1
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Roelofs JJM, Camps G, Leenders LM, Marciani L, Spiller RC, Van Eijnatten EJM, Alyami J, Deng R, Freitas D, Grimm M, Karhunen LJ, Krishnasamy S, Le Feunteun S, Lobo DN, Mackie AR, Mayar M, Weitschies W, Smeets PAM. Intra- and interindividual variability in fasted gastric content volume. Neurogastroenterol Motil 2024:e14904. [PMID: 39189312 DOI: 10.1111/nmo.14904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 07/15/2024] [Accepted: 08/18/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND Gastric fluid plays a key role in food digestion and drug dissolution, therefore, the amount of gastric fluid present in a fasted state may influence subsequent digestion and drug delivery. We aimed to describe intra- and interindividual variation in fasted gastric content volume (FGCV) and to determine the association with age, sex, and body size characteristics. METHODS Data from 24 MRI studies measuring FGCV in healthy, mostly young individuals after an overnight fast were pooled. The analysis included 366 participants who had up to 6 repeated measurements, with a total of 870 measurements. Linear mixed model analysis was performed to calculate intra- and interindividual variability and to assess the effects of age, sex, weight, height, weight*height as a proxy for body size, and body mass index (BMI). RESULTS FGCV ranged from 0 to 156 mL, with a mean (± SD) value of 33 ± 25 mL. The overall coefficient of variation within the study population was 75.6%, interindividual SD was 15 mL, and the intraindividual SD was 19 mL. Age, weight, height, weight*height, and BMI had no effect on FGCV. Women had lower volumes compared to men (MD: -6 mL), when corrected for the aforementioned factors. CONCLUSION FGCV is highly variable, with higher intraindividual compared to interindividual variability, indicating that FGCV is subject to day-to-day and within-day variation and is not a stable personal characteristic. This highlights the importance of considering FGCV when studying digestion and drug dissolution. Exact implications remain to be studied.
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Affiliation(s)
- Julia J M Roelofs
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Guido Camps
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Louise M Leenders
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Luca Marciani
- Nottingham Digestive Diseases Centre, NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK
| | - Robin C Spiller
- Nottingham Digestive Diseases Centre, NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK
| | | | - Jaber Alyami
- Nottingham Digestive Diseases Centre, NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK
- Radiological Sciences Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ruoxuan Deng
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Daniela Freitas
- Université Paris-Saclay, INRAE, AgroParisTech, UMR SayFood, Thiverval-Grignon, France
| | - Michael Grimm
- Institute of Pharmacy, Center of Drug Absorption and Transport, University of Greifswald, Greifswald, Germany
| | - Leila J Karhunen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Shanthi Krishnasamy
- Nottingham Digestive Diseases Centre, NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK
| | | | - Dileep N Lobo
- Nottingham Digestive Diseases Centre, NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK
- Division of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Alan R Mackie
- Food Colloids and Processing Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Morwarid Mayar
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Werner Weitschies
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Paul A M Smeets
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
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2
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Milan AM, Barnett MP, McNabb WC, Roy NC, Coutinho S, Hoad CL, Marciani L, Nivins S, Sharif H, Calder S, Du P, Gharibans AA, O'Grady G, Fraser K, Bernstein D, Rosanowski SM, Sharma P, Shrestha A, Mithen RF. The impact of heat treatment of bovine milk on gastric emptying and nutrient appearance in peripheral circulation in healthy females: a randomized controlled trial comparing pasteurized and ultra-high temperature milk. Am J Clin Nutr 2024; 119:1200-1215. [PMID: 38452857 DOI: 10.1016/j.ajcnut.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 02/29/2024] [Accepted: 03/04/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Heat treatments of dairy, including pasteurization and ultra-high temperature (UHT) processing, alter milk macromolecular structures, and ultimately affect digestion. In vitro, animal, and human studies show faster nutrient release or circulating appearance after consuming UHT milk (UHT-M) compared with pasteurized milk (PAST-M), with a faster gastric emptying (GE) rate proposed as a possible mechanism. OBJECTIVES To investigate the impact of milk heat treatment on GE as a mechanism of faster nutrient appearance in blood. We hypothesized that GE and circulating nutrient delivery following consumption would be faster for UHT-M than PAST-M. METHODS In this double-blind randomized controlled cross-over trial, healthy female (n = 20; 27.3 ± 1.4 y, mean ± SD) habitual dairy consumers, consumed 500 mL of either homogenized bovine UHT-M or PAST-M (1340 compared with 1320 kJ). Gastric content volume (GCV) emptying half-time (T50) was assessed over 3 h by magnetic resonance imaging subjective digestive symptoms, plasma amino acid, lipid and B vitamin concentrations, and gastric myoelectrical activity were measured over 5 h. RESULTS Although GCV T50 did not differ (102 ± 7 min compared with 89 ± 8 min, mean ± SEM, UHT-M and PAST-M, respectively; P = 0.051), GCV time to emptying 25% of the volume was 31% longer following UHT-M compared with PAST-M (42 ± 2 compared with 32 ± 4 min, P = 0.004). Although GCV remained larger for a longer duration following UHT-M (treatment × time interaction, P = 0.002), plasma essential amino acid AUC was greater following UHT-M than PAST-M (55,324 ± 3809 compared with 36,598 ± 5673 μmol·min·L-1, P = 0.006). Heat treatment did not impact gastric myoelectrical activity, plasma appetite hormone markers or subjective appetite scores. CONCLUSIONS Contrary to expectations, GE was slower with UHT-M, yet, as anticipated, aminoacidemia was greater. The larger GCV following UHT-M suggests that gastric volume may poorly predict circulating nutrient appearance from complex food matrices. Dairy heat treatment may be an effective tool to modify nutrient release by impacting digestion kinetics. CLINICAL TRIAL REGISTRY www.anzctr.org.au (ACTRN12620000172909).
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Affiliation(s)
- Amber Marie Milan
- The Liggins Institute, The University of Auckland, Auckland, New Zealand; AgResearch Limited, Palmerston North, New Zealand; The High-Value Nutrition National Science Challenge, Auckland, New Zealand.
| | - Matthew Pg Barnett
- AgResearch Limited, Palmerston North, New Zealand; The Riddet Institute, Palmerston North, New Zealand
| | - Warren C McNabb
- The High-Value Nutrition National Science Challenge, Auckland, New Zealand; The Riddet Institute, Palmerston North, New Zealand
| | - Nicole C Roy
- The High-Value Nutrition National Science Challenge, Auckland, New Zealand; The Riddet Institute, Palmerston North, New Zealand; Department of Human Nutrition, The University of Otago, Otago, New Zealand
| | - Schynell Coutinho
- The Liggins Institute, The University of Auckland, Auckland, New Zealand; AgResearch Limited, Palmerston North, New Zealand
| | - Caroline L Hoad
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, United Kingdom; NIHR Nottingham BRC, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, United Kingdom
| | - Luca Marciani
- NIHR Nottingham BRC, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, United Kingdom; Nottingham Digestive Diseases Centre, University of Nottingham, Nottingham, United Kingdom
| | - Samson Nivins
- The Liggins Institute, The University of Auckland, Auckland, New Zealand; Department of Neuroscience, Karolinska Institutet, Solna, Sweden
| | - Hayfa Sharif
- NIHR Nottingham BRC, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, United Kingdom; Nottingham Digestive Diseases Centre, University of Nottingham, Nottingham, United Kingdom; Amiri Hospital, Ministry of Health, Civil Service Commission, Kuwait City, Kuwait
| | - Stefan Calder
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Peng Du
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Armen A Gharibans
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand; Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Greg O'Grady
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand; Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Karl Fraser
- AgResearch Limited, Palmerston North, New Zealand; The High-Value Nutrition National Science Challenge, Auckland, New Zealand; The Riddet Institute, Palmerston North, New Zealand
| | | | | | - Pankaja Sharma
- The Liggins Institute, The University of Auckland, Auckland, New Zealand; AgResearch Limited, Palmerston North, New Zealand
| | - Aahana Shrestha
- The Liggins Institute, The University of Auckland, Auckland, New Zealand; AgResearch Limited, Palmerston North, New Zealand
| | - Richard F Mithen
- The Liggins Institute, The University of Auckland, Auckland, New Zealand; The High-Value Nutrition National Science Challenge, Auckland, New Zealand; The Riddet Institute, Palmerston North, New Zealand
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3
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Gunn D, Yeldho C, Hoad C, Menys A, Gowland P, Marciani L, Spiller R. Mechanisms underlying the laxative effect of lactulose: A randomized placebo-controlled trial showing increased small bowel water and motility unaltered by the 5-HT 3 receptor antagonist, ondansetron. Neurogastroenterol Motil 2024; 36:e14754. [PMID: 38316636 DOI: 10.1111/nmo.14754] [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: 09/20/2023] [Revised: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 02/07/2024]
Abstract
BACKGROUND Lactulose is a laxative which accelerates transit and softens stool. Our aim was to investigate its mechanism of action and use this model of diarrhea to investigate the anti-diarrheal actions of ondansetron. METHODS A double-blind, randomized, placebo-controlled crossover study of the effect of ondansetron 8 mg in 16 healthy volunteers. Serial MRI scans were performed fasted and 6 h after a meal. Participants then received lactulose 13.6 g twice daily and study drug for a further 36 h. On Day 3, they had further serial MRI scans for 4 h. Measurements included small bowel water content (SBWC), colonic volume, colonic gas, small bowel motility, whole gut transit, and ascending colon relaxation time (T1AC), a measure of colonic water content. KEY RESULTS Lactulose increased area under the curve (AUC) of SBWC from 0 to 240 min, mean difference 14.2 L · min (95% CI 4.1, 24.3), p = 0.009, and substantially increased small bowel motility after 4 h (mean (95% CI) 523 (457-646) a.u. to 852 (771-1178) a.u., p = 0.007). There were no changes in T1AC after 36 h treatment. Ondansetron did not significantly alter SBWC, small bowel motility, transit, colonic volumes, colonic gas nor T1AC, with or without lactulose. CONCLUSION & INFERENCES Lactulose increases SBWC and stimulates small bowel motility; however, unexpectedly it did not significantly alter colonic water content, suggesting its laxative effect is not osmotic but due to stimulation of motility. Ondansetron's lack of effect on intestinal water suggests its anti-diarrheal effect is not due to inhibition of secretion but more likely altered colonic motility.
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Affiliation(s)
- D Gunn
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
- Nottingham Digestive Diseases Centre, University of Nottingham, Nottingham, UK
| | - C Yeldho
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
- Nottingham Digestive Diseases Centre, University of Nottingham, Nottingham, UK
| | - C Hoad
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK
| | - A Menys
- Division of Medicine, Centre for Medical Imaging, University College London, London, UK
| | - P Gowland
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK
| | - L Marciani
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
- Nottingham Digestive Diseases Centre, University of Nottingham, Nottingham, UK
| | - R Spiller
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
- Nottingham Digestive Diseases Centre, University of Nottingham, Nottingham, UK
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4
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Shen J, Wu Y, Wei T, He Y, Liu X, Deng Z, Li J. The digestion and absorption characteristics of human milk phospholipid analogs: a combination study between in vitro and in vivo. Food Funct 2023; 14:10617-10627. [PMID: 37964622 DOI: 10.1039/d3fo02779a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
Phospholipids play a crucial role in the growth and neurodevelopment of infants. Currently, soybean phospholipids (SPLs) are the common phospholipid component in most infant formulas (IFs), which, however, shows an obvious difference with the phospholipid (PL) composition of human milk fat. Therefore, in the present study, human milk phospholipid analogs (HMPAs) were prepared by mimicking the composition of PE, PC, PI, PS, and SM in breast milk phospholipids and the composition of the major fatty acids (C16:0, C18:0, C18:1, and C18:2), and their digestion and absorption characteristics were explored using in vitro and mice models. The prepared HMPA contained 26.48% PE, 24.64% PC, 36.19% SM, 6.35% PI, and 6.32% PS, with 40.51% C16:0, 17.02% C18:0, 29.19% C18:1, and 13.26% C18:2, showing different digestive properties relative to SPL. There was little effect on the physical and chemical properties of HMPA under in vitro gastric conditions. The hydrolysis degree, fatty acids release rate, and average particle size decreasing rate of HMPA was significantly higher than that of SPL during digestion in vitro intestine (P < 0.05), showing better digestive process relative to SPL. In terms of the mice model, HMPA had a higher hydrolysis degree in the intestinal tract. Based on the area under curve (AUC) analysis of serum fatty acids, it was found that despite HMPA being absorbed at a slower rate than SPL, it was absorbed more than SPL. In summary, the digestion and absorption of HMPA were preferred to SPL, and these obtained results might provide a theoretical basis for the development and utilization of HMPA in IF.
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Affiliation(s)
- Jiaxin Shen
- State Key Laboratory of Food Science and Resources, Nanchang University, Nanchang, Jiangxi, 330047, China.
| | - Yanping Wu
- State Key Laboratory of Food Science and Resources, Nanchang University, Nanchang, Jiangxi, 330047, China.
| | - Teng Wei
- State Key Laboratory of Food Science and Resources, Nanchang University, Nanchang, Jiangxi, 330047, China.
| | - Yangzheng He
- State Key Laboratory of Food Science and Resources, Nanchang University, Nanchang, Jiangxi, 330047, China.
| | - Xiaoru Liu
- State Key Laboratory of Food Science and Resources, Nanchang University, Nanchang, Jiangxi, 330047, China.
| | - Zeyuan Deng
- State Key Laboratory of Food Science and Resources, Nanchang University, Nanchang, Jiangxi, 330047, China.
| | - Jing Li
- State Key Laboratory of Food Science and Resources, Nanchang University, Nanchang, Jiangxi, 330047, China.
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5
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Dassoff E, Shireen A, Wright A. Lipid emulsion structure, digestion behavior, physiology, and health: a scoping review and future directions. Crit Rev Food Sci Nutr 2023:1-33. [PMID: 37947287 DOI: 10.1080/10408398.2023.2273448] [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: 11/12/2023]
Abstract
Research investigating the effects of the food matrix on health is needed to untangle many unresolved questions in nutritional science. Emulsion structure plays a fundamental role in this inquiry; however, the effects of oil-in-water emulsion structure on broad metabolic, physiological, and health-related outcomes have not been comprehensively reviewed. This systematic scoping review targets this gap and examines methodological considerations for the field of relating food structure and health. MEDLINE, Web of Science, and CAB Direct were searched from inception to December 2022, returning 3106 articles, 52 of which were eligible for inclusion. Many investigated emulsion lipid droplet size and/or gastric colloidal stability and their relation to postprandial weight-loss-related outcomes. The present review also identifies numerous novel relationships between emulsion structures and health-related outcomes. "Omics" endpoints present an exciting avenue for more comprehensive analysis in this area, yet interpretation remains difficult. Identifying valid surrogate biomarkers for long-term outcomes and disease risk will be a turning point for food structure research, leading to breakthroughs in the pace and utility of research that generates advancements in health. The review's findings and recommendations aim to support new hypotheses, future trial design, and evidence-based emulsion design for improved health and well-being.
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Affiliation(s)
- Erik Dassoff
- Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Arshia Shireen
- Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Amanda Wright
- Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
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6
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Dai YH, Wei JR, Chen XQ. Interactions between tea polyphenols and nutrients in food. Compr Rev Food Sci Food Saf 2023; 22:3130-3150. [PMID: 37195216 DOI: 10.1111/1541-4337.13178] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 04/08/2023] [Accepted: 05/01/2023] [Indexed: 05/18/2023]
Abstract
Tea polyphenols (TPs) are important secondary metabolites in tea and are active in the food and drug industry because of their rich biological activities. In diet and food production, TPs are often in contact with other food nutrients, affecting their respective physicochemical properties and functional activity. Therefore, the interaction between TPs and food nutrients is a very important topic. In this review, we describe the interactions between TPs and food nutrients such as proteins, polysaccharides, and lipids, highlight the forms of their interactions, and discuss the changes in structure, function, and activity resulting from their interactions.
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Affiliation(s)
- Yi-Hui Dai
- Cooperative Innovation Center of Industrial Fermentation (Ministry of Education & Hubei Province), Key Laboratory of Fermentation Engineering (Ministry of Education), National "111" Center for Cellular Regulation and Molecular Pharmaceutics, Hubei University of Technology, Wuhan, China
| | - Jia-Ru Wei
- Cooperative Innovation Center of Industrial Fermentation (Ministry of Education & Hubei Province), Key Laboratory of Fermentation Engineering (Ministry of Education), National "111" Center for Cellular Regulation and Molecular Pharmaceutics, Hubei University of Technology, Wuhan, China
| | - Xiao-Qiang Chen
- Cooperative Innovation Center of Industrial Fermentation (Ministry of Education & Hubei Province), Key Laboratory of Fermentation Engineering (Ministry of Education), National "111" Center for Cellular Regulation and Molecular Pharmaceutics, Hubei University of Technology, Wuhan, China
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7
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Eroglu A, Al'Abri IS, Kopec RE, Crook N, Bohn T. Carotenoids and Their Health Benefits as Derived via Their Interactions with Gut Microbiota. Adv Nutr 2023; 14:238-255. [PMID: 36775788 DOI: 10.1016/j.advnut.2022.10.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/21/2022] [Accepted: 10/28/2022] [Indexed: 12/23/2022] Open
Abstract
Carotenoids have been related to a number of health benefits. Their dietary intake and circulating levels have been associated with a reduced incidence of obesity, diabetes, certain types of cancer, and even lower total mortality. Their potential interaction with the gut microbiota (GM) has been generally overlooked but may be of relevance, as carotenoids largely bypass absorption in the small intestine and are passed on to the colon, where they appear to be in part degraded into unknown metabolites. These may include apo-carotenoids that may have biological effects because of higher aqueous solubility and higher electrophilicity that could better target transcription factors, i.e., NF-κB, PPARγ, and RAR/RXRs. If absorbed in the colon, they could have both local and systemic effects. Certain microbes that may be supplemented were also reported to produce carotenoids in the colon. Although some bactericidal aspects of carotenoids have been shown in vitro, a few studies have also demonstrated a prebiotic-like effect, resulting in bacterial shifts with health-associated properties. Also, stimulation of IgA could play a role in this respect. Carotenoids may further contribute to mucosal and gut barrier health, such as stabilizing tight junctions. This review highlights potential gut-related health-beneficial effects of carotenoids and emphasizes the current research gaps regarding carotenoid-GM interactions.
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Affiliation(s)
- Abdulkerim Eroglu
- Department of Molecular and Structural Biochemistry, College of Agriculture and Life Sciences, North Carolina State University, Raleigh, NC, USA; Plants for Human Health Institute, North Carolina Research Campus, North Carolina State University, Kannapolis, NC, USA.
| | - Ibrahim S Al'Abri
- Department of Chemical and Biomolecular Engineering, College of Engineering, North Carolina State University, Raleigh, NC, USA
| | - Rachel E Kopec
- Human Nutrition Program, Department of Human Sciences, The Ohio State University, Columbus, OH, USA; Foods for Health Discovery Theme, The Ohio State University, Columbus, OH, USA
| | - Nathan Crook
- Department of Chemical and Biomolecular Engineering, College of Engineering, North Carolina State University, Raleigh, NC, USA
| | - Torsten Bohn
- Nutrition and Health Research Group, Department of Precision Health, Luxembourg Institute of Health, rue 1 A-B, Thomas Edison, L-1445 Strassen, Luxembourg.
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8
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Bertoli D, Steinkohl E, Mark EB, Brock C, Drewes AM, Frøkjaer JB. Quantification of gastric emptying with magnetic resonance imaging in healthy volunteers: A systematic review. Neurogastroenterol Motil 2022; 34:e14371. [PMID: 35340100 PMCID: PMC10078504 DOI: 10.1111/nmo.14371] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/17/2022] [Accepted: 03/14/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND Several magnetic resonance imaging (MRI) protocols have been used to assess gastric emptying (GE) with MRI. This systematic review summarizes the current literature on the topic. The aim was to provide an overview of the available imaging protocols and underline the items that appear most agreed upon and those that deserve further investigation. METHODS According to PRISMA guidelines, two independent reviewers conducted a systematic literature search with a pre-specified strategy in different databases. Peer-reviewed articles that utilized MRI techniques to assess GE in healthy volunteers (HVs) were included. The quality and the outcomes of the studies were reported and analyzed. KEY RESULTS The literature search yielded 30 studies (531 HVs, weighted mean age 27.4, weighted mean body mass index 23.0 kg/m2 ), T2-weighted sequences, balanced turbo field echo, and balanced gradient echo were evenly utilized, with volunteers in the supine position (74% of the studies). After overnight fasting, both liquid (56%) and mixed (44%) meals were equally utilized. Segmentation of the volumes was predominantly performed manually (63%) with a reported mean T50 ranging from 7 to 330 min. CONCLUSIONS & INFERENCES As observed in this systematic review, MRI is a flexible tool for assessing GE. Different protocols were analyzed, showing an equal capacity to assess the GE. However, many items in these protocols still require further investigation to obtain a common standard and increase this assessment quality.
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Affiliation(s)
- Davide Bertoli
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Emily Steinkohl
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Mech-Sense, Department of Radiology, Aalborg University Hospital, Aalborg, Denmark
| | - Esben Bolvig Mark
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark.,Mech-Sense, Department of Radiology, Aalborg University Hospital, Aalborg, Denmark
| | - Christina Brock
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Asbjørn Mohr Drewes
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Jens Brøndum Frøkjaer
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Mech-Sense, Department of Radiology, Aalborg University Hospital, Aalborg, Denmark
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9
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Dellschaft N, Hoad C, Marciani L, Gowland P, Spiller R. Small bowel water content assessed by MRI in health and disease: a collation of single-centre studies. Aliment Pharmacol Ther 2022; 55:327-338. [PMID: 34716925 DOI: 10.1111/apt.16673] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/12/2021] [Accepted: 10/13/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND New developments in MRI have allowed the non-invasive, accurate measurement of the small bowel water content (SBWC). AIMS To collate studies measuring SBWC following ingestion of a range of foods in both health and disease to provide data for adequately powering future studies in this area. METHODS This collation brings together 29 studies including 954 participants (530 healthy, 54 diverticulosis, 255 IBS, 53 functional constipation, 12 cystic fibrosis, 15 Crohn's disease, 20 coeliac disease, 15 scleroderma) which have been carried out in a single centre using comparable study designs. RESULTS Fasting SBWC (mean 82 [SD 65] mL) shows high variability with a small decline with advancing age (healthy volunteers only; individual patient data). Fasting values are increased in untreated coeliac disease (202 [290] mL, P = 0.004). Post-prandial SBWC shows less intra-individual variability than fasting values in healthy volunteers. SBWC is increased by eating, most markedly by high fat meals but also by fibre, both viscous and particulate. Indigestible residue accumulates in late post-prandial period but empties soon after ingestion of a high calorie meal which produces a significant drop (by 50 [52] mL) in healthy volunteers. The associated fall in SBWC is abnormal in people with cystic fibrosis (SBWC reduced by 10 [121] mL, P = 0.002) and in people with irritable bowel syndrome with diarrhoea (SBWC reduced by 17 [43] mL, P = 0.007). CONCLUSIONS SBWC as assessed by MRI is a valuable biomarker indicating the balance of secretion and absorption in health and disease and the impact of treatments.
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Affiliation(s)
- Neele Dellschaft
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK.,NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK
| | - Caroline Hoad
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK.,NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK
| | - Luca Marciani
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK.,NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK
| | - Penny Gowland
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK.,NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK
| | - Robin Spiller
- NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK.,Nottingham Digestive Diseases Centre, University of Nottingham, Nottingham, UK
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10
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Impact of Gastropexy/Omentopexy on Gastrointestinal Symptoms after Laparoscopic Sleeve Gastrectomy. Obes Surg 2021; 32:729-736. [PMID: 34870791 PMCID: PMC8866353 DOI: 10.1007/s11695-021-05806-y] [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: 02/16/2021] [Revised: 11/11/2021] [Accepted: 11/14/2021] [Indexed: 11/15/2022]
Abstract
Background Laparoscopic sleeve gastrectomy (LSG) has become a single-step operation for the management of severe obesity. A statistically significant number of participants who undergo this procedure experience nausea, vomiting, and reflux symptoms early after the operation. The objectives of this study were to measure the positive or negative effect of gastropexy on reducing distressing postoperative LSG-related gastrointestinal symptoms. Patients and Methods This was a comparative randomized study conducted from January 2018 to January 2021. The study was carried out in the general surgery department at Menoufia University Hospital, Menoufia Faculty of Medicine in Egypt. Two hundred participants were included randomly during this trial. The participants were divided into two groups, with 100 patients in each group. Patients in group A underwent gastropexy, and patients in group B underwent LSG without gastropexy. Results There was no significant difference between the groups in age or sex (p > 0.05). There was no significant difference in the length of hospital stay (p > 0.05). There was a significant difference between the two groups regarding nausea, vomiting, reflux symptoms, and the amount and frequency of antiemetics used (p < 0.001). There was also a significant difference in hospital readmissions (p < 0.05) and in clinic visits during the postoperative period. Conclusions Patients who underwent gastropexy showed a significant reduction in antiemetic consumption and a significantly lower incidence of postoperative nausea, vomiting, gastroesophageal reflux disease symptoms and gastric torsion than those who did not undergo gastropexy. Graphical abstract ![]()
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11
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Hamad S, Tari NR, Mathiyalagan G, Wright AJ. Emulsion acid colloidal stability and droplet crystallinity modulate postprandial gastric emptying and short-term satiety: a randomized, double-blinded, crossover, controlled trial in healthy adult males. Am J Clin Nutr 2021; 114:997-1011. [PMID: 33963742 DOI: 10.1093/ajcn/nqab116] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 03/16/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Emulsion droplet triacylglycerol (TAG) crystallinity and colloidal stability can alter the postprandial metabolism, although evidence of their interactive effects is limited. OBJECTIVES This acute meal crossover study investigated the influences of droplet TAG crystallinity at 37°C and colloidal gastric stability on gastric emptying (GE), acute lipemia, and satiety. METHODS We gave 15 healthy adult males (mean ± SD age, 24.9 y ± 4.5 y; BMI, 26.0 kg/m2 ± 2.0 kg/m2; fasting TAG, 0.9 mmol/L ± 0.3 mmol/L) 250 mL of four 20% palm stearin or palm olein emulsions with similar particle size distributions and containing partially crystalline droplets that remained stable (SS) or destabilized (SU) or containing liquid droplets that remained stable (LS) or destabilized (LU) when exposed to simulated gastric conditions. Baseline and 6-h postprandial ultrasound gastric antrum measurements, satiety visual analogue scales (VAS), and blood samples for analyses of plasma TAG, peptide YY (PYY), glucagon-like peptide-1 (GLP-1), ghrelin, leptin, glucose-dependent insulinotropic polypeptide, insulin, and glucose were collected. Changes from baseline and incremental area under the curve (iAUC) values were analyzed by repeated-measures ANOVA. RESULTS TAG responses did not differ significantly. The gastric antrum area decreased faster (P ≤ 0.01) after treatment with the acid-unstable emulsions (SU and LU), and satiety VAS ratings and plasma endpoints differed between treatments. After LS treatment, participants had 65% and 59% lower 3-h iAUC values for hunger (P = 0.021) and desire to eat (P = 0.031), respectively, compared to after SU treatment. LS treatment resulted in higher 6-h iAUC values for ghrelin (141%; P = 0.023) and PYY (150%; P = 0.043) compared to SU treatment, and LS treatment also resulted in higher GLP-1 values compared to SU (38%; P = 0.016) and LU (76%; P = 0.001) treatment. CONCLUSION Emulsion acid colloidal stability, independent of TAG physical state, delayed GE, and satiety was enhanced after consuming acid stable emulsions containing TAG in the liquid state. The study was registered at clinicaltrials.gov as NCT03990246.
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Affiliation(s)
- Samar Hamad
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Niloufar Rafiee Tari
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Gajuna Mathiyalagan
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Amanda J Wright
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
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12
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Howard E, Attenbourgh A, O'Mahoney LL, Sakar A, Ke L, Campbell MD. Postprandial vascular-inflammatory and thrombotic responses to high-fat feeding are augmented by manipulating the lipid droplet size distribution. Nutr Metab Cardiovasc Dis 2021; 31:2716-2723. [PMID: 34218987 DOI: 10.1016/j.numecd.2021.05.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/29/2021] [Accepted: 05/19/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND AIMS Postprandial responses are influenced not only by the type and amount of fat ingested, but also lipid droplet size distribution. However, little research has investigated the impact of differential lipid size distributions within a mixed-macronutrient meal context on postprandial vascular health. Therefore, we examined whether manipulating the lipid droplet size distribution within a mixed-macronutrient meal impacts vascular-inflammatory and thrombotic parameters. METHODS AND RESULTS In a randomised and counterbalanced fashion, sixteen adults (8 males; age 34 ± 7 years; BMI of 25.3 ± 4.5 kg/m2) completed three separate fasted morning-time feeding challenges, each separated by a minimum washout of 7-days. On each occasion, test-meals matched for carbohydrate and protein content differing only in fat amount and the lipid droplet size distribution were administered, such that participants consumed (1) a low-fat meal (LF) with negligible fat content, (2) an emulsified-high-fat meal with a fine lipid droplet size (FE), or (3) an emulsified-high-fat meal with a coarse lipid droplet size (CE). Periodic blood samples were retrospectively analysed for plasma triglycerides, tumour necrosis factor alpha (TNFα), tissue factor (TF), fibrinogen, and plasminogen activator inhibitor-1 (PAI-1). Triglyceride concentrations increased rapidly overtime under FE (P-time<0.05); this rise was attenuated under CE (P-time>0.05) and was comparable to LF (P-condition>0.05). Similarly, FE induced a significant rise in TNFα, TF, fibrinogen, and PAI-1 (P-time<0.05); these parameters remained unchanged under LF and CE (P-time>0.05). CONCLUSION A high-fat mixed-macronutrient meal with a larger lipid droplet size distribution ameliorates the associated rise in vascular-inflammatory and thrombotic parameters. TRIAL REGISTRATION ISRCTN88881254.
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Affiliation(s)
- Emma Howard
- School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | | | - Lauren L O'Mahoney
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
| | - Anwesha Sakar
- School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Lijin Ke
- School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, China
| | - Matthew D Campbell
- School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, China; Faculty of Health Science and Wellbeing, University of Sunderland, Sunderland, UK; Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK.
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13
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Spiller R. Impact of Diet on Symptoms of the Irritable Bowel Syndrome. Nutrients 2021; 13:nu13020575. [PMID: 33572262 PMCID: PMC7915127 DOI: 10.3390/nu13020575] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/02/2021] [Accepted: 02/04/2021] [Indexed: 02/08/2023] Open
Abstract
Irritable bowel syndrome (IBS), with its key features of abdominal pain and disturbed bowel habit, is thought by both patients and clinicians to be strongly influenced by diet. However, the complexities of diet have made identifying specific food intolerances difficult. Eating disorders can masquerade as IBS and may need specialist treatment. While typical food allergy is readily distinguished from IBS, the mechanisms of gut-specific adverse reactions to food are only just being defined. These may include gut-specific mast cell activation as well as non-specific activation by stressors and certain foods. Visceral hypersensitivity, in some cases mediated by mast cell activation, plays a key part in making otherwise innocuous gut stimuli painful. Rapidly fermented poorly absorbed carbohydrates produce gaseous distension as well as short-chain fatty acids and lowering of colonic pH which may cause symptoms in IBS patients. Limiting intake of these in low FODMAP and related diets has proven popular and apparently successful in many patients. Existing diet, colonic microbiota and their metabolic products may be helpful in predicting who will respond. Wheat intolerance may reflect the fact that wheat is often a major source of dietary FODMAPs. It may also be either a forme fruste of coeliac disease or non-specific immune activation. Wheat exclusion can be successful in some of these patients. More research is needed to fully understand the mechanisms of food intolerances and how to best ameliorate them in a personalised medicine approach to diet in IBS.
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Affiliation(s)
- Robin Spiller
- NIHR Nottingham Biomedical Research Centre, Nottingham NG7 2UH, UK
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14
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Milan AM, Samuelsson LM, Shrestha A, Sharma P, Day L, Cameron-Smith D. Circulating Branched Chain Amino Acid Concentrations Are Higher in Dairy-Avoiding Females Following an Equal Volume of Sheep Milk Relative to Cow Milk: A Randomized Controlled Trial. Front Nutr 2020; 7:553674. [PMID: 33240914 PMCID: PMC7678490 DOI: 10.3389/fnut.2020.553674] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 10/07/2020] [Indexed: 12/23/2022] Open
Abstract
Background: Intolerances to bovine dairy are a motivating factor in consumers seeking alternate-or replacement-dairy beverages and foods. Sheep milk (SM) is an alternate dairy source, with greater protein, although similar amino acid composition compared to cow milk (CM). Studies are yet to address the appearance of circulating amino acids following consumption of SM, relative to CM, in humans. Objective: To clinically determine the appearance of branched chain amino acids, and other amino acids, in circulation in response to equal servings of SM and CM, in females who avoid dairy products. Design: In a double-blinded, randomized, cross-over trial, 30 self-described dairy avoiding females (20-40 years) drank 650 mL of SM or CM that were reconstituted from the spray dried powders (30 and 25 g in 180 mL water, respectively) on separate occasions, following an overnight fast. After reconstitution, the energy and protein provided by SM was higher than for CM (2,140 vs. 1,649 kJ; 29.9 vs. 19.4 g protein); content of branched chain amino acids (BCAAs) were 10.5 and 6.5 mg·mL-1, respectively. Blood samples were collected at fasting and at regular intervals over 5 h after milk consumption. Plasma amino acids were measured by HPLC. Results: 80% of subjects self-identified as lactose intolerant, and the majority (47%) "avoided drinking milk" "most of the time". SM resulted in greater plasma appearance of BCAAs at 60 min (641.1 ± 16.3 vs. 563.5 ± 14.4 μmol·L-1; p < 0.001) compared with CM. SM similarly resulted in elevated postprandial concentrations of the amino acids lysine, methionine, and proline, particularly at 240 min (time × milk interactions p = 0.011, 0.017, and p = 0.002, respectively). Postprandial increases in plasma alanine concentrations were sustained to 120 min after CM (time × milk interaction p = 0.001) but not after SM, despite greater quantities provided by SM. Conclusions: SM is a rich source of protein, and relative to CM, provides a greater quantity of BCAAs, with a corresponding elevation of the postprandial circulating BCAA response. SM is therefore a possible dairy alternative of benefit to those who need to increase total protein intake or for individuals with heightened protein requirements. Unique Identifier and Registry: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375324, identifier U1111-1209-7768.
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Affiliation(s)
- Amber M. Milan
- The Liggins Institute, The University of Auckland, Auckland, New Zealand
- AgResearch Ltd, Grasslands Research Center, Palmerston North, New Zealand
| | | | - Aahana Shrestha
- The Liggins Institute, The University of Auckland, Auckland, New Zealand
- Riddet Institute, Palmerston North, New Zealand
| | - Pankaja Sharma
- The Liggins Institute, The University of Auckland, Auckland, New Zealand
- Riddet Institute, Palmerston North, New Zealand
| | - Li Day
- AgResearch Ltd, Grasslands Research Center, Palmerston North, New Zealand
| | - David Cameron-Smith
- The Liggins Institute, The University of Auckland, Auckland, New Zealand
- AgResearch Ltd, Grasslands Research Center, Palmerston North, New Zealand
- Riddet Institute, Palmerston North, New Zealand
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15
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Hamad S, Thilakarathna SH, Cuncins A, Brown M, Wright AJ. Emulsion Droplet Crystallinity Attenuates Short-Term Satiety in Healthy Adult Males: A Randomized, Double-Blinded, Crossover, Acute Meal Study. J Nutr 2020; 150:2295-2304. [PMID: 32556204 DOI: 10.1093/jn/nxaa164] [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: 03/16/2020] [Revised: 04/08/2020] [Accepted: 05/18/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The influence of triacylglycerol (TAG) physical properties on satiety remains poorly understood. OBJECTIVES The objective was to investigate if and how TAG digestion and absorption, modulated only by differences in TAG crystallinity, would differentially affect short-term satiety in healthy men. METHODS We tempered 500 mL 10% palm stearin oil-in-water emulsions such that the lipid droplets were either undercooled liquid (LE) or partially crystalline solid (SE). Fifteen healthy men (mean ± SD age: 27.5 ± 5.7 y; BMI: 24.1 ± 2.5 kg/m2; fasting TAG: 0.9 ± 0.3 mmol/L) consumed each beverage at two 6-h study visits separated by ≥6 d after an overnight fast, along with 1500 mg acetaminophen suspended in water. The participants characterized the emulsion sensory properties, completed satiety visual analog scale ratings, and had serial blood samples collected for 6-h analysis of plasma peptide YY (PYY), glucagon-like peptide-1 (GLP-1), ghrelin, leptin, glucose-dependent insulinotropic polypeptide (GIP), insulin, and acetaminophen (for assessing gastric emptying). Repeated-measures ANOVAs and 2-tailed paired t tests were used to analyze the changes from baseline and incremental area under the curve (iAUC) values, respectively. RESULTS With consumption of LE compared with SE, there was a 358% higher fullness (P = 0.015) and a 103% lower average appetite (P = 0.041) score, along with higher iAUC values for PYY (P = 0.011) and GLP-1 (P = 0.028) (103% and 66% higher, respectively), but not for ghrelin (P = 0.39), based on change from baseline values. Acetaminophen response trended toward significance (P = 0.08) and was 15% higher with LE. SE was rated as 44% thicker (P = 0.034) and 24% creamier (P = 0.05) than LE. CONCLUSIONS The suppression of TAG digestion by the presence of partially crystalline lipid droplets blunted the appetite-suppressing effects of an oil-in-water emulsion.This trial was registered at clinicaltrials.gov as NCT03990246.
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Affiliation(s)
- Samar Hamad
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Surangi H Thilakarathna
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Amanda Cuncins
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Melissa Brown
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Amanda J Wright
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
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16
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Stamatopoulos K, Pathak SM, Marciani L, Turner DB. Population-Based PBPK Model for the Prediction of Time-Variant Bile Salt Disposition within GI Luminal Fluids. Mol Pharm 2020; 17:1310-1323. [DOI: 10.1021/acs.molpharmaceut.0c00019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - Shriram M. Pathak
- Certara Ltd (Simcyp Division), Level 2-Acero, 1 Concourse Way, Sheffield S1 2BJ, United Kingdom
| | - Luca Marciani
- Nottingham Digestive Diseases Centre and National Institute for Health Research, Biomedical Research Unit, Nottingham University Hospitals, University of Nottingham, Nottingham NG7 2RD, United Kingdom
| | - David B. Turner
- Certara Ltd (Simcyp Division), Level 2-Acero, 1 Concourse Way, Sheffield S1 2BJ, United Kingdom
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17
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Mulet-Cabero AI, Mackie AR, Brodkorb A, Wilde PJ. Dairy structures and physiological responses: a matter of gastric digestion. Crit Rev Food Sci Nutr 2020; 60:3737-3752. [PMID: 32056441 DOI: 10.1080/10408398.2019.1707159] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Digestion and health properties of food do not solely rely on the sum of nutrients but are also influenced by food structure. Dairy products present an array of structures due to differences in the origin of milk components and the changes induced by processing. Some dairy structures have been observed to induce specific effects on digestion rates and physiological responses. However, the underlying mechanisms are not fully understood. Gastric digestion plays a key role in controlling digestion kinetics. The main objective of this review is to expose the relevance of gastric phase as the link between dairy structures and physiological responses. The focus is on human and animal studies, and physiological relevant in vitro digestion models. Data collected showed that the structure of dairy products have a profound impact on rate of nutrient bioavailability, absorption and physiological responses, suggesting gastric digestion as the main driver. Control of gastric digestion can be a tool for delivering specific rates of nutrient digestion. Therefore, the design of food structure targeting specific gastric behavior could be of great interest for particular population needs e.g. rapid nutrient digestion will benefit elderly, and slow nutrient digestion could help to enhance satiety.
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Affiliation(s)
| | - Alan R Mackie
- School of Food Science and Nutrition, University of Leeds, Leeds, UK
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18
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Fotschki J, Wróblewska B, Fotschki B, Kalicki B, Rigby N, Mackie A. Microbial transglutaminase alters the immunogenic potential and cross-reactivity of horse and cow milk proteins. J Dairy Sci 2020; 103:2153-2166. [PMID: 31928755 DOI: 10.3168/jds.2019-17264] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 11/12/2019] [Indexed: 12/31/2022]
Abstract
Horse milk is a valuable raw material and a very attractive alternative for scientific research to address the issue of cow milk (CM) allergy due to its protein profile. A decrease in immunoreactive properties can be achieved by thermal, enzymatic, and hydrolytic processing. Therefore, the aim of this study was to explore the possibility of reducing the immunoreactivity of horse milk proteins by microbial transglutaminase (TG) polymerization. To determine how TG linking alters immunoreactivity under simulated digestion of the examined milk, analyses were performed before, during, and after digestion. The dose-dependent (1, 10, and 100 U) effects of microbial TG on horse and cow milk were analyzed. A consecutive 3-stage digestion was simulated with salivary, gastric, and intestinal fluids. The effects of digestion were analyzed by SDS-PAGE, particle size analysis, and size-exclusion chromatography. Immunoreactivity was assessed using competitive ELISA (β-lactoglobulin and α-casein) and immunodot (sera from 7 patients aged 3 to 13 years who are allergic to CM proteins). Horse milk contained almost half of the amount of total proteins in CM. The dose 1 U/g of total milk protein changed the immunoreactivity of both cow and horse milk. With increasing TG doses, α-casein immunoreactivity increased, and β-lactoglobulin decreased. After total digestion, horse milk was characterized by 2.4-fold lower average IgE and 4.8-fold lower IgG reactivity than CM. We found that TG alters the IgE and IgG reactivity of CM after in vitro digestion. Horse milk was less reactive to IgE and IgG than was CM, with animal and patient sera. The effect of TG on immunoreactivity depends on enzyme quantity and milk protein type. The diet based on modified horse milk proteins could be an alternative for some patients with CM protein allergy; however, confirmation through clinical trials is needed.
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Affiliation(s)
- J Fotschki
- Department of Immunology and Food Microbiology, Division of Food Science, Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, 10-748 Olsztyn, Poland.
| | - B Wróblewska
- Department of Immunology and Food Microbiology, Division of Food Science, Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, 10-748 Olsztyn, Poland
| | - B Fotschki
- Department of Biological Function of Food, Division of Food Science, Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, 10-748 Olsztyn, Poland
| | - B Kalicki
- Department of Pediatrics, Nephrology and Allergology, Military Institute of Medicine, 04-141 Warsaw, Poland
| | - N Rigby
- Institute of Food Research, Norwich NR4 7UA, United Kingdom; School of Food Science and Nutrition, University of Leeds, LS2 9JT, United Kingdom
| | - A Mackie
- Institute of Food Research, Norwich NR4 7UA, United Kingdom; School of Food Science and Nutrition, University of Leeds, LS2 9JT, United Kingdom
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19
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Humphrey B, Zhao J, Faris R. Review: Link between intestinal immunity and practical approaches to swine nutrition. Animal 2019; 13:2736-2744. [PMID: 31475667 DOI: 10.1017/s1751731119001861] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Gaining a deeper understanding into the underlying mechanisms associated with intestinal function and immunity during the weaning transition is critical to help shed new light into applied nutrition approaches to improve piglet performance and health during this critical life-stage transition. The transient anorexia triggered at weaning leads to compromised intestinal barrier function and a localized inflammatory response. Considering barrier function, specific nutrient fractions appear to have a significant impact on the development and function of the immune and microbial systems around weaning. Understanding the specific impact of nutrients in the small intestine and hindgut is important for helping to bring more focus and consistency to nutritional approaches to support health and immunity during the weaning transition period. The challenge continues to be how to translate these modes of action into practical and scalable approaches for swine nutrition. We will focus specifically on practical nutritional approaches to influence intestinal immunity through lipid, protein and antioxidant nutrition.
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Affiliation(s)
- B Humphrey
- Provimi, 10 Nutrition Way, Brookville, OH 45309, USA
| | - J Zhao
- Cargill Animal Nutrition, 10383 165th Ave NW, Elk River, MN 55330, USA
| | - R Faris
- Cargill Animal Nutrition, 10383 165th Ave NW, Elk River, MN 55330, USA
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20
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Zhang Z, Jung KJ, Zhang R, Muriel Mundo JL, McClements DJ. In situ monitoring of lipid droplet release from biopolymer microgels under simulated gastric conditions using magnetic resonance imaging and spectroscopy. Food Res Int 2019; 123:181-188. [DOI: 10.1016/j.foodres.2019.04.063] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 03/29/2019] [Accepted: 04/27/2019] [Indexed: 02/06/2023]
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21
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Variations in gastrointestinal lipases, pH and bile acid levels with food intake, age and diseases: Possible impact on oral lipid-based drug delivery systems. Adv Drug Deliv Rev 2019; 142:3-15. [PMID: 30926476 DOI: 10.1016/j.addr.2019.03.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 02/27/2019] [Accepted: 03/25/2019] [Indexed: 12/21/2022]
Abstract
The lipids and some surfactants present in oral lipid-based drug delivery systems are potential substrates for the various lipases involved in gastrointestinal (GI) lipolysis. The levels of these enzymes, together with pH and biliairy secretion, are important parameters that condition the fate of lipid-based formulations (LBF) and the dispersion, solubilization and absorption of lipophilic drugs in the GI tract. Since in vitro methods of digestion are now combined with dissolution assays for a better assessment of LBF performance, it is essential to have a basic knowledge on lipase, pH and bile acid (BA) levels in vivo to develop relevant in vitro models. While these parameters and their variations in healthy subjects are today well documented, in vivo data on specific populations (age groups, patients with various diseases, patients with treatment affecting GI tract parameters, …) are scarce and obtaining them from clinical studies is sometimes difficult due to ethical limitations. Here we collected some in vivo data already available on the levels of digestive lipases, gastric and intestinal pH, and BAs at various ages and in patients with exocrine pancreatic insufficiency, a pathological situation that leads to drastic changes in GI tract parameters and impacts pharmacological treatments.
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22
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Hoad C, Clarke C, Marciani L, Graves MJ, Corsetti M. Will MRI of gastrointestinal function parallel the clinical success of cine cardiac MRI? Br J Radiol 2019; 92:20180433. [PMID: 30299989 PMCID: PMC6435057 DOI: 10.1259/bjr.20180433] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 09/21/2018] [Accepted: 10/03/2018] [Indexed: 12/11/2022] Open
Abstract
Cine cardiac MRI is generally accepted as the "gold-standard" for functional myocardial assessment. It only took a few years after the development of commercial MRI systems for functional cardiac imaging to be developed, with electrocardiogram (ECG)-gated cine imaging first reported in 1988. The function of the gastrointestinal (GI) tract is more complex to study compared to the heart. However, the idea of having a non-invasive tool to study the GI function that also allows the concurrent assessment of different aspects of this function has become more and more attractive in the gastroenterological field. This review summarises key literature of the last 5 years to describe the current status of MRI in respect to the evaluation of GI function, highlighting the gaps and challenges and the future prospects. As the clinical application of a new technique requires that its clinical utility is confirmed by demonstration of its ability to enable clinicians to make a diagnosis and/or predict the treatment response, this review also considers whether or not this has been achieved, and how MRI has been validated against techniques currently recognised as the gold standard in clinical practice.
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Affiliation(s)
| | - Christopher Clarke
- Department of Radiology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | | | - Martin John Graves
- Department of Radiology, Cambridge University Hospitals NHS Trust, Cambridge, UK
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23
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Wilkinson-Smith VC, Major G, Ashleigh L, Murray K, Hoad CL, Marciani L, Gowland PA, Spiller RC. Insights Into the Different Effects of Food on Intestinal Secretion Using Magnetic Resonance Imaging. JPEN J Parenter Enteral Nutr 2018; 42:1342-1348. [PMID: 29603286 DOI: 10.1002/jpen.1157] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 02/08/2018] [Indexed: 12/17/2023]
Abstract
BACKGROUND Plant foods may stimulate intestinal secretion through chemicals designed to deter herbivores, including lactucins in lettuce and rhein in rhubarb. This may increase ileostomy output and induce diarrhoea in people with intact bowels. OBJECTIVE We aimed to determine the effect of food on intestinal water content using Magnetic Resonance Imaging (MRI). DESIGN A three period crossover trial of isocaloric meals in adults without bowel disorders. Meals: 2 slices white bread with 10 g butter; 300 g rhubarb with 60 mL lactose free cream; 300 g lettuce with 30 mL mayonnaise. PRIMARY OUTCOME Area under curve (AUC) small bowel water content (SBWC) using MRI. SECONDARY OUTCOMES ascending colon water content; T1 relaxation time of ascending colon (T1AC); gastric volume; visual analogue scales of bloating and satiety (0-100). MRI analysts were blinded. Scanned fasting and hourly to 180 min postprandial. Symptoms scored half-hourly. RESULTS 9 female and 6 male subjects completed the study. AUC SBWC fell after bread but rose after lettuce and even more after rhubarb, difference from baseline being (Bread AUC -5662 (1209) ml.min vs Lettuce 3194 (1574) ml.min and Rhubarb 10586 (1629) ml.min (P < 0.01). Rhubarb induced a rise in T1AC but differences at 3 hours were not significant (P = 0.06). Gastric volume at T = 0 significantly was higher for both lettuce and rhubarb (571 ± 92 and 558 ± 89 mls) respectively compared to bread (314 ± 108 mls) (p < 0.0001). Symptom scores were higher for lettuce > rhubarb > bread. CONCLUSION Lettuce and rhubarb meals increased intestinal water content, demonstrating how different foods can alter ileal flow and stool consistency.
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Affiliation(s)
- Victoria C Wilkinson-Smith
- National Institute for Health Research, Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, United Kingdom
- Nottingham Digestive Diseases Centre, University of Nottingham, Nottingham, United Kingdom
| | - Giles Major
- National Institute for Health Research, Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, United Kingdom
- Nottingham Digestive Diseases Centre, University of Nottingham, Nottingham, United Kingdom
| | - Lucy Ashleigh
- Nottingham Digestive Diseases Centre, University of Nottingham, Nottingham, United Kingdom
| | - Kathryn Murray
- National Institute for Health Research, Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, United Kingdom
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, United Kingdom
| | - Caroline L Hoad
- National Institute for Health Research, Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, United Kingdom
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, United Kingdom
| | - Luca Marciani
- National Institute for Health Research, Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, United Kingdom
- Nottingham Digestive Diseases Centre, University of Nottingham, Nottingham, United Kingdom
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, United Kingdom
| | - Penny A Gowland
- National Institute for Health Research, Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, United Kingdom
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, United Kingdom
| | - Robin C Spiller
- National Institute for Health Research, Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, United Kingdom
- Nottingham Digestive Diseases Centre, University of Nottingham, Nottingham, United Kingdom
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Tardelli LP, Breda L, Marques LF, Gomes Carvalho Lima NC, Furtado de Camargo T, Scherer BR, Moreira NF, Dias JF, Dalia RA, Thomazini BF, Corezolla do Amaral ME, Alves AA. High lipid and low carbohydrate content diet, immediately after weaning, causes hepatic injury, systemic oxidative stress and diminishment of lipids in white adipose tissue. JOURNAL OF NUTRITION & INTERMEDIARY METABOLISM 2018. [DOI: 10.1016/j.jnim.2018.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Lipids in the Stomach – Implications for the Evaluation of Food Effects on Oral Drug Absorption. Pharm Res 2018; 35:55. [DOI: 10.1007/s11095-017-2289-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 10/20/2017] [Indexed: 10/18/2022]
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27
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Tan KWJ, Sun LJ, Goh KKT, Henry CJ. Lipid droplet size and emulsification on postprandial glycemia, insulinemia and lipidemia. Food Funct 2018; 7:4278-4284. [PMID: 27605048 DOI: 10.1039/c6fo00897f] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Previous studies have suggested that a smaller lipid droplet size results in a greater rate of lipolysis. However, acute health impacts of emulsification and small lipid droplet size are not well understood. We aimed to investigate the effect of emulsification and lipid droplet size on postprandial lipidemia, glycemia and insulinemia. Fifteen healthy Chinese males (mean ± SD, age of 26 ± 6 years and BMI of 22.2 ± 1.2 kg m-2) participated on 3 separate occasions in a randomized order. Participants received an olive oil-water beverage and white bread as test meals. The three test beverages were as follows: (1) an olive oil-water mixture (non-emulsified, control), (2) fine olive oil-water emulsion (small lipid droplet size) and (3) coarse olive oil-water emulsion (large lipid droplet size). Glucose, insulin, triglyceride, non-esterified fatty acid (NEFA), gastric antral distention and appetite measurements were recorded for 4 hours. Glucose and insulin concentrations increased rapidly after administration of non-emulsified beverages as compared to fine and coarse emulsions with a significant difference at 30 min (95% confidence interval, P < 0.05). Fine emulsion led to a significant increase in triglyceride responses, a smaller suppression of NEFA responses and slowed gastric emptying compared to the non-emulsified beverage and coarse emulsion (iAUC, 95% confidence interval, P < 0.05). Emulsification and alteration of lipid droplet size have acute effects on glucose, insulin, triglyceride and fatty acid responses.
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Affiliation(s)
- Kevin Wei Jie Tan
- Clinical Nutrition Research Centre (CNRC), Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore.
| | - Li Juan Sun
- Clinical Nutrition Research Centre (CNRC), Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore.
| | - Kelvin Kim Tha Goh
- School of Food and Nutrition, Massey University, Palmerston North, New Zealand
| | - Christiani Jeyakumar Henry
- Clinical Nutrition Research Centre (CNRC), Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore. and Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Maher T, Clegg ME. Dietary lipids with potential to affect satiety: Mechanisms and evidence. Crit Rev Food Sci Nutr 2018; 59:1619-1644. [DOI: 10.1080/10408398.2017.1423277] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Tyler Maher
- Oxford Brookes Centre for Nutrition and Health, Department of Sport, Health Sciences and Social Work, Faculty of Health and Life Sciences, Oxford Brookes University, Gipsy Lane, Oxford, UK
| | - Miriam E. Clegg
- Oxford Brookes Centre for Nutrition and Health, Department of Sport, Health Sciences and Social Work, Faculty of Health and Life Sciences, Oxford Brookes University, Gipsy Lane, Oxford, UK
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29
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Poppitt SD, Budgett SC, MacGibbon AK, Quek SY, Kindleysides S, Wiessing KR. Effects of lipid emulsion particle size on satiety and energy intake: a randomised cross-over trial. Eur J Clin Nutr 2017; 72:349-357. [DOI: 10.1038/s41430-017-0016-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 08/26/2017] [Accepted: 09/10/2017] [Indexed: 01/16/2023]
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30
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Camps G, Mars M, de Graaf C, Smeets PA. A tale of gastric layering and sieving: Gastric emptying of a liquid meal with water blended in or consumed separately. Physiol Behav 2017; 176:26-30. [DOI: 10.1016/j.physbeh.2017.03.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2016] [Revised: 03/17/2017] [Accepted: 03/17/2017] [Indexed: 10/19/2022]
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Infant milk fat droplet size and coating affect postprandial responses in healthy adult men: a proof-of-concept study. Eur J Clin Nutr 2017; 71:1108-1113. [PMID: 28422122 DOI: 10.1038/ejcn.2017.50] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 03/01/2017] [Accepted: 03/09/2017] [Indexed: 01/15/2023]
Abstract
BACKGROUND/OBJECTIVES Fat droplets in human milk (HM) are larger and surrounded by a phospholipid membrane compared with infant milk formulas (IMF). Since the physical structure of fat droplets might affect digestion and postprandial metabolism, an IMF was developed more mimicking HM lipid structure than current IMF. SUBJECTS/METHODS A randomised, double-blind, crossover study was performed in 29 fasted healthy men (aged 18-25 years, BMI: 18-25 kg/m2) to compare 5-hour postprandial responses after consumption of an experimental IMF (Concept, Nuturis) with a current IMF (Control). RESULTS Postprandial triacylglycerol (TAG) concentrations tended to increase faster after intake of Concept IMF (P=0.054), but peaked 3 h after intakes at similar concentrations. ApoB48 increased steadily and peaked 3 h after consumption. Increases in plasma glucose concentrations were comparable, but peak concentrations were reached faster after consumption of Concept IMF (P<0.05). Peak insulin concentrations were higher and reached earlier after intake of Concept IMF, causing a sharper decremental glucose rebound (P<0.05) and an earlier time to nadir in non-esterified fatty acid (NEFA) concentrations (P<0.01). Changes in plasma amino acids (AA), apoB100 and apoA1 were comparable. The incremental or decremental areas under-the-curve did not differ between Concept and Control IMF. Satiety scores and changes in the satiety hormones ghrelin and peptide YY were comparable, while cholecystokinin responses were earlier and higher after consumption of Control IMF (P<0.05). CONCLUSIONS This proof-of-concept study suggests that fats and carbohydrates from the Concept IMF with larger and phospholipid-coated fat droplets are more rapidly absorbed than those from the current IMF.
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Steingoetter A, Buetikofer S, Curcic J, Menne D, Rehfeld JF, Fried M, Schwizer W, Wooster TJ. The Dynamics of Gastric Emptying and Self-Reported Feelings of Satiation Are Better Predictors Than Gastrointestinal Hormones of the Effects of Lipid Emulsion Structure on Fat Digestion in Healthy Adults-A Bayesian Inference Approach. J Nutr 2017; 147:706-714. [PMID: 28228504 DOI: 10.3945/jn.116.237800] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 08/10/2016] [Accepted: 01/25/2017] [Indexed: 11/14/2022] Open
Abstract
Background: Limited information exists on the relation between fat emulsion structure and its effect on the release of gastrointestinal hormones and feelings of satiation.Objective: We investigated the impact of fat emulsion droplet size, gravitational and acid stability, and redispersibility on gastrointestinal responses and sought to deduce the relative importance of the hormones ghrelin, cholecystokinin, glucagon-like peptide-1, and peptide YY (PYY) in controlling fat emptying and related satiation.Methods: Within a randomized, double-blind, 4-armed crossover study, an extensive data set was generated by MRI of gastric function, analysis of hormone profiles, and ratings of satiation in healthy participants [10 women and 7 men with a mean ± SD age of 25 ± 7 y and body mass index (in kg/m2) of 22 ± 1] after intake of 4 different fat emulsions. Iterative Bayesian model averaging variable selection was used to investigate the influence of hormone profiles in controlling fat emulsion emptying and satiation.Results: The emulsion structure had a distinct effect on the gastric emptying (primary outcome), gastrointestinal hormone profiles, and ratings of satiation (secondary outcomes). Gravitational and acid stability were stronger modulators of fat emptying and hormone profiles than were emulsion droplet size or redispersibility. Cholecystokinin and PYY were most strongly affected by fat emulsion instability and droplet size. Although both hormones were relevant predictors of gastric emptying, only PYY was identified as a relevant predictor of satiation.Conclusions: This work indicates that evenly dispersed, stable, small-emulsion droplets within the stomach lead to prolonged gastric distension, longer ghrelin suppression, and accelerated fat sensing (cholecystokinin and PPY), triggering prolonged feelings of satiation. It suggests that the effects of emulsion instability and droplet size on energy consumption are best studied by assessing changes in gastric emptying and ratings of satiation rather than changes in venous hormone profiles. This trial was registered at clinicaltrials.gov as NCT01253005.
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Affiliation(s)
- Andreas Steingoetter
- Division of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland; .,Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Simon Buetikofer
- Division of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland
| | - Jelena Curcic
- Division of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland.,Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland
| | | | - Jens F Rehfeld
- Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, København, Denmark; and
| | - Michael Fried
- Division of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland
| | - Werner Schwizer
- Division of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland
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Borreani J, Espert M, Salvador A, Sanz T, Quiles A, Hernando I. Oil-in-water emulsions stabilised by cellulose ethers: stability, structure and in vitro digestion. Food Funct 2017; 8:1547-1557. [DOI: 10.1039/c7fo00159b] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Cellulose ether emulsions have good physical and oxidative stability and can delay in vitro lipid digestion. HMC emulsions inhibit lipolysis more than others and could enhance gastric fullness and satiety.
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Affiliation(s)
- Jennifer Borreani
- Food Microstructure and Chemistry Research Group
- Department of Food Technology
- Universitat Politècnica de València
- Valencia
- Spain
| | - María Espert
- Instituto de Agroquímica y Tecnología de Alimentos (IATA-CSIC)
- Valencia
- Spain
| | - Ana Salvador
- Instituto de Agroquímica y Tecnología de Alimentos (IATA-CSIC)
- Valencia
- Spain
| | - Teresa Sanz
- Instituto de Agroquímica y Tecnología de Alimentos (IATA-CSIC)
- Valencia
- Spain
| | - Amparo Quiles
- Food Microstructure and Chemistry Research Group
- Department of Food Technology
- Universitat Politècnica de València
- Valencia
- Spain
| | - Isabel Hernando
- Food Microstructure and Chemistry Research Group
- Department of Food Technology
- Universitat Politècnica de València
- Valencia
- Spain
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Chan YK, Budgett SC, MacGibbon AK, Quek SY, Kindleysides S, Poppitt SD. Small particle size lipid emulsions, satiety and energy intake in lean men. Physiol Behav 2016; 169:98-105. [PMID: 27890592 DOI: 10.1016/j.physbeh.2016.11.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 10/26/2016] [Accepted: 11/19/2016] [Indexed: 01/17/2023]
Abstract
Lipid emulsions have been proposed to suppress hunger and food intake. Whilst there is no consensus on optimal structural properties or mechanism of action, small particle size (small-PS) stable emulsions may have greatest efficacy. Fabuless®, a commercial lipid emulsion reported in some studies to decrease energy intake (EI), is a small-PS, 'hard' fat emulsion comprising highly saturated palm oil base (PS, 82nm). To determine whether small-PS dairy lipid emulsions can enhance satiety, firstly, we investigated 2 'soft' fat dairy emulsions generated using dairy and soy emulsifying agents (PS, 114nm and 121nm) and a non-emulsified dairy control. Secondly, we investigated a small-PS palmolein based 'hard' fat emulsion (fractionated palm oil, PS, 104nm) and non-emulsified control. This was a 6 arm, randomized, cross-over study in 18 lean men, with test lipids delivered in a breakfast meal: (i) Fabuless® emulsion (FEM); (ii) dairy emulsion with dairy emulsifier (DEDE); (iii) dairy emulsion with soy lecithin emulsifier (DESE); (iv) dairy control (DCON); (v) palmolein emulsion with dairy emulsifier (PEDE); (vi) palmolein control (PCON). Participants rated postprandial appetite sensations using visual analogue scales (VAS), and ad libitum energy intake (EI) was measured at a lunch meal 3.5h later. Dairy lipid emulsions did not significantly alter satiety ratings or change EI relative to dairy control (DEDE, 4035kJ; DESE, 3904kJ; DCON, 3985kJ; P>0.05) nor did palm oil based emulsion relative to non-emulsified control (PEDE, 3902 kJ; PCON, 3973kJ; P>0.05). There was no evidence that small-PS dairy lipid emulsions or commercial Fabuless altered short-term appetite or food intake in lean adults.
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Affiliation(s)
- Y K Chan
- Human Nutrition Unit, University of Auckland, Auckland, New Zealand; School of Biological Sciences, University of Auckland, Auckland, New Zealand.
| | - S C Budgett
- Department of Statistics, University of Auckland, Auckland, New Zealand
| | - A K MacGibbon
- Fonterra Research and Development Centre, Palmerston North, New Zealand
| | - S Y Quek
- Department of Food Science, University of Auckland, Auckland, New Zealand
| | - S Kindleysides
- Human Nutrition Unit, University of Auckland, Auckland, New Zealand
| | - S D Poppitt
- Human Nutrition Unit, University of Auckland, Auckland, New Zealand; School of Biological Sciences, University of Auckland, Auckland, New Zealand; Department of Medicine, University of Auckland, Auckland, New Zealand.
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Rezhdo O, Speciner L, Carrier R. Lipid-associated oral delivery: Mechanisms and analysis of oral absorption enhancement. J Control Release 2016; 240:544-560. [PMID: 27520734 PMCID: PMC5082615 DOI: 10.1016/j.jconrel.2016.07.050] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 07/27/2016] [Accepted: 07/28/2016] [Indexed: 01/29/2023]
Abstract
The majority of newly discovered oral drugs are poorly water soluble, and co-administration with lipids has proven effective in significantly enhancing bioavailability of some compounds with low aqueous solubility. Yet, lipid-based delivery technologies have not been widely employed in commercial oral products. Lipids can impact drug transport and fate in the gastrointestinal (GI) tract through multiple mechanisms including enhancement of solubility and dissolution kinetics, enhancement of permeation through the intestinal mucosa, and triggering drug precipitation upon lipid emulsion depletion (e.g., by digestion). The effect of lipids on drug absorption is currently not quantitatively predictable, in part due to the multiple complex dynamic processes that can be impacted by lipids. Quantitative mechanistic analysis of the processes significant to lipid system function and overall impact on drug absorption can aid in the understanding of drug-lipid interactions in the GI tract and exploitation of such interactions to achieve optimal lipid-based drug delivery. In this review, we discuss the impact of co-delivered lipids and lipid digestion on drug dissolution, partitioning, and absorption in the context of the experimental tools and associated kinetic expressions used to study and model these processes. The potential benefit of a systems-based consideration of the concurrent multiple dynamic processes occurring upon co-dosing lipids and drugs to predict the impact of lipids on drug absorption and enable rational design of lipid-based delivery systems is presented.
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Affiliation(s)
- Oljora Rezhdo
- Department of Chemical Engineering, Northeastern University, 360 Huntington Avenue, Boston, MA 02115, United States
| | - Lauren Speciner
- Department of Bioengineering, Northeastern University, 360 Huntington Avenue, Boston, MA 02115, United States
| | - Rebecca Carrier
- Department of Chemical Engineering, Northeastern University, 360 Huntington Avenue, Boston, MA 02115, United States.
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Liu D, Parker HL, Curcic J, Kozerke S, Steingoetter A. Emulsion Stability Modulates Gastric Secretion and Its Mixing with Emulsified Fat in Healthy Adults in a Randomized Magnetic Resonance Imaging Study. J Nutr 2016; 146:2158-2164. [PMID: 27605407 DOI: 10.3945/jn.116.234955] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 08/09/2016] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Oil-in-water emulsions have recently become of interest to nutritional sciences because of their ability to influence gastrointestinal digestive processes and ultimately benefit human health. MRI offers the potential to noninvasively characterize the interaction between emulsified lipids and gastric secretion within the stomach. OBJECTIVES We determined noninvasively how emulsion stability modulates volumes of fat and secretion, layering of fat, and the mixing of emulsified fat with secretion within the stomach. This required the development of MRI technology for quantifying fat and secretion concentrations inside the stomach. METHODS Twenty-one healthy adults [13 men, mean ± SD age: 22.5 ± 2.5 y, mean ± SD body mass index (in kg/m2): 22.7 ± 1.8] were analyzed in a single-blind, randomized, parallel design. MRI was used to acquire the distributions of fat and secretion in the stomach after ingestion of 2 emulsions: a stable emulsion (E1) or an unstable emulsion (E4) with 20% fat fraction and ∼0.3 mm droplet sizes. Layer, volume, and mixing variables were fitted to the data and compared between the 2 emulsions. RESULTS The intragastric mixing between fat and secretion was better with the E4 than the E1 [increase in content heterogeneity of 17.1% (95% CI: 12.3%, 21.9%)]. The E4 demonstrated a linear relation [slope 1.57 (95% CI: 0.86, 2.29)] between the degree of layering and mixing. In contrast, no such relation was detected for the E1. Accumulated secretion volume in the stomach was lower with the E4 [decrease in volume variable ks of 2.3 (95% CI: -3.9, -0.7)] and correlated with the degree of layering (r = 0.62, P < 0.001). CONCLUSIONS In healthy adults, intragastric fat layering was influenced mainly by the degree of intragastric mixing, rather than the overall dominance of secretion. The E1 triggered a higher accumulation of gastric secretion, which in turn facilitated homogenization of intragastric content in comparison with its unstable counterpart. This trial was registered at clinicaltrials.gov as NCT02602158.
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Affiliation(s)
- Dian Liu
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland; and
| | - Helen L Parker
- Division of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland
| | - Jelena Curcic
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland; and Division of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland
| | - Sebastian Kozerke
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland; and
| | - Andreas Steingoetter
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland; and Division of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland
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Qin D, Yang X, Gao S, Yao J, McClements DJ. Influence of Hydrocolloids (Dietary Fibers) on Lipid Digestion of Protein-Stabilized Emulsions: Comparison of Neutral, Anionic, and Cationic Polysaccharides. J Food Sci 2016; 81:C1636-45. [DOI: 10.1111/1750-3841.13361] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 03/28/2016] [Accepted: 05/13/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Dingkui Qin
- Dept. of Animal Science and Technology; Northwest A&F Univ; Yangling Shaanxi 712100 China
- Biopolymer and Colloids Research Laboratory, Dept. of Food Science; Univ. of Massachusetts; Amherst Mass. 01003 U.S.A
| | - Xiaojun Yang
- Dept. of Animal Science and Technology; Northwest A&F Univ; Yangling Shaanxi 712100 China
| | - Songran Gao
- Biopolymer and Colloids Research Laboratory, Dept. of Food Science; Univ. of Massachusetts; Amherst Mass. 01003 U.S.A
| | - Junhu Yao
- Dept. of Animal Science and Technology; Northwest A&F Univ; Yangling Shaanxi 712100 China
| | - David Julian McClements
- Biopolymer and Colloids Research Laboratory, Dept. of Food Science; Univ. of Massachusetts; Amherst Mass. 01003 U.S.A
- Dept. of Biochemistry, Faculty of Science; King Abdulaziz Univ; P.O. Box 80203 Jeddah 21589 Saudi Arabia
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Abstract
Despite being one of the most common conditions leading to gastroenterological referral, irritable bowel syndrome (IBS) is poorly understood. However, recent years have seen major advances. These include new understanding of the role of both inflammation and altered microbiota as well as the impact of dietary intolerances as illuminated by magnetic resonance imaging (MRI), which has thrown new light on IBS. This article will review new data on how excessive bile acid secretion mediates diarrhea and evidence from post infectious IBS which has shown how gut inflammation can alter gut microbiota and function. Studies of patients with inflammatory bowel disease (IBD) have also shown that even when inflammation is in remission, the altered enteric nerves and abnormal microbiota can generate IBS-like symptoms. The efficacy of the low FODMAP diet as a treatment for bloating, flatulence, and abdominal discomfort has been demonstrated by randomized controlled trials. MRI studies, which can quantify intestinal volumes, have provided new insights into how FODMAPs cause symptoms. This article will focus on these areas together with recent trials of new agents, which this author believes will alter clinical practice within the foreseeable future.
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Affiliation(s)
- Robin Spiller
- Nottingham Digestive Diseases Centre, University of Nottingham, Nottingham, UK
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Feinle-Bisset C. Upper gastrointestinal sensitivity to meal-related signals in adult humans - relevance to appetite regulation and gut symptoms in health, obesity and functional dyspepsia. Physiol Behav 2016; 162:69-82. [PMID: 27013098 DOI: 10.1016/j.physbeh.2016.03.021] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 03/08/2016] [Accepted: 03/16/2016] [Indexed: 12/20/2022]
Abstract
Both the stomach and small intestine play important roles in sensing the arrival of a meal, and its physico-chemical characteristics, in the gastrointestinal lumen. The presence of a meal in the stomach provides a distension stimulus, and, as the meal empties into the small intestine, nutrients interact with small intestinal receptors, initiating the release of gut hormones, associated with feedback regulation of gastrointestinal functions, including gut motility, and signaling to the central nervous system, modulating eating behaviours, including energy intake. Lipid appears to have particularly potent effects, also in close interaction with, and modulating the effects of, gastric distension, and involving the action of gut hormones, particularly cholecystokinin (CCK). These findings have not only provided important, and novel, insights into how gastrointestinal signals interact to modulate subjective appetite perceptions, including fullness, but also laid the foundation for an increasing appreciation of the role of altered gastrointestinal sensitivities, e.g. as a consequence of excess dietary intake in obesity, or underlying the induction of gastrointestinal symptoms in functional dyspepsia (a condition characterized by symptoms, including bloating, nausea and early fullness, amongst others, after meals, particularly those high in fat, in the absence of any structural or functional abnormalities in the gastrointestinal tract). This paper will review the effects of dietary nutrients, particularly lipid, on gastrointestinal function, and associated effects on appetite perceptions and energy intake, effects of interactions of gastrointestinal stimuli, as well as the role of altered gastrointestinal sensitivities (exaggerated, or reduced) in eating-related disorders, particularly obesity and functional dyspepsia.
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Affiliation(s)
- Christine Feinle-Bisset
- University of Adelaide Discipline of Medicine, Royal Adelaide Hospital, Adelaide, SA 5000, Australia; National Health and Medical Research Council of Australia (NHMRC) Centre of Research Excellence in Translating Nutritional Science to Good Health, University of Adelaide, Adelaide, SA 5000, Australia.
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The visualisation and quantification of human gastrointestinal fat distribution with MRI: a randomised study in healthy subjects. Br J Nutr 2016; 115:903-12. [DOI: 10.1017/s0007114515005188] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
AbstractWe aimed to study the fate of fat during digestion. For this purpose, we validated and investigated the non-invasive quantification of gastric and duodenal fat emptying and emulsion processing (creaming and phase separation) using the MRI method iterative decomposition with echo asymmetry and least squares estimation (IDEAL). In total, twelve healthy subjects were studied on two separate visits in a single-blind, randomised, cross-over design study. IDEAL was utilised to repeatedly acquire quantitative fat fraction maps of the gastrointestinal tract after infusion of one of two fat emulsions: E1 (acid stable, droplet size 0·33 mm) and E4 (acid unstable, 0·38 mm). In vitro and in vivo validation was carried out using diluted emulsion and gastric content samples, respectively, and resulted in Lin’s concordance correlation coefficients of 1·00 (95 % CI 0·98, 1·00) and 0·91 (95 % CI 0·87, 0·94), respectively. Fat fraction maps and intragastric emulsion profiles enabled the identification of features of intraluminal phase separation and creaming that were not visible in conventional MRI. Gastric fat emptying was faster for E4 compared with E1 with a difference of 2·5 (95 % CI 1·9, 3·1) ml/h. Duodenal content volumes were larger for E1 than for E4 with a difference of 4·9 (95 % CI 3·9, 8·5) ml. This study demonstrated that with IDEAL it was possible (1) to visualise the intragastric and duodenal fat distribution and (2) to quantify the differences in emptying, phase separation and creaming of an acid-stable and an acid-unstable emulsion. This method has potential to bridge the gap between current in vitro digestive models and in vivo behaviour and to be applied in the development of effective functional foods.
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Khalaf A, Hoad CL, Spiller RC, Gowland PA, Moran GW, Marciani L. Magnetic resonance imaging biomarkers of gastrointestinal motor function and fluid distribution. World J Gastrointest Pathophysiol 2015; 6:140-149. [PMID: 26600972 PMCID: PMC4644878 DOI: 10.4291/wjgp.v6.i4.140] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 09/28/2015] [Accepted: 10/27/2015] [Indexed: 02/07/2023] Open
Abstract
Magnetic resonance imaging (MRI) is a well established technique that has revolutionized diagnostic radiology. Until recently, the impact that MRI has had in the assessment of gastrointestinal motor function and bowel fluid distribution in health and in disease has been more limited, despite the novel insights that MRI can provide along the entire gastrointestinal tract. MRI biomarkers include intestinal motility indices, small bowel water content and whole gut transit time. The present review discusses new developments and applications of MRI in the upper gastrointestinal tract, the small bowel and the colon reported in the literature in the last 5 years.
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Barker LE, Shaw KM. Best (but oft-forgotten) practices: checking assumptions concerning regression residuals. Am J Clin Nutr 2015; 102:533-9. [PMID: 26201816 PMCID: PMC4558311 DOI: 10.3945/ajcn.115.113498] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 07/02/2015] [Indexed: 11/14/2022] Open
Abstract
The residuals of a least squares regression model are defined as the observations minus the modeled values. For least squares regression to produce valid CIs and P values, the residuals must be independent, be normally distributed, and have a constant variance. If these assumptions are not satisfied, estimates can be biased and power can be reduced. However, there are ways to assess these assumptions and steps one can take if the assumptions are violated. Here, we discuss both assessment and appropriate responses to violation of assumptions.
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Affiliation(s)
| | - Kate M Shaw
- Centers for Disease Control and Prevention, Chamblee, GA
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