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Abstract
Food ingestion induces homeostatic sensations (satiety, fullness) with a hedonic dimension (satisfaction, changes in mood) that characterize the postprandial experience. Both types of sensation are secondary to intraluminal stimuli produced by the food itself, as well as to the activity of the digestive tract. Postprandial sensations also depend on the nutrient composition of the meal and on colonic fermentation of non-absorbed residues. Gastrointestinal function and the sensitivity of the digestive tract, i.e., perception of gut stimuli, are determined by inherent individual factors, e.g., sex, and can be modulated by different conditioning mechanisms. This narrative review examines the factors that determine perception of digestive stimuli and the postprandial experience.
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Affiliation(s)
- Dan M. Livovsky
- Digestive System Research Unit, University Hospital Vall d’Hebron, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Departament de Medicina, Universitat Autònoma de Barcelona, 08193 Bellaterra, Cerdanyola del Vallès, Spain;
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9103102, Israel
- ShaareZedek Medical Center, Digestive Diseases Institute, Jerusalem 9103102, Israel
| | - Fernando Azpiroz
- Digestive System Research Unit, University Hospital Vall d’Hebron, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Departament de Medicina, Universitat Autònoma de Barcelona, 08193 Bellaterra, Cerdanyola del Vallès, Spain;
- Correspondence: ; Tel.: +34-93-2746259
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Livovsky DM, Barber C, Barba E, Accarino A, Azpiroz F. Abdominothoracic Postural Tone Influences the Sensations Induced by Meal Ingestion. Nutrients 2021; 13:nu13020658. [PMID: 33670508 PMCID: PMC7922384 DOI: 10.3390/nu13020658] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/12/2021] [Accepted: 02/15/2021] [Indexed: 12/21/2022] Open
Abstract
Postprandial objective abdominal distention is frequently associated with a subjective sensation of abdominal bloating, but the relation between both complaints is unknown. While the bloating sensation has a visceral origin, abdominal distention is a behavioral somatic response, involving contraction and descent of the diaphragm with protrusion of the anterior abdominal wall. Our aim was to determine whether abdominal distention influences digestive sensations. In 16 healthy women we investigated the effect of intentional abdominal distention on experimentally induced bloating sensation (by a meal overload). Participants were first taught to produce diaphragmatic contraction and visible abdominal distention. After a meal overload, sensations of bloating (0 to 10) and digestive well-being (-5 to + 5) were measured during 30-s. maneuvers alternating diaphragmatic contraction and diaphragmatic relaxation. Compared to diaphragmatic relaxation, diaphragmatic contraction was associated with diaphragmatic descent (by 21 + 3 mm; p < 0.001), objective abdominal distension (32 + 5 mm girth increase; p = 0.001), more intense sensation of bloating (7.3 + 0.4 vs. 8.0 + 0.4 score; p = 0.010) and lower digestive well-being (-0.9 + 0.5 vs. -1.9 + 0.5 score; p = 0.028). These results indicate that somatic postural tone underlying abdominal distention worsens the perception of visceral sensations (ClinicalTrials.gov ID: NCT04691882).
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Affiliation(s)
- Dan M. Livovsky
- Digestive System Research Unit, University Hospital Vall d’Hebron, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Departament de Medicina, Universitat Autònoma de Barcelona, 08193 Bellaterra (Cerdanyola del Vallès), Spain; (D.M.L.); (C.B.); (A.A.)
- Faculty of Medicine, Hebrew University of Jerusalem, Digestive Diseases Institute, Shaare Zedek Medical Center, Jerusalem 9103401, Israel
| | - Claudia Barber
- Digestive System Research Unit, University Hospital Vall d’Hebron, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Departament de Medicina, Universitat Autònoma de Barcelona, 08193 Bellaterra (Cerdanyola del Vallès), Spain; (D.M.L.); (C.B.); (A.A.)
| | - Elizabeth Barba
- Neurogastroenterology Motility Unit, Hospital Clínic, University of Barcelona, 08007 Barcelona, Spain;
| | - Anna Accarino
- Digestive System Research Unit, University Hospital Vall d’Hebron, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Departament de Medicina, Universitat Autònoma de Barcelona, 08193 Bellaterra (Cerdanyola del Vallès), Spain; (D.M.L.); (C.B.); (A.A.)
| | - Fernando Azpiroz
- Digestive System Research Unit, University Hospital Vall d’Hebron, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Departament de Medicina, Universitat Autònoma de Barcelona, 08193 Bellaterra (Cerdanyola del Vallès), Spain; (D.M.L.); (C.B.); (A.A.)
- Correspondence: ; Tel.: +34-93-274-6259
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Monrroy H, Pribic T, Galan C, Nieto A, Amigo N, Accarino A, Correig X, Azpiroz F. Meal Enjoyment and Tolerance in Women and Men. Nutrients 2019; 11:E119. [PMID: 30626147 DOI: 10.3390/nu11010119] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 12/31/2018] [Accepted: 01/02/2019] [Indexed: 12/11/2022] Open
Abstract
Various conditioning factors influence the sensory response to a meal (inducible factors). We hypothesized that inherent characteristics of the eater (constitutive factors) also play a role. The aim of this proof-of-concept study was to determine the role of gender, as an individual constitutive factor, on the meal-related experience. Randomized parallel trial in 10 women and 10 men, comparing the sensations before, during, and after stepwise ingestion of a comfort meal up to full satiation. Comparisons were performed by repeated Analysis of Covariance (ANCOVA) measures. During stepwise ingestion, satisfaction initially increased up to a peak, and later decreased down to a nadir at the point of full satiation. Interestingly, the amount of food consumed at the well-being peak was lower, and induced significantly less fullness in women than in men. Hence, men required a larger meal load and stronger homeostatic sensations to achieve satisfaction. The same pattern was observed at the level of full satiation: men ate more and still experienced positive well-being, whereas in women, well-being scores dropped below pre-meal level. The effect of gender on the ingestion experience suggests that other constitutive factors of the eater may also influence responses to meals.
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Malagelada C, Pribic T, Ciccantelli B, Cañellas N, Gomez J, Amigo N, Accarino A, Correig X, Azpiroz F. Metabolomic signature of the postprandial experience. Neurogastroenterol Motil 2018; 30:e13447. [PMID: 30101554 DOI: 10.1111/nmo.13447] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 06/22/2018] [Accepted: 07/17/2018] [Indexed: 01/02/2023]
Abstract
BACKGROUND Ingestion of a meal up to maximal tolerance induces unpleasant fullness sensation and changes in circulating metabolites. Our aim was to evaluate the relation between postprandial sensations and the metabolomic responses to a comfort meal. METHODS In 32 non-obese healthy men, homeostatic sensations (hunger/satiety, fullness), hedonic sensations (digestive well-being, mood), and the metabolomic profile in plasma (low-molecular weight metabolites and lipoprotein profiles) were measured before and 20 minutes after a comfort meal (warm ham and cheese sandwich and juice; total 300 mL; 425 kcal). Perception was measured on 10 cm scales and the metabolomic response by nuclear magnetic resonance spectroscopy. KEY RESULTS The comfort meal induced homeostatic sensations (satiety and fullness) associated with a positive hedonic reward (enhanced digestive well-being and mood) and a clear change in the metabolomic profile with a sharp discrimination between the pre and postprandial state by a non-supervised principal component analysis. The change in circulating metabolites correlated with the postprandial sensations: the increase in alanine correlated with the increase in fullness (R = 0.50; P = 0.004) and well-being (R = 0.50; P = 0.004); the increase in glucose correlated with the sensation of fullness (R = 0.40; P = 0.023) and enhanced mood (R = 0.41; P = 0.020). CONCLUSION AND INFERENCES Metabolomic changes in the response to a meal may provide an objective index of the postprandial experience, which may have clinical implications in the management of patients with poor meal tolerance or meal-related symptoms.
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Affiliation(s)
- Carolina Malagelada
- Digestive System Research Unit, University Hospital Vall d'Hebron, Bellaterra, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Bellaterra, Spain.,Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Teodora Pribic
- Digestive System Research Unit, University Hospital Vall d'Hebron, Bellaterra, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Bellaterra, Spain.,Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Barbara Ciccantelli
- Digestive System Research Unit, University Hospital Vall d'Hebron, Bellaterra, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Bellaterra, Spain.,Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Nicolau Cañellas
- Metabolomics Platform, IISPV, Universitat Rovira i Virgili, Tarragona, Spain.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas (Ciberdem), Tarragona, Spain
| | - Josep Gomez
- Metabolomics Platform, IISPV, Universitat Rovira i Virgili, Tarragona, Spain.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas (Ciberdem), Tarragona, Spain
| | - Nuria Amigo
- Metabolomics Platform, IISPV, Universitat Rovira i Virgili, Tarragona, Spain.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas (Ciberdem), Tarragona, Spain.,Biosfer Teslab S.L, Reus, Spain
| | - Anna Accarino
- Digestive System Research Unit, University Hospital Vall d'Hebron, Bellaterra, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Bellaterra, Spain.,Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Xavier Correig
- Metabolomics Platform, IISPV, Universitat Rovira i Virgili, Tarragona, Spain.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas (Ciberdem), Tarragona, Spain
| | - Fernando Azpiroz
- Digestive System Research Unit, University Hospital Vall d'Hebron, Bellaterra, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Bellaterra, Spain.,Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
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Pribic T, Vilaseca H, Nieto A, Hernandez L, Monrroy H, Malagelada C, Accarino A, Roca J, Azpiroz F. Meal composition influences postprandial sensations independently of valence and gustation. Neurogastroenterol Motil 2018; 30:e13337. [PMID: 29575437 DOI: 10.1111/nmo.13337] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 02/13/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Palatability of meals with identical composition has been shown to influence postprandial sensations. Our aim was to determine to what extent meal composition influences postprandial sensations independently of palatability. METHODS Randomized, crossover, double-blind trial comparing the postprandial responses to a low-fat vs a high-fat test meal, with the same physical and organoleptic characteristics (taste, smell, texture, color, and temperature). The test meal consisted in 150 g hummus containing either 17.7 g fat (low-fat) or 22.3 g fat (high-fat), 19.8 g toasts, 120 mL water and 50 g apple puree. In 12 non-obese healthy men, palatability, homeostatic sensations (hunger/satiety, fullness) and hedonic sensations (digestive well-being, mood) were measured on 10 cm scales before and during the 60-min postprandial period. Comparisons between meals were performed with a two-way repeated measures ANCOVA with premeal data as co-variate. KEY RESULTS Both test meals were rated equally palatable (palatability scores 3.8 ± 0.3 low-fat, 3.3 ± 0.2 high-fat; P = .156). As compared to the high-fat meal, the low-fat meal induced more satisfaction (meal effect on well-being F(1,21) = 4.92; P = .038) and tended to improve mood (meal effect F(1,21) = 3.02; P = .064), and this was associated with a non-significant decrease in satiety (meal effect F(1,21) = 2.29; P = .145) and fullness (meal effect F(1,21) = 1.57; P = .224). CONCLUSIONS AND INFERENCES The composition of meals with equal palatability influences postprandial satisfaction, even without significant impact on homeostatic sensations, although an effect on homeostatic sensations has not been excluded. These conditioning factors may have clinical implications in patients with impaired meal tolerance or meal-related symptoms.
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Affiliation(s)
- T Pribic
- Digestive System Research Unit, University Hospital Vall d'Hebron, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - A Nieto
- Digestive System Research Unit, University Hospital Vall d'Hebron, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - L Hernandez
- Digestive System Research Unit, University Hospital Vall d'Hebron, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - H Monrroy
- Digestive System Research Unit, University Hospital Vall d'Hebron, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - C Malagelada
- Digestive System Research Unit, University Hospital Vall d'Hebron, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Accarino
- Digestive System Research Unit, University Hospital Vall d'Hebron, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Roca
- El Celler de Can Roca, Girona, Spain
| | - F Azpiroz
- Digestive System Research Unit, University Hospital Vall d'Hebron, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
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