal gut, which are linked to metabolic syndrome. TB was designed to counterbalance these effects. METHODS A total of 1020 obese patients with body mass index (BMI) ranging from 33 to 72 Kg/m underwent SG and TB (SG + TB). TB creates a gastroileal anastomosis in the antrum after the SG; nutrient transit is maintained in the duodenum, avoiding blind loops and minimizing malabsorption. The stomach retains 2 outflow pathways. A lateral enteroanastomosis connects both segments at 80 cm proximal to the cecum. RESULTS Adequate follow-up data were collected in 59.1% of patients from 4 months to 5 years. The average percent of excess BMI loss was 91%, 94%, 85%, 78%, and 74% in the first, second, third, fourth, and fifth year, respectively. Patients experienced early satiety and major improvement in presurgical comorbidities, including diabetes (86% in remission), following surgery. Two deaths occurred (0.2%). Other surgical complications occurred in 6% of patients. Signs of malabsorption were rare. CONCLUSIONS SG + TB is a simple procedure that results in rapid weight loss and remission or major improvement of comorbidities. Strictly aiming at physiological correction, TB avoids prostheses, narrow anastomoses, excluded segments, and malabsorption. Weight and comorbidities are much improved. Diabetes is improved without duodenal exclusion. TB is an excellent complement to an SG.
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Cassady BA, Considine RV, Mattes RD. Beverage consumption, appetite, and energy intake: what did you expect? Am J Clin Nutr 2012; 95:587-93. [PMID: 22258267 PMCID: PMC3278240 DOI: 10.3945/ajcn.111.025437] [Citation(s) in RCA: 171] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Beverage consumption is implicated in the overweight/obesity epidemic through the weaker energy compensation response it elicits compared with solid food forms. However, plausible mechanisms are not documented. OBJECTIVE This study assessed the cognitive and sensory contributions of differential postingestive responses to energy- and macronutrient-matched liquid (in beverage form) and solid food forms and identifies physiologic processes that may account for them. DESIGN Fifty-two healthy adults [mean ± SD age: 24.7 ± 5.5 y; BMI (in kg/m(2)): 26.3 ± 6.3] completed this randomized, 4-arm crossover study. Participants consumed oral liquid and solid preloads that they perceived, through cognitive manipulation, to be liquid or solid in their stomach (ie, oral liquid/perceived gastric liquid, oral liquid/perceived gastric solid, oral solid/perceived gastric liquid, or oral solid/perceived gastric solid). However, all preloads were designed to present a liquid gastric challenge. Appetite, gastric-emptying and orocecal transit times, and selected endocrine responses were monitored for the following 4 h; total energy intake was also recorded. RESULTS Oral-liquid and perceived gastric-liquid preloads elicited greater postprandial hunger and lower fullness sensations, more rapid gastric-emptying and orocecal transit times, attenuated insulin and glucagon-like peptide 1 release, and lower ghrelin suppression than did responses after oral-solid and perceived gastric-solid treatments (all P < 0.05). Faster gastric-emptying times were significantly associated with greater energy intake after consumption of perceived gastric-liquid preloads (P < 0.05). Energy intake was greater on days when perceived gastric-liquid preloads were consumed than when perceived gastric solids were consumed (2311 ± 95 compared with 1897 ± 72 kcal, P = 0.007). CONCLUSIONS These data document sensory and cognitive effects of food form on ingestive behavior and identify physical and endocrine variables that may account for the low satiety value of beverages. They are consistent with findings that clear, energy-yielding beverages pose a particular risk for positive energy balance. This study was registered at clinicaltrials.gov as NCT01070199.
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Affiliation(s)
- Bridget A Cassady
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907-2059, USA
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41
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Little TJ, Feinle-Bisset C. Effects of dietary fat on appetite and energy intake in health and obesity — Oral and gastrointestinal sensory contributions. Physiol Behav 2011; 104:613-20. [DOI: 10.1016/j.physbeh.2011.04.038] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Revised: 04/15/2011] [Accepted: 04/26/2011] [Indexed: 02/08/2023]
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Li J, Ma W, Wang S. Slower gastric emptying in high-fat diet induced obese rats is associated with attenuated plasma ghrelin and elevated plasma leptin and cholecystokinin concentrations. ACTA ACUST UNITED AC 2011; 171:53-7. [PMID: 21784108 DOI: 10.1016/j.regpep.2011.07.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Revised: 06/03/2011] [Accepted: 07/08/2011] [Indexed: 01/17/2023]
Abstract
Gastrointestinal (GI) motility and gut hormones have been considered to be involved in the development and maintenance of obesity. Our aim was to assess the relationships between gastric emptying (GE), GI transit and gut hormones and leptin concentrations in diet-induced obese rat model. Male 6-week-old Sprague-Dawley rats were fed with a high-fat (HF) diet for 8weeks to generate diet-induced obesity (DIO) and diet resistant (DR) rats. GE, GI transit and plasma ghrelin, cholecystokinin (CCK), PYY and leptin concentrations were determined in DIO, DR and control (CON) rats. The DIO rats had slower GE, higher plasma leptin and CCK concentrations, and lower plasma ghrelin concentration compared with CON and DR rats. GE was correlated with plasma ghrelin (r=0.402, P=0.028), CCK (r=-0.518, P=0.003) and leptin concentration (r=-0.514, P=0.004). The slower GE, which can be considered as an adaptive response aimed at HF diet induced obesity, may be mediated by changes of plasma ghrelin, CCK and leptin concentrations.
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Affiliation(s)
- Jie Li
- Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, PR China
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Abstract
The two incretin hormones glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) are key factors in the regulation of islet function and glucose metabolism, and incretin-based therapy for type 2 diabetes has gained considerable interest during recent years. Regulation of incretin hormone secretion is less well characterized. The main stimulus for incretin hormone secretion is presence of nutrients in the intestinal lumen, and carbohydrate, fat as well as protein all have the capacity to stimulate GIP and GLP-1 secretion. More recently, it has been established that a diurnal regulation exists with incretin hormone secretion to an identical meal being greater when the meal is served in the morning compared to in the afternoon. Finally, whether incretin hormone secretion is altered in disease states is an area with, so far, controversial results in different studies, although some studies have demonstrated reduced incretin hormone secretion in type 2 diabetes. This review summarizes our knowledge on regulation of incretin hormone secretion and its potential changes in disease states.
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Affiliation(s)
- Bo Ahrén
- Department of Clinical Sciences in Lund, Division of Medicine, Lund University, Lund, Sweden
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Xu X, Lei Y, Chen JDZ. Duodenum electrical stimulation delays gastric emptying, reduces food intake and accelerates small bowel transit in pigs. Obesity (Silver Spring) 2011; 19:442-8. [PMID: 20948518 DOI: 10.1038/oby.2010.247] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Duodenum electrical stimulation (DES) has been shown to delay gastric emptying and reduce food intake in dogs. The aim of this study was to investigate the effects of DES on gastric emptying, small bowel transit and food intake in pigs, a large animal model of obesity. The study consisted of three experiments (gastric emptying, small bowel transit, and food intake) in pigs implanted with internal duodenal electrodes for DES and one or two duodenal cannulas for gastric emptying and small bowel transit. We found that (i) gastric emptying was dose-dependently delayed by DES of different stimulation parameters; (ii) small bowel transit was significantly accelerated with continuous DES in proximal intestine but not with intermittent DES; (iii) DES significantly reduced body weight gain with 100% duty cycle (DC), but not with DES with 40% DC. A marginal difference was noted in food intake among 100% DC session, 40% DC session, and control session. DES with long pulses energy-dependently inhibits gastric emptying in pigs. DES with appropriate parameters accelerates proximal small bowel transit in pigs. DES reduces body weight gain in obese pigs, and this therapeutic effect on obesity is mediated by inhibiting gastric emptying and food intake, and may also possibly by accelerating intestinal transit. DES may have a potential application to treat patients with obesity.
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Affiliation(s)
- Xiaohong Xu
- Veterans Research and Education Foundation, VA Medical Center, Oklahoma City, Oklahoma, USA
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Small intestinal clustered contractions and bacterial overgrowth: a frequent finding in obese patients. Dig Dis Sci 2011; 56:155-60. [PMID: 20431947 DOI: 10.1007/s10620-010-1239-9] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2009] [Accepted: 04/06/2010] [Indexed: 12/11/2022]
Abstract
BACKGROUND Small intestinal bacterial overgrowth (SIBO) has been observed in several disorders of the gastrointestinal tract. Studies have shown abnormalities of motor function in obese patients, and there is indirect evidence suggesting that SIBO is present in them. AIMS To study small intestinal motility and the prevalence of SIBO in obese patients and to determine whether there was any relationship between both parameters. METHODS Thirty-nine patients scheduled for bariatric surgery were subjected to hydrogen breath test with lactulose and to a stationary small intestinal motility study with perfused catheters. RESULTS SIBO was observed in 41% of obese patients and was not related to body mass index. Small intestinal manometry showed a marked increase of clustered contractions in obese patients with SIBO compared to obese subjects without SIBO, whereas all the other parameters of fasting cyclic activity were not different. CONCLUSIONS SIBO was a frequent finding in obese patients and was associated with an increased pattern of clustered contractions, which was not observed in absence of SIBO.
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Little TJ, Feinle-Bisset C. Oral and gastrointestinal sensing of dietary fat and appetite regulation in humans: modification by diet and obesity. Front Neurosci 2010; 4:178. [PMID: 21088697 PMCID: PMC2981385 DOI: 10.3389/fnins.2010.00178] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2010] [Accepted: 09/23/2010] [Indexed: 01/25/2023] Open
Abstract
Dietary fat interacts with receptors in both the oral cavity and the gastrointestinal (GI) tract to regulate fat and energy intake. This review discusses recent developments in our understanding of the mechanisms underlying the effects of fat, through its digestive products, fatty acids (FAs), on GI function and energy intake, the role of oral and intestinal FA receptors, and the implications that changes in oral and small intestinal sensitivity in response to ingested fat may have for the development of obesity.
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Affiliation(s)
- Tanya J. Little
- Discipline of Medicine, Royal Adelaide Hospital, University of AdelaideAdelaide, SA, Australia
- NHMRC Centre of Clinical Research Excellence in Nutritional Physiology, Interactions and Outcomes, University of AdelaideAdelaide, SA, Australia
| | - Christine Feinle-Bisset
- Discipline of Medicine, Royal Adelaide Hospital, University of AdelaideAdelaide, SA, Australia
- NHMRC Centre of Clinical Research Excellence in Nutritional Physiology, Interactions and Outcomes, University of AdelaideAdelaide, SA, Australia
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Metabolism and pharmacokinetics of contraceptive steroids in obese women: a review. Contraception 2010; 82:314-23. [DOI: 10.1016/j.contraception.2010.04.016] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2010] [Revised: 04/06/2010] [Accepted: 04/14/2010] [Indexed: 01/31/2023]
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Covasa M. Deficits in gastrointestinal responses controlling food intake and body weight. Am J Physiol Regul Integr Comp Physiol 2010; 299:R1423-39. [PMID: 20861277 DOI: 10.1152/ajpregu.00126.2010] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The gastrointestinal tract serves as a portal sensing incoming nutrients and relays mechanical and chemosensory signals of a meal to higher brain centers. Prolonged consumption of dietary fat causes adaptive changes within the alimentary, metabolic, and humoral systems that promote a more efficient process for energy metabolism from this rich source, leading to storage of energy in the form of adipose tissue. Furthermore, prolonged ingestion of dietary fats exerts profound effects on responses to signals involved in termination of a meal. This article reviews the effects of ingested fat on gastrointestinal motility, hormone release, and neuronal substrates. It focuses on changes in sensitivity to satiation signals resulting from chronic ingestion of high-fat diet, which may lead to disordered appetite and dysregulation of body weight.
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Affiliation(s)
- Mihai Covasa
- L'Institute National de la Recherche Agronomique, Centre de Recherche, Microbiologie de l'Alimentation au service de la Santé Humaine (MICALIS), Neurobiology of Ingestive Behavior, Jouy-en-Josas, France.
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Abstract
Gastroesophageal reflux disease (GERD) is a common condition, with multifactorial pathogenesis, affecting up to 40% of the population. Obesity is also common. Obesity and GERD are clearly related, both from a prevalence and causality association. GERD symptoms increase in severity when people gain weight. Obese patients tend to have more severe erosive esophagitis and obesity is a risk factor for the development of Barrett's esophagus and adenocarcinoma of the esophagus. Patients report improvement in GERD when they lose weight and there are several reports suggesting a decrease in GERD symptoms after bariatric surgery. At present, there is little evidence that obesity has any effect on the efficacy of antisecretory therapy, with conflicting data on surgical outcomes. This review attempts to put in perspective the relationship of these two common entities.
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Affiliation(s)
- Girish Anand
- Division of Gastroenterology, Albert Einstein Medical Center, 5401 Old York Road, Philadelphia, PA 19141, USA
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Effects of food form and timing of ingestion on appetite and energy intake in lean young adults and in young adults with obesity. ACTA ACUST UNITED AC 2009; 109:430-7. [PMID: 19248858 DOI: 10.1016/j.jada.2008.11.031] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2008] [Accepted: 09/25/2008] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Overweight and obesity have been attributed to increased eating frequency and the size of eating events. This study explored the influence of the timing of eating events and food form on appetite and daily energy intake. DESIGN Crossover, clinical intervention where participants consumed 300-kcal loads of a solid (apple), semisolid (apple sauce), and beverage (apple juice) at a meal or 2 hours later (snack). SUBJECTS Twenty normal-weight (body mass index 22.6+/-1.8) and 20 obese (body mass index 32.3+/-1.5) adults. There were 10 men and 10 women within each body mass index group. MEASUREMENTS On six occasions, participants reported to the laboratory at their customary midday mealtime. Appetite questionnaires and motor skills tests were completed upon arrival and at 30-minute intervals for the 2 hours participants were in the laboratory and at 30-minute intervals for 4 hours after leaving the laboratory. Diet recalls were collected the next day. Data were collected between January 2006 and March 2007. RESULTS Whether consumed with a meal or alone as a snack, the beverage elicited the weakest appetitive response, the solid food form elicited the strongest appetitive response and the semisolid response was intermediate. The appetite shift was greatest for the solid food when consumed as a snack. The interval between test food consumption and the first spontaneous eating event >100 kcal was shortest for the beverage. No significant treatment effects were observed for test day energy intake or between lean individuals and individuals with obesity. CONCLUSIONS Based on the appetitive findings, consumption of an energy-yielding beverage either with a meal or as a snack poses a greater risk for promoting positive energy than macronutrient-matched semisolid or solid foods consumed at these times.
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