Echo-planar imaging relaxometry to measure the viscosity of a model meal

An evolving view on food viscosity regulating gastric emptying

Viscosity is a property of most foods. The consumption of the high-viscosity food is associated with a variety of physiological responses, one of which is their ability to regulate gastric emptying and modulate postprandial glycemic response. Gastric emptying has been proven to be a key step affecting the digestion and absorption of food, whereas, the relationship between viscosity and gastric emptying is still far away from being understood. Here, we reviewed the factors that influence food viscosity and food viscosity changes during digestion. Besides, the effect of food viscosity on gastric emptying and food-viscosity-physiological response were highlighted. Finally, "quantitative relationship" of viscosity and gastric emptying was discussed. This review can contribute to the understanding that how food viscosity affects gastric emptying, and help for developing foods that could control satiety and manage body weight for the specific populations.

Monitoring food digestion with magnetic resonance techniques

This review outlines the current use of magnetic resonance (MR) techniques to study digestion and highlights their potential for providing markers of digestive processes such as texture changes and nutrient breakdown. In vivo digestion research can be challenging due to practical constraints and biological complexity. Therefore, digestion is primarily studied using in vitro models. These would benefit from further in vivo validation. NMR is widely used to characterise food systems. MRI is a related technique that can be used to study both in vitro model systems and in vivo gastro-intestinal processes. MRI allows visualisation and quantification of gastric processes such as gastric emptying and coagulation. Both MRI and NMR scan sequences can be configured to be sensitive to different aspects of gastric or intestinal contents. For example, magnetisation transfer and chemical exchange saturation transfer can detect proton (1H) exchange between water and proteins. MRI techniques have the potential to provide molecular-level and quantitative information on in vivo gastric (protein) digestion. This requires careful validation in order to understand what these MR markers of digestion mean in a specific digestion context. Combined with other measures they can be used to validate and inform in vitro digestion models. This may bridge the gap between in vitro and in vivo digestion research and can aid the optimisation of food properties for different applications in health and disease.

Oat β-glucan: physico-chemical characteristics in relation to its blood-glucose and cholesterol-lowering properties

The water-soluble, mixed-linkage β-glucan, a form of soluble dietary fibre, is considered the main biologically active component responsible for the capacity of many oat products to lower postprandial glycaemia and fasting plasma cholesterol in human subjects. The present review discusses the physical and chemical properties of oat β-glucan that are considered important predictors of these beneficial metabolic effects. In vitro modelling and animal and human studies have provided compelling evidence showing that the ability of oat β-glucan to increase the viscosity of digesta in the gastrointestinal tract (GIT) is a primary determinant of its blood-glucose and cholesterol-lowering properties. Therefore, the chemical structure, molecular weight (MW), the rate and extent of dissolution and solution rheology of oat β-glucan are key factors in determining the physiological function of oat-containing foods. The structure and properties of oat β-glucan vary between species and varieties of oats, and are also affected by the growing and storage conditions and processing of oat grain. In addition, the extraction and analysis methods may also contribute to the variations in the structure, MW, hydration and solution rheology of β-glucan obtained from different laboratories. Recent work has demonstrated that β-glucan solubility in foods depends on the source of the material and processing conditions; solubility may also be subject to changes during food preparation and storage (such as freezing). In conclusion, both the amount and MW of β-glucan that are solubilised in the GIT need to be considered when assessing the blood-glucose and cholesterol-lowering properties of oat-containing foods.

The effect of gastric secretion on gastric physiology and emptying in the fasted and fed state assessed by magnetic resonance imaging

Conventional measurement of gastric secretion is invasive and cannot assess the intra-gastric distribution of gastric contents or the effects of secretion on gastric function. This study assessed the effect of gastric secretion on gastric volume responses and emptying (GE) using a validated fast T(1) mapping magnetic resonance imaging (MRI) technique. Twelve healthy participants were studied in the fasted state and after 200 kcal Gadolinium-DOTA labelled glucose meal during intravenous infusion of pentagastrin or placebo in double-blind, randomized order. Total gastric volume (TGV) and gastric content volume (GCV) was assessed by MRI volume scans and secretion by fast T(1) mapping. Data was described by the kappa-coefficient (volume change after meal ingestion), by GE half time (T(50)) and maximal GE rate (GER(max)) derived all from a GE model. Pentagastrin increased GCV and TGV compared to placebo [kappa(GCV):1.6 +/- 0.1 vs 0.6 +/- 0.1; kappa(TGV): 1.6 +/- 0.1 vs 0.7 +/- 0.1; P < 0.001]. T(1) maps revealed a secretion layer above the meal, the volume of which was associated with kappa (R(2) = 83%, P < 0.001). TGV and GCV change were similar in both conditions (kappa; P = ns). T(50) was higher for pentagastrin than for placebo (84 +/- 7 vs 56 +/- 4min, P < 0.001); however, GER(max) was similar (5.9 +/- 0.6 vs 4.9 +/- 0.4 mL min(-1), P = ns). This study shows volume and distribution of gastric secretion can be quantified in-vivo by non-invasive MRI T(1) mapping. Increased GCV drove TGV accommodation without evidence of a direct effect of pentagastrin or excess acid on gastric function. Secretion increases GCV thus prolongs GE as assessed by T(50); however, GE rate is unchanged.

No effect of added beta-glucan or of fructooligosaccharide on appetite or energy intake

BACKGROUND

An increase in gastrointestinal viscosity or colonic fermentation is suggested to improve appetite control and reduce food intake. It has been proposed that beta-glucan and fructooligosaccharide (FOS) are food ingredients that increase gastrointestinal viscosity and colonic fermentation, but the results are inconclusive.

OBJECTIVE

The objective was to test the effect of FOS, beta-glucan, or a combination thereof on appetite ratings and food intake over 2 consecutive days.

DESIGN

In a 4-way balanced-order, crossover, double-blind design, 21 healthy volunteers [mean body mass index (in kg/m(2)) 25.9] consumed a meal-replacement bar at 0900 and an ad libitum lunch at 1300 on 2 consecutive days. On day 1 only, the subjects consumed a second (identical) bar at 1700 and a fixed snack at 1900. The control bar contained 0.3 g beta-glucan from 6.8 g oats (control), and the 3 equicaloric test bars contained an additional 0.9 g beta-glucan (from 8.0 g barley), 8 g FOS, or 0.9 g beta-glucan + 8 g FOS. Appetite scores and subsequent ad libitum test meal intakes were measured. Viscosities in response to bar consumption were determined under simulated gastric conditions. The results were analyzed by analysis of covariance.

RESULTS

The addition of beta-glucan, FOS, or a combination thereof did not affect appetite ratings or food intake, although the addition of beta-glucan to the bar doubled gastric viscosity (841 compared with 351 mPa . s).

CONCLUSIONS

Consumption of beta-glucan, FOS, or a combination thereof in meal-replacement bars at the levels tested for 2 consecutive days does not improve appetite control. Efficacy may have improved if the consumption period was longer, if the content of beta-glucan was greater, or if a form of beta-glucan that generates even higher gastric viscosity was consumed. This trial was registered at (clinicaltrials.gov) as NCT00776256.

Fast and optimized T1 mapping technique for the noninvasive quantification of gastric secretion

PURPOSE

To evaluate the noninvasive quantification of gastric secretion volume after administration of a labeled viscous glucose solution by fast T(1) mapping.

MATERIALS AND METHODS

T(1) values of a series of labeled and diluted glucose solutions were measured in vitro to characterize the interrelationship between T(1) and contrast agent concentration (C(Gd)) as well as the dependency of relaxivity and reference T(1) (T(10)) on the macromolecular concentration. Abdominal T(1) mapping in five healthy volunteers of different body mass index was performed after filling an intragastric balloon with a labeled and diluted glucose solution. In additional ex vivo experiments, T(1) values of gastric (GJ) and duodenal juice (DJ) and 0.1 N HCl solution were determined.

RESULTS

A linear relationship between relaxivity and macromolecular concentration and between T(10) and macromolecular concentration was found. The in vitro T(1)-C(Gd) calibration curve was successfully validated in all volunteers. T(1) values of GJ, DJ, and HCl (2939 msec vs. 2858 msec vs. 2760 msec) were close to the T(1) of water ( approximately 3000 msec).

CONCLUSION

The presented method allows one to noninvasively quantify the spatial distribution of gastric secretory products in the human stomach and provides a valuable tool for evaluating the efficacy of drugs to stimulate/inhibit gastric secretion.

Rapid and accurate measurement of transverse relaxation times using a single shot multi-echo echo-planar imaging sequence

Methods for making rapid and accurate measurements and maps of the transverse relaxation time from a single free induction decay (FID) are proposed. The methods use a multi-echo sequence in combination with B1 insensitive (hyperbolic secant or BIREF2b) refocusing pulses and rapid echo-planar imaging techniques. The results were calibrated against a single spin echo echo-planar imaging sequence using a phantom containing a range of CuSO4 concentrations. The mean percentage absolute difference between the multi-echo and single-echo results was 3% for the multi-echo sequence using the hyperbolic secant refocusing pulse, and 7% for the multi-echo sequence using the BIREF2b refocusing pulse, compared to 13% for a multi-echo sequence using a nonselective sinc refocusing pulse. The use of the sequences in vivo has been demonstrated in studies of gastric function, i.e., the measurement of gastric dilution and monitoring of formation of a raft of alginate polysaccharide within the stomach.

In vivo imaging of intragastric gelation and its effect on satiety in humans

Previous studies indicated that physical characteristics of food influence satiety, but the relative importance of the oral, gastric, and intestinal behaviors of the food is unclear. The aim of this study was to investigate the satiating effects of 2 types of alginates, which gel weakly or strongly on exposure to acid, compared with guar gum whose viscosity is unaffected by acid. Subjects (n = 12; 3 men, 9 women) ingested a 325-mL sweetened, milk-based meal replacer beverage on 4 separate occasions, either alone as a control or including 1% by weight alginate or guar gum. Intragastric gelling, gastric emptying, and meal dilution were assessed by serial MRI while satiety was recorded for 4 h. MR images showed that all of the meals became heterogeneous in the stomach except for guar, which remained homogeneous. The alginate meals formed lumps in the stomach, with the strong-gelling alginate producing the largest volume. Although gastric emptying was similar for all 4 meals, the sense of fullness at the same gastric volume was significantly greater for all 3 viscous meals than for the control. Compared with the control meal, the strong-gelling alginate (P = 0.031) and guar (P = 0.041) meals increased fullness at 115 min, and the strong-gelling alginate decreased hunger by the 115-min (P = 0.041) and 240-min (P = 0.041) time points. Agents that gel on contact with acid may be useful additions to weight-reducing diets. We hypothesize that this effect is due to distension in the gastric antrum and/or altered transport of nutrients to the small intestine in the lumps.

Echo-planar magnetic resonance imaging of Gaviscon alginate rafts in-vivo

Liquid Gaviscon and Gaviscon Advance are established reflux suppressant formulations. This study describes the use of echo-planar magnetic resonance imaging (EPI) to visualise non-invasively intragastric alginate rafts of Liquid Gaviscon and Gaviscon Advance in healthy subjects. Secondly, the feasibility of using relaxation rate (T2(-1)) measurements to monitor changes in the physicochemical properties of the rafts in-vivo is evaluated. Six subjects ingested 500 mL of a liquid meal and received a single dose of 20 mL Liquid Gaviscon or 10 mL Gaviscon Advance on 2 separate visits each and were imaged every 15 min. An alginate raft was observed in the stomach for all subjects and both treatments. The raft was observed to consist of a few large fragments on the majority of the scans for both products. At t = 60 min a raft was still present in all cases. Three-dimensional volume reconstructions showed, for the first time, the spatial distribution of the rafts within the gastric lumen. The T2(-1) data showed potential for assessment of dynamic changes in the physicochemical properties of the alginate rafts in-vivo. We conclude that EPI shows great potential in assessing alginate rafts formation in-vivo.

Effect of meal viscosity and nutrients on satiety, intragastric dilution, and emptying assessed by MRI

The relationship between the intragastric distribution, dilution, and emptying of meals and satiety was studied using noninvasive magnetic resonance imaging techniques in 12 healthy subjects with four polysaccharide test meals of varying viscosity and nutrient content as follows: 1) low-viscosity nonnutrient, 2) low-viscosity nutrient, 3) high-viscosity nonnutrient, and 4) high-viscosity nutrient. Increasing the nutrient content of the high-viscosity meal delayed gastric emptying from 46 +/- 9 to 76 +/- 6 min (P < 0.004), whereas increasing viscosity had a smaller effect. The volume of secretions within the stomach 60 min after ingestion was higher for the high-viscosity nutrient meal (P < 0.04). A simple model to calculate the total volume of secretion added to the test meal is presented. Color-coded dilution map images showed the heterogeneous process of progressive gastric dilution of high-viscosity meals, whereas low-viscosity meals were uniformly diluted. Fullness was found to be linearly related to total gastric volumes for the nutrient meals (R(2) = 0.98) and logarithmically related for the nonnutrient meals (R(2) = 0.96). Fullness was higher for high- compared with low-viscosity meals (P < 0.02), and with the nutrient meals this was associated with greater antral volumes (P < 0.05).

Gastric response to increased meal viscosity assessed by echo-planar magnetic resonance imaging in humans

Normal meals are highly viscous, and viscosity is a key factor in influencing gastric emptying of food. However, the process of meal dilution and mixing is difficult to assess with the use of conventional methods. The aim of this study was to validate an in vivo, novel, noninvasive, echo-planar magnetic resonance imaging (EPI) technique, capable of monitoring the viscosity of a model meal, and to use this to investigate the effects of viscosity on gastric emptying, meal dilution and satiety. Healthy volunteers (n = 8) ingested 500 mL of locust bean gum (0.25, 0.5, 1.0 or 1.5 g/100 g), nonnutrient, liquid meals of varying viscosities, and labeled with a nonabsorbable marker, phenol red. Meal viscosity was calibrated against the water proton transverse relaxation rate (T(2)(-1)) in vitro before ingestion, thus viscosity was measured in vivo via EPI measurements of T(2)(-1). Viscosity and dilution were also measured directly using nasogastric aspirates. Gastric volumes as measured by EPI, fullness, appetite and hunger were also assessed serially. Before ingestion, the log of initial meal viscosity was linearly related to T(2)(-1) (n = 8, r(2) = 0.95). Similarly, T(2)(-1) measured in vivo was also linearly related to the viscosity of the aspirates (r(2) = 0.88). All meals underwent rapid dilution, leading to a reduction in viscosity, which was greatest for the most viscous meal (P < 0.01). Surprisingly, despite the fact that the initial meal viscosity varied 1000-fold, there was only a small delay in gastric emptying (P for trend < 0.05). The area under the curve for satiety increased with initial meal viscosity, whereas that for hunger decreased (P < 0.05). In conclusion, the viscosity of a meal in vivo can be measured noninvasively using EPI. The stomach responds to meal ingestion by rapid intragastric dilution, causing a reduction of meal viscosity, and gastric emptying is minimally delayed. However, increased viscosity is associated with more prolonged satiety.