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PH van Trijp M, Wilms E, Ríos-Morales M, Masclee AA, Brummer RJ, Witteman BJ, Troost FJ, Hooiveld GJ. Using naso- and oro-intestinal catheters in physiological research for intestinal delivery and sampling in vivo: practical and technical aspects to be considered. Am J Clin Nutr 2021; 114:843-861. [PMID: 34036315 PMCID: PMC8408849 DOI: 10.1093/ajcn/nqab149] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 04/09/2021] [Indexed: 01/19/2023] Open
Abstract
Intestinal catheters have been used for decades in human nutrition, physiology, pharmacokinetics, and gut microbiome research, facilitating the delivery of compounds directly into the intestinal lumen or the aspiration of intestinal fluids in human subjects. Such research provides insights about (local) dynamic metabolic and other intestinal luminal processes, but working with catheters might pose challenges to biomedical researchers and clinicians. Here, we provide an overview of practical and technical aspects of applying naso- and oro-intestinal catheters for delivery of compounds and sampling luminal fluids from the jejunum, ileum, and colon in vivo. The recent literature was extensively reviewed, and combined with experiences and insights we gained through our own clinical trials. We included 60 studies that involved a total of 720 healthy subjects and 42 patients. Most of the studies investigated multiple intestinal regions (24 studies), followed by studies investigating only the jejunum (21 studies), ileum (13 studies), or colon (2 studies). The ileum and colon used to be relatively inaccessible regions in vivo. Custom-made state-of-the-art catheters are available with numerous options for the design, such as multiple lumina, side holes, and inflatable balloons for catheter progression or isolation of intestinal segments. These allow for multiple controlled sampling and compound delivery options in different intestinal regions. Intestinal catheters were often used for delivery (23 studies), sampling (10 studies), or both (27 studies). Sampling speed decreased with increasing distance from the sampling syringe to the specific intestinal segment (i.e., speed highest in duodenum, lowest in ileum/colon). No serious adverse events were reported in the literature, and a dropout rate of around 10% was found for these types of studies. This review is highly relevant for researchers who are active in various research areas and want to expand their research with the use of intestinal catheters in humans in vivo.
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Affiliation(s)
- Mara PH van Trijp
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Ellen Wilms
- Division Gastroenterology-Hepatology, Department of Internal Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Melany Ríos-Morales
- Laboratory of Pediatrics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Ad Am Masclee
- Division Gastroenterology-Hepatology, Department of Internal Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Robert Jan Brummer
- Nutrition-Gut-Brain Interactions Research Centre, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Ben Jm Witteman
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands,Hospital Gelderse Vallei, Department of Gastroenterology and Hepatology, Ede, The Netherlands
| | - Freddy J Troost
- Division Gastroenterology-Hepatology, Department of Internal Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands,Food Innovation and Health, Centre for Healthy Eating and Food Innovation, Maastricht University, Maastricht, The Netherlands
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Wilbrink J, Masclee G, Klaassen T, van Avesaat M, Keszthelyi D, Masclee A. Review on the Regional Effects of Gastrointestinal Luminal Stimulation on Appetite and Energy Intake: (Pre)clinical Observations. Nutrients 2021; 13:nu13051601. [PMID: 34064724 PMCID: PMC8151500 DOI: 10.3390/nu13051601] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/22/2021] [Accepted: 05/05/2021] [Indexed: 02/06/2023] Open
Abstract
Macronutrients in the gastrointestinal (GI) lumen are able to activate “intestinal brakes”, feedback mechanisms on proximal GI motility and secretion including appetite and energy intake. In this review, we provide a detailed overview of the current evidence with respect to four questions: (1) are regional differences (duodenum, jejunum, ileum) present in the intestinal luminal nutrient modulation of appetite and energy intake? (2) is this “intestinal brake” effect macronutrient specific? (3) is this “intestinal brake” effect maintained during repetitive activation? (4) can the “intestinal brake” effect be activated via non-caloric tastants? Recent evidence indicates that: (1) regional differences exist in the intestinal modulation of appetite and energy intake with a proximal to distal gradient for inhibition of energy intake: ileum and jejunum > duodenum at low but not at high caloric infusion rates. (2) the “intestinal brake” effect on appetite and energy appears not to be macronutrient specific. At equi-caloric amounts, the inhibition on energy intake and appetite is in the same range for fat, protein and carbohydrate. (3) data on repetitive ileal brake activation are scarce because of the need for prolonged intestinal intubation. During repetitive activation of the ileal brake for up to 4 days, no adaptation was observed but overall the inhibitory effect on energy intake was small. (4) the concept of influencing energy intake by intra-intestinal delivery of non-caloric tastants is intriguing. Among tastants, the bitter compounds appear to be more effective in influencing energy intake. Energy intake decreases modestly after post-oral delivery of bitter tastants or a combination of tastants (bitter, sweet and umami). Intestinal brake activation provides an interesting concept for preventive and therapeutic approaches in weight management strategies.
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Affiliation(s)
- Jennifer Wilbrink
- Division of Gastroenterology-Hepatology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands; (J.W.); (G.M.); (T.K.); (M.v.A.); (D.K.)
| | - Gwen Masclee
- Division of Gastroenterology-Hepatology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands; (J.W.); (G.M.); (T.K.); (M.v.A.); (D.K.)
| | - Tim Klaassen
- Division of Gastroenterology-Hepatology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands; (J.W.); (G.M.); (T.K.); (M.v.A.); (D.K.)
| | - Mark van Avesaat
- Division of Gastroenterology-Hepatology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands; (J.W.); (G.M.); (T.K.); (M.v.A.); (D.K.)
| | - Daniel Keszthelyi
- Division of Gastroenterology-Hepatology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands; (J.W.); (G.M.); (T.K.); (M.v.A.); (D.K.)
- NUTRIM School of Nutrition and Translational Research in Metabolism, 6229 ER Maastricht, The Netherlands
| | - Adrian Masclee
- Division of Gastroenterology-Hepatology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands; (J.W.); (G.M.); (T.K.); (M.v.A.); (D.K.)
- NUTRIM School of Nutrition and Translational Research in Metabolism, 6229 ER Maastricht, The Netherlands
- Correspondence: ; Tel.: +31-43-3875021
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Enteroendocrine Hormone Secretion and Metabolic Control: Importance of the Region of the Gut Stimulation. Pharmaceutics 2020; 12:pharmaceutics12090790. [PMID: 32825608 PMCID: PMC7559385 DOI: 10.3390/pharmaceutics12090790] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/19/2020] [Accepted: 08/19/2020] [Indexed: 12/11/2022] Open
Abstract
It is now widely appreciated that gastrointestinal function is central to the regulation of metabolic homeostasis. Following meal ingestion, the delivery of nutrients from the stomach into the small intestine (i.e., gastric emptying) is tightly controlled to optimise their subsequent digestion and absorption. The complex interaction of intraluminal nutrients (and other bioactive compounds, such as bile acids) with the small and large intestine induces the release of an array of gastrointestinal hormones from specialised enteroendocrine cells (EECs) distributed in various regions of the gut, which in turn to regulate gastric emptying, appetite and postprandial glucose metabolism. Stimulation of gastrointestinal hormone secretion, therefore, represents a promising strategy for the management of metabolic disorders, particularly obesity and type 2 diabetes mellitus (T2DM). That EECs are distributed distinctively between the proximal and distal gut suggests that the region of the gut exposed to intraluminal stimuli is of major relevance to the secretion profile of gastrointestinal hormones and associated metabolic responses. This review discusses the process of intestinal digestion and absorption and their impacts on the release of gastrointestinal hormones and the regulation of postprandial metabolism, with an emphasis on the differences between the proximal and distal gut, and implications for the management of obesity and T2DM.
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Mangan AM, Al Najim W, McNamara N, Martin WP, Antanaitis A, Bleiel SB, Kent RM, le Roux CW, Docherty NG. Effect of Macronutrient Type and Gastrointestinal Release Site on PYY Response in Normal Healthy Subjects. J Clin Endocrinol Metab 2019; 104:3661-3669. [PMID: 31127818 DOI: 10.1210/jc.2018-01697] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 04/16/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND AND AIMS Enteroendocrine L cells release satiety inducing hormones in response to stimulation by luminal macronutrients. We sought to profile the differential effect of macronutrient type and site of release on circulating concentrations of the L cell-derived enteroendocrine hormone peptide tyrosine tyrosine (amino acids 1 to 36) (PYY). MATERIALS AND METHODS Eight healthy volunteers were recruited to a randomized, double-blinded, six-way crossover study. At each visit, the participants consumed a 500-kcal drink containing carbohydrate, protein, or fat in either gastric or small intestinal release formulations. Plasma PYY concentrations and hunger ratings were assessed for 3 hours after consumption of the test drink. The food intake was recorded thereafter at an ad libitum lunch. RESULTS Microcapsular formulations targeting the distal small intestinal delivery of fat, but not carbohydrate or protein, markedly enhance PYY release relative to macronutrient delivery in gastric release formulations. Food intake at an ad libitum meal was lowest after consumption of the formulation releasing fat at the distal small intestine. CONCLUSION Targeting of fat to the distal small intestine in delayed release microcapsules enhanced PYY release and was associated with reductions in food intake.
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Affiliation(s)
- Aisling M Mangan
- Diabetes Complications Research Centre, Conway Institute, School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
| | - Werd Al Najim
- Diabetes Complications Research Centre, Conway Institute, School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
- Division of Investigative Science, Imperial College London, London, United Kingdom
| | - Niamh McNamara
- Diabetes Complications Research Centre, Conway Institute, School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
| | - William P Martin
- Diabetes Complications Research Centre, Conway Institute, School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
| | - Andrius Antanaitis
- Diabetes Complications Research Centre, Conway Institute, School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
| | - Sinéad B Bleiel
- AnaBio Technologies Ltd., R&D Centre of Excellence and Production, Carrigtwohill, Ireland
| | - Robert M Kent
- AnaBio Technologies Ltd., R&D Centre of Excellence and Production, Carrigtwohill, Ireland
| | - Carel W le Roux
- Diabetes Complications Research Centre, Conway Institute, School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
- Division of Investigative Science, Imperial College London, London, United Kingdom
| | - Neil G Docherty
- Diabetes Complications Research Centre, Conway Institute, School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
- Department of Gastrosurgical Research and Education, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Encapsulation of lipids as emulsion-alginate beads reduces food intake: a randomized placebo-controlled cross-over human trial in overweight adults. Nutr Res 2019; 63:86-94. [DOI: 10.1016/j.nutres.2018.12.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 10/03/2018] [Accepted: 12/05/2018] [Indexed: 01/09/2023]
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van Leusden P, den Hartog G, Bast A, Postema M, van der Linden E, Sagis L. Lipase diffusion in oil-filled, alginate micro- and macrobeads. Food Hydrocoll 2018. [DOI: 10.1016/j.foodhyd.2018.07.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Guo Q, Totosy de Zepetnek J, Chang J, Hayden J, Crozier SJ, Mongia G, Rousseau D, Bellissimo N. Effect of Midmorning Puree Snacks on Subjective Appetite, Food Intake, and Glycemic and Insulin Responses in Healthy Adults. J Am Coll Nutr 2018; 37:659-669. [PMID: 29702032 DOI: 10.1080/07315724.2018.1457457] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Qing Guo
- Department of Chemistry and Biology, Ryerson University, Toronto, Ontario, Canada
| | | | - Jennifer Chang
- School of Nutrition, Ryerson University, Toronto, Ontario, Canada
| | - Julia Hayden
- School of Nutrition, Ryerson University, Toronto, Ontario, Canada
| | | | | | - Dérick Rousseau
- Department of Chemistry and Biology, Ryerson University, Toronto, Ontario, Canada
| | - Nick Bellissimo
- School of Nutrition, Ryerson University, Toronto, Ontario, Canada
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Zhou FZ, Yan L, Yin SW, Tang CH, Yang XQ. Development of Pickering Emulsions Stabilized by Gliadin/Proanthocyanidins Hybrid Particles (GPHPs) and the Fate of Lipid Oxidation and Digestion. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2018; 66:1461-1471. [PMID: 29350533 DOI: 10.1021/acs.jafc.7b05261] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This work attempted to engineer emulsions' interface using the special affinity between proline-rich gliadin and proanthocyanidins (PA), to develop surfactant-free antioxidant Pickering emulsions with digestive-resistant properties. This binding interaction between gliadin and PA benefited the interfacial adsorption of the particles to corn oil droplets. Pickering droplets as building units assembled into an interconnected three-dimensional network structure, giving the emulsions viscoelasticity and ultrastability. Oxidative markers in Pickering emulsions were periodically monitored under thermally accelerated storage. Lipid digestion and oxidation fates were characterized using in vitro gastrointestinal (GI) models. The interfacial membrane constructed by antioxidant particles served as a valid barrier against lipid oxidation and digestion, in a PA dose-dependent manner. Briefly, lipid oxidation under storage and simulated GI tract was retarded. Free fatty acid (FFA) fraction released decreased by 55% from 87.9% (bulk oil) to 39.5% (Pickering emulsion), implying engineering interfacial architecture potentially benefited to fight obesity. This study opens a facile strategy to tune lipid oxidation and digestion profiles through the cooperation of the Pickering principle and the interfacial delivery of antioxidants.
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Affiliation(s)
- Fu-Zhen Zhou
- Research and Development Center of Food Proteins, School of Food Science and Engineering and ‡Guangdong Province Key Laboratory for Green Processing of Natural Products and Product Safety, South China University of Technology , Guangzhou 510640, P.R. China
| | - Li Yan
- Research and Development Center of Food Proteins, School of Food Science and Engineering and ‡Guangdong Province Key Laboratory for Green Processing of Natural Products and Product Safety, South China University of Technology , Guangzhou 510640, P.R. China
| | - Shou-Wei Yin
- Research and Development Center of Food Proteins, School of Food Science and Engineering and ‡Guangdong Province Key Laboratory for Green Processing of Natural Products and Product Safety, South China University of Technology , Guangzhou 510640, P.R. China
| | - Chuan-He Tang
- Research and Development Center of Food Proteins, School of Food Science and Engineering and ‡Guangdong Province Key Laboratory for Green Processing of Natural Products and Product Safety, South China University of Technology , Guangzhou 510640, P.R. China
| | - Xiao-Quan Yang
- Research and Development Center of Food Proteins, School of Food Science and Engineering and ‡Guangdong Province Key Laboratory for Green Processing of Natural Products and Product Safety, South China University of Technology , Guangzhou 510640, P.R. China
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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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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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Modulating fat digestion through food structure design. Prog Lipid Res 2017; 68:109-118. [DOI: 10.1016/j.plipres.2017.10.001] [Citation(s) in RCA: 110] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 10/05/2017] [Accepted: 10/06/2017] [Indexed: 01/21/2023]
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Li S, Wang X, Qu L, Dou T, Ma M, Shen M, Guo J, Hu Y, Wang K. Genome-wide association studies for small intestine length in an F2 population of chickens. ITALIAN JOURNAL OF ANIMAL SCIENCE 2017. [DOI: 10.1080/1828051x.2017.1368419] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Shangmin Li
- Department of Laying Hen Breeding, Jiangsu Institute of Poultry Science, Yangzhou, China
| | - Xingguo Wang
- Department of Laying Hen Breeding, Jiangsu Institute of Poultry Science, Yangzhou, China
| | - Liang Qu
- Department of Laying Hen Breeding, Jiangsu Institute of Poultry Science, Yangzhou, China
| | - Taocun Dou
- Department of Laying Hen Breeding, Jiangsu Institute of Poultry Science, Yangzhou, China
| | - Meng Ma
- Department of Laying Hen Breeding, Jiangsu Institute of Poultry Science, Yangzhou, China
| | - Manman Shen
- Department of Laying Hen Breeding, Jiangsu Institute of Poultry Science, Yangzhou, China
| | - Jun Guo
- Department of Laying Hen Breeding, Jiangsu Institute of Poultry Science, Yangzhou, China
| | - Yuping Hu
- Department of Laying Hen Breeding, Jiangsu Institute of Poultry Science, Yangzhou, China
| | - KeHua Wang
- Department of Laying Hen Breeding, Jiangsu Institute of Poultry Science, Yangzhou, China
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Poppitt SD, Shin HS, McGill AT, Budgett SC, Lo K, Pahl M, Duxfield J, Lane M, Ingram JR. Duodenal and ileal glucose infusions differentially alter gastrointestinal peptides, appetite response, and food intake: a tube feeding study. Am J Clin Nutr 2017; 106:725-735. [PMID: 28701300 DOI: 10.3945/ajcn.117.157248] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 06/15/2017] [Indexed: 11/14/2022] Open
Abstract
Background: Activation of the ileal brake through the delivery of nutrients into the distal small intestine to promote satiety and suppress food intake provides a new target for weight loss. Evidence is limited, with support from naso-ileal lipid infusion studies.Objective: The objective of the study was to investigate whether glucose infused into the duodenum and ileum differentially alters appetite response, food intake, and secretion of satiety-related gastrointestinal peptides.Design: Fourteen healthy male participants were randomly assigned to a blinded 4-treatment crossover, with each treatment of single-day duration. On the day before the intervention (day 0), a 380-cm multilumen tube (1.75-mm diameter) with independent port access to the duodenum and ileum was inserted, and position was confirmed by X-ray. Subsequently (days 1-4), a standardized breakfast meal was followed midmorning by a 90-min infusion of isotonic glucose (15 g, 235 kJ) or saline to the duodenum or ileum. Appetite ratings were assessed with the use of visual analog scales (VASs), blood samples collected, and ad libitum energy intake (EI) measured at lunch, afternoon snack, and dinner.Results: Thirteen participants completed the 4 infusion days. There was a significant effect of nutrient infused and site (treatment × time, P < 0.05) such that glucose-to-ileum altered VAS-rated fullness, satisfaction, and thoughts of food compared with saline-to-ileum (Tukey's post hoc, P < 0.05); decreased ad libitum EI at lunch compared with glucose-to-duodenum [-22%, -988 ± 379 kJ (mean ± SEM), Tukey's post hoc, P < 0.05]; and increased glucagon-like peptide-1 (GLP-1) and peptide YY (PYY) compared with all other treatments (Tukey's post hoc, P < 0.05).Conclusions: Macronutrient delivery to the proximal and distal small intestine elicits different outcomes. Glucose infusion to the ileum increased GLP-1 and PYY secretion, suppressed aspects of VAS-rated appetite, and decreased ad libitum EI at a subsequent meal. Although glucose to the duodenum also suppressed appetite ratings, eating behavior was not altered. This trial was registered at www.anzctr.org.au as ACTRN12612000429853.
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Affiliation(s)
- Sally D Poppitt
- Human Nutrition Unit, School of Biological Sciences and Department of Medicine,
| | - Hyun Sang Shin
- Human Nutrition Unit, School of Biological Sciences and Department of Medicine
| | - Anne-Thea McGill
- Human Nutrition Unit, School of Biological Sciences and Department of Medicine.,School of Population Health, and
| | | | - Kim Lo
- Plant and Food Research Ltd., Auckland, New Zealand; and
| | - Malcolm Pahl
- Plant and Food Research Ltd., Auckland, New Zealand; and
| | - Janice Duxfield
- Department of Gastroenterology and Hepatology, Auckland City Hospital, Auckland, New Zealand
| | - Mark Lane
- Department of Gastroenterology and Hepatology, Auckland City Hospital, Auckland, New Zealand
| | - John R Ingram
- Plant and Food Research Ltd., Auckland, New Zealand; and
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Corstens MN, Berton-Carabin CC, Elichiry-Ortiz PT, Hol K, Troost FJ, Masclee AA, Schroën K. Emulsion-alginate beads designed to control in vitro intestinal lipolysis: Towards appetite control. J Funct Foods 2017. [DOI: 10.1016/j.jff.2017.05.003] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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15
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Does the Ileal Brake Contribute to Delayed Gastric Emptying After Pancreatoduodenectomy? Dig Dis Sci 2017; 62:319-335. [PMID: 27995402 DOI: 10.1007/s10620-016-4402-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 11/29/2016] [Indexed: 12/18/2022]
Abstract
Delayed gastric emptying (DGE) represents a significant cause for morbidity following pancreatoduodenectomy (PD). At a time when no specific and universally effective therapy exists to treat these patients, elucidating other potential (preventable or treatable) mechanisms for DGE is important. The aim of the manuscript was to test the hypothesis that ileal brake contributes to DGE in PD patients receiving jejunal tube feeding by systematically reviewing experimental and clinical literature. A series of clinically relevant questions were framed related to the potential role of the ileal brake in development of DGE post-PD and formed the basis of targeted literature searches. A comprehensive search of major reference databases from January 1980 to June 2015 was carried out which included human and animal studies. The ileal brake is a feedback loop neurally mediated by the vagus and sympatho-adrenergic pathways and hormonally by gut peptides including glucagon-like peptide-1, peptide YY (PYY), and neurotensin. The most potent stimulus for this inhibitory reflex is intra-ileal fat. There is evidence to indicate the role of an inhibitory reflex (on gastric emptying) mediated by PYY and CCK which, in turn, are stimulated by nutrient delivery into the distal small intestine providing indirect support to the role of ileal brake in post-PD DGE. The ileal brake is a likely factor contributing to DGE post-PD. While there has been no study to directly test this hypothesis, there is compelling indirect evidence to support it. Designing a trial that would answer such a question appears to be the most appropriate way forward.
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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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17
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Scheuble N, Lussi M, Geue T, Carrière F, Fischer P. Blocking Gastric Lipase Adsorption and Displacement Processes with Viscoelastic Biopolymer Adsorption Layers. Biomacromolecules 2016; 17:3328-3337. [DOI: 10.1021/acs.biomac.6b01081] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Nathalie Scheuble
- Institute
of Food Nutrition and Health, ETH Zurich, 8092 Zurich, Switzerland
| | - Micha Lussi
- Institute
of Food Nutrition and Health, ETH Zurich, 8092 Zurich, Switzerland
| | - Thomas Geue
- Laboratory
of Neutron Scattering and Imaging, Paul Scherrer Institut, 5232 Villigen PSI, Switzerland
| | - Frédéric Carrière
- CNRS,
Aix Marseille University, UMR7282 Enzymologie Interfaciale et Physiologie de la Lipolyse, Marseille, France
| | - Peter Fischer
- Institute
of Food Nutrition and Health, ETH Zurich, 8092 Zurich, Switzerland
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18
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Lehmann A, Hornby PJ. Intestinal SGLT1 in metabolic health and disease. Am J Physiol Gastrointest Liver Physiol 2016; 310:G887-98. [PMID: 27012770 DOI: 10.1152/ajpgi.00068.2016] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 03/21/2016] [Indexed: 01/31/2023]
Abstract
The Na(+)-glucose cotransporter 1 (SGLT1/SLC5A1) is predominantly expressed in the small intestine. It transports glucose and galactose across the apical membrane in a process driven by a Na(+) gradient created by Na(+)-K(+)-ATPase. SGLT2 is the major form found in the kidney, and SGLT2-selective inhibitors are a new class of treatment for type 2 diabetes mellitus (T2DM). Recent data from patients treated with dual SGLT1/2 inhibitors or SGLT2-selective drugs such as canagliflozin (SGLT1 IC50 = 663 nM) warrant evaluation of SGLT1 inhibition for T2DM. SGLT1 activity is highly dynamic, with modulation by multiple mechanisms to ensure maximal uptake of carbohydrates (CHOs). Intestinal SGLT1 inhibition lowers and delays the glucose excursion following CHO ingestion and augments glucagon-like peptide-1 (GLP-1) and peptide YY (PYY) secretion. The latter is likely due to increased glucose exposure of the colonic microbiota and formation of metabolites such as L cell secretagogues. GLP-1 and PYY secretion suppresses food intake, enhances the ileal brake, and has an incretin effect. An increase in colonic microbial production of propionate could contribute to intestinal gluconeogenesis and mediate positive metabolic effects. On the other hand, a threshold of SGLT1 inhibition that could lead to gastrointestinal intolerability is unclear. Altered Na(+) homeostasis and increased colonic CHO may result in diarrhea and adverse gastrointestinal effects. This review considers the potential mechanisms contributing to positive metabolic and negative intestinal effects. Compounds that inhibit SGLT1 must balance the modulation of these mechanisms to achieve therapeutic efficacy for metabolic diseases.
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Affiliation(s)
- Anders Lehmann
- Division of Endocrinology, Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; and
| | - Pamela J Hornby
- Cardiovascular and Metabolic Disease, Janssen Research and Development, LLC, Spring House, Pennsylvania
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19
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Alleleyn AME, van Avesaat M, Troost FJ, Masclee AAM. Gastrointestinal Nutrient Infusion Site and Eating Behavior: Evidence for A Proximal to Distal Gradient within the Small Intestine? Nutrients 2016; 8:117. [PMID: 26927170 PMCID: PMC4808847 DOI: 10.3390/nu8030117] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 02/16/2016] [Accepted: 02/19/2016] [Indexed: 12/23/2022] Open
Abstract
The rapidly increasing prevalence of overweight and obesity demands new strategies focusing on prevention and treatment of this significant health care problem. In the search for new and effective therapeutic modalities for overweight subjects, the gastrointestinal (GI) tract is increasingly considered as an attractive target for medical and food-based strategies. The entry of nutrients into the small intestine activates so-called intestinal "brakes", negative feedback mechanisms that influence not only functions of more proximal parts of the GI tract but also satiety and food intake. Recent evidence suggests that all three macronutrients (protein, fat, and carbohydrates) are able to activate the intestinal brake, although to a different extent and by different mechanisms of action. This review provides a detailed overview of the current evidence for intestinal brake activation of the three macronutrients and their effects on GI function, satiety, and food intake. In addition, these effects appear to depend on region and length of infusion in the small intestine. A recommendation for a therapeutic approach is provided, based on the observed differences between intestinal brake activation.
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Affiliation(s)
- Annick M E Alleleyn
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands.
| | - Mark van Avesaat
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands.
- Top Institute of Food and Nutrition, 6700 AN Wageningen, The Netherlands.
| | - Freddy J Troost
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands.
- Top Institute of Food and Nutrition, 6700 AN Wageningen, The Netherlands.
| | - Adrian A M Masclee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands.
- Top Institute of Food and Nutrition, 6700 AN Wageningen, The Netherlands.
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20
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Investigating acute satiation and meal termination effects of a commercial lipid emulsion: A breakfast meal study. Physiol Behav 2015; 152:20-5. [DOI: 10.1016/j.physbeh.2015.09.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 09/03/2015] [Accepted: 09/08/2015] [Indexed: 01/22/2023]
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21
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Corstens MN, Berton-Carabin CC, de Vries R, Troost FJ, Masclee AAM, Schroën K. Food-grade micro-encapsulation systems that may induce satiety via delayed lipolysis: A review. Crit Rev Food Sci Nutr 2015; 57:2218-2244. [DOI: 10.1080/10408398.2015.1057634] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Meinou N. Corstens
- Department of Agrotechnology & Food Sciences, Food Process Engineering Group, Wageningen University and Research Center, Wageningen, The Netherlands
| | - Claire C. Berton-Carabin
- Department of Agrotechnology & Food Sciences, Food Process Engineering Group, Wageningen University and Research Center, Wageningen, The Netherlands
| | - Renko de Vries
- Department of Agrotechnology & Food Sciences, Physical Chemistry and Colloid Science Group, Wageningen University and Research Center, Wageningen, The Netherlands
| | - Freddy J. Troost
- Department of Internal Medicine, Division of Gastroenterology-Hepatology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Ad A. M. Masclee
- Department of Internal Medicine, Division of Gastroenterology-Hepatology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Karin Schroën
- Department of Agrotechnology & Food Sciences, Food Process Engineering Group, Wageningen University and Research Center, Wageningen, The Netherlands
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22
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Hussein MO, Hoad CL, Wright J, Singh G, Stephenson MC, Cox EF, Placidi E, Pritchard SE, Costigan C, Ribeiro H, Ciampi E, Nandi A, Hedges N, Sanderson P, Peters HPF, Rayment P, Spiller RC, Gowland PA, Marciani L. Fat emulsion intragastric stability and droplet size modulate gastrointestinal responses and subsequent food intake in young adults. J Nutr 2015; 145:1170-7. [PMID: 25926408 PMCID: PMC4442113 DOI: 10.3945/jn.114.204339] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 04/03/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Intragastric creaming and droplet size of fat emulsions may affect intragastric behavior and gastrointestinal and satiety responses. OBJECTIVES We tested the hypotheses that gastrointestinal physiologic responses and satiety will be increased by an increase in intragastric stability and by a decrease in fat droplet size of a fat emulsion. METHODS This was a double-blind, randomized crossover study in 11 healthy persons [8 men and 3 women, aged 24 ± 1 y; body mass index (in kg/m(2)): 24.4 ± 0.9] who consumed meals containing 300-g 20% oil and water emulsion (2220 kJ) with 1) larger, 6-μm mean droplet size (Coarse treatment) expected to cream in the stomach; 2) larger, 6-μm mean droplet size with 0.5% locust bean gum (LBG; Coarse+LBG treatment) to prevent creaming; or 3) smaller, 0.4-μm mean droplet size with LBG (Fine+LBG treatment). The participants were imaged hourly by using MRI and food intake was assessed by using a meal that participants consumed ad libitum. RESULTS The Coarse+LBG treatment (preventing creaming in the stomach) slowed gastric emptying, resulting in 12% higher gastric volume over time (P < 0.001), increased small bowel water content (SBWC) by 11% (P < 0.01), slowed appearance of the (13)C label in the breath by 17% (P < 0.01), and reduced food intake by 9% (P < 0.05) compared with the Coarse treatment. The Fine+LBG treatment (smaller droplet size) slowed gastric emptying, resulting in 18% higher gastric volume (P < 0.001), increased SBWC content by 15% (P < 0.01), and significantly reduced food intake by 11% (P < 0.05, equivalent to an average of 411 kJ less energy consumed) compared with the Coarse+LBG treatment. These high-fat meals stimulated substantial increases in SBWC, which increased to a peak at 4 h at 568 mL (range: 150-854 mL; P < 0.01) for the Fine+LBG treatment. CONCLUSION Manipulating intragastric stability and fat emulsion droplet size can influence human gastrointestinal physiology and food intake.
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Affiliation(s)
- Mahamoud O Hussein
- Sir Peter Mansfield Magnetic Resonance Centre, School of Physics and Astronomy, and
| | - Caroline L Hoad
- Sir Peter Mansfield Magnetic Resonance Centre, School of Physics and Astronomy, and
| | - Jeff Wright
- Gastrointestinal Surgery, University of Nottingham, Nottingham, United Kingdom
| | - Gulzar Singh
- Nottingham Digestive Diseases Centre and National Institute for Health Research Biomedical Research Unit, Nottingham University Hospitals, University of Nottingham, Nottingham, United Kingdom
| | - Mary C Stephenson
- Sir Peter Mansfield Magnetic Resonance Centre, School of Physics and Astronomy, and
| | - Eleanor F Cox
- Sir Peter Mansfield Magnetic Resonance Centre, School of Physics and Astronomy, and
| | - Elisa Placidi
- Sir Peter Mansfield Magnetic Resonance Centre, School of Physics and Astronomy, and
| | - Susan E Pritchard
- Sir Peter Mansfield Magnetic Resonance Centre, School of Physics and Astronomy, and
| | - Carolyn Costigan
- Sir Peter Mansfield Magnetic Resonance Centre, School of Physics and Astronomy, and
| | | | | | - Asish Nandi
- Unilever Discover, Sharnbrook, United Kingdom; and
| | - Nick Hedges
- Unilever Discover, Sharnbrook, United Kingdom; and
| | | | - Harry PF Peters
- Unilever Research and Development, Vlaardingen, The Netherlands
| | - Pip Rayment
- Unilever Discover, Sharnbrook, United Kingdom; and
| | - Robin C Spiller
- Nottingham Digestive Diseases Centre and National Institute for Health Research Biomedical Research Unit, Nottingham University Hospitals, University of Nottingham, Nottingham, United Kingdom
| | - Penny A Gowland
- Sir Peter Mansfield Magnetic Resonance Centre, School of Physics and Astronomy, and
| | - Luca Marciani
- Nottingham Digestive Diseases Centre and National Institute for Health Research Biomedical Research Unit, Nottingham University Hospitals, University of Nottingham, Nottingham, United Kingdom;
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23
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Evidence-Based Approach to Fiber Supplements and Clinically Meaningful Health Benefits, Part 1: What to Look for and How to Recommend an Effective Fiber Therapy. ACTA ACUST UNITED AC 2015; 50:82-89. [PMID: 25972618 PMCID: PMC4415962 DOI: 10.1097/nt.0000000000000082] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Dietary fiber that is intrinsic and intact in fiber-rich foods (eg, fruits, vegetables, legumes, whole grains) is widely recognized to have beneficial effects on health when consumed at recommended levels (25 g/d for adult women, 38 g/d for adult men). Most (90%) of the US population does not consume this level of dietary fiber, averaging only 15 g/d. In an attempt to bridge this “fiber gap,” many consumers are turning to fiber supplements, which are typically isolated from a single source. Fiber supplements cannot be presumed to provide the health benefits that are associated with dietary fiber from whole foods. Of the fiber supplements on the market today, only a minority possess the physical characteristics that underlie the mechanisms driving clinically meaningful health benefits. The first part (current issue) of this 2-part series will focus on the 4 main characteristics of fiber supplements that drive clinical efficacy (solubility, degree/rate of fermentation, viscosity, and gel formation), the 4 clinically meaningful designations that identify which health benefits are associated with specific fibers, and the gel-dependent mechanisms in the small bowel that drive specific health benefits (eg, cholesterol lowering, improved glycemic control). The second part (next issue) of this 2-part series will focus on the effects of fiber supplements in the large bowel, including the 2 mechanisms by which fiber prevents/relieves constipation (insoluble mechanical irritant and soluble gel-dependent water-holding capacity), the gel-dependent mechanism for attenuating diarrhea and normalizing stool form in irritable bowel syndrome, and the combined large bowel/small bowel fiber effects for weight loss/maintenance. The second part will also discuss how processing for marketed products can attenuate efficacy, why fiber supplements can cause gastrointestinal symptoms, and how to avoid symptoms for better long-term compliance.
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24
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Sadoul BC, Schuring EA, Mela DJ, Peters HP. The relationship between appetite scores and subsequent energy intake: An analysis based on 23 randomized controlled studies. Appetite 2014; 83:153-159. [DOI: 10.1016/j.appet.2014.08.016] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 07/29/2014] [Accepted: 08/13/2014] [Indexed: 10/24/2022]
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25
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Duca FA, Yue JTY. Fatty acid sensing in the gut and the hypothalamus: in vivo and in vitro perspectives. Mol Cell Endocrinol 2014; 397:23-33. [PMID: 25261798 DOI: 10.1016/j.mce.2014.09.022] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 09/19/2014] [Accepted: 09/19/2014] [Indexed: 12/15/2022]
Abstract
The ability to properly sense both ingested and circulating nutrients is crucial for the maintenance of metabolic homeostasis. As such, both the gastrointestinal tract and the hypothalamus have demonstrated the capacity to sense and effectively respond to nutrients, such as fatty acids, to control food intake and glucose production to regulate energy and glucose homeostasis. In modern, Westernized societies, obesity and diabetes rates continue to rise unabated, due in part to an increase in highly palatable high-fat diet consumption. Thus, our understanding in the ability of the body to successfully monitor lipids is more vital than ever. This review details the current understanding of both the gut and the brain, specifically the hypothalamus, in sensing fatty acids. Highlighting both in vivo and in vitro studies, we explore some of the mechanisms upon which different fatty acids activate enteroendocrine and neural lipid-sensing signaling mechanisms to subsequently lower food intake and glucose production to ultimately regulate metabolic homeostasis. A better understanding of these lipid-sensing pathways could lay the groundwork for successful pharmacological targets for the treatment of obesity and diabetes.
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Affiliation(s)
- Frank A Duca
- Toronto General Research Institute and Department of Medicine, UHN, Toronto, M5G 1L7, Canada
| | - Jessica T Y Yue
- Toronto General Research Institute and Department of Medicine, UHN, Toronto, M5G 1L7, Canada.
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26
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Validation of an iPad visual analogue rating system for assessing appetite and satiety. Appetite 2014; 84:259-63. [PMID: 25450987 DOI: 10.1016/j.appet.2014.10.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Revised: 10/23/2014] [Accepted: 10/24/2014] [Indexed: 11/22/2022]
Abstract
The study aimed to validate appetite ratings made on a new electronic device, the Apple iPad Mini, against an existing but now obsolete electronic device (Hewlett Packard iPAQ). Healthy volunteers (9 men and 9 women) rated their appetite before and 0, 30, 60, 90 and 120 minutes after consuming both a low energy (LE: 77 kcal) and high energy (HE: 274 kcal) beverage at breakfast on 2 non-consecutive days in counter-balanced order. Rated hunger, desire to eat and how much participants could consume was significantly lower after HE than LE on both devices, although there was better overall differentiation between HE and LE for ratings on iPad. Rated satiation and fullness, and a composite measure combining all five ratings, was significantly higher after HE than LE on both devices. There was also evidence that differences between conditions were more significant when analysed at each time point than using an overall area under the curve (AUC) measure. Overall, these data confirm that appetite ratings made using iPad are at least as sensitive as those on iPAQ, and offer a new platform for researchers to collect appetite data.
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27
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Ripken D, van der Wielen N, Wortelboer HM, Meijerink J, Witkamp RF, Hendriks HFJ. Steviol glycoside rebaudioside A induces glucagon-like peptide-1 and peptide YY release in a porcine ex vivo intestinal model. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2014; 62:8365-8370. [PMID: 25062288 DOI: 10.1021/jf501105w] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Glucagon-like peptide-1 (GLP-1) and peptide YY (PYY) are hormones important for satiation and are involved in the process called "ileal brake". The aim of this study was to investigate the GLP-1- and PYY-stimulating efficacy of rebaudioside A, casein, and sucrose. This was studied using tissue segments collected from various regions of the pig small intestine. GLP-1 release was strongest from the distal ileum. There, control release was 0.06 ± 0.01 (GLP-1) and 0.07 ± 0.01 (PYY) pmol/cm(2) of tissue. Rebaudioside A (2.5, 12.5, and 25 mM) stimulated GLP-1 release (0.14 ± 0.02, 0.16 ± 0.02, and 0.13 ± 0.02 pmol/cm(2) of tissue, p < 0.001) and PYY release (0.19 ± 0.02, 0.42 ± 0.06, and 0.27 ± 0.03 pmol/cm(2) of tissue, p < 0.001). Sucrose stimulated GLP-1 release (0.08 ± 0.01 pmol/cm(2) of tissue, p < 0.05) only at 10 mM. Casein (0.5%, 1%, and 2.5%, w/v) stimulated GLP-1 release (0.15 ± 0.03, 0.13 ± 0.02, and 0.14 ± 0.01 pmol/cm(2) of tissue, p < 0.001) and PYY release (0.13 ± 0.02, 0.20 ± 0.03, and 0.27 ± 0.03 pmol/cm(2) of tissue, p < 0.01). These findings may help in developing dietary approaches for weight management.
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Affiliation(s)
- Dina Ripken
- Top Institute Food and Nutrition , Nieuwe Kanaal 9A, 6709 PA Wageningen, The Netherlands
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28
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van Avesaat M, Troost FJ, Ripken D, Hendriks HF, Masclee AAM. Ileal brake activation: macronutrient-specific effects on eating behavior? Int J Obes (Lond) 2014; 39:235-43. [PMID: 24957485 DOI: 10.1038/ijo.2014.112] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 06/11/2014] [Accepted: 06/17/2014] [Indexed: 01/03/2023]
Abstract
BACKGROUND Activation of the ileal brake, by infusing lipid directly into the distal part of the small intestine, alters gastrointestinal (GI) motility and inhibits food intake. The ileal brake effect on eating behavior of the other macronutrients is currently unknown. OBJECTIVE The objective of this study was to investigate the effects of ileal infusion of sucrose and casein on food intake, release of GI peptides, gastric emptying rate and small-bowel transit time with safflower oil as positive control. DESIGN This randomized, single-blind, crossover study was performed in 13 healthy subjects (6 male; mean age 26.4±2.9 years; mean body mass index 22.8±0.4 kg m(-2)) who were intubated with a naso-ileal catheter. Thirty minutes after the intake of a standardized breakfast, participants received an ileal infusion, containing control ((C) saline), safflower oil ((HL) 51.7 kcal), low-dose casein ((LP) 17.2 kcal) or high-dose casein ((HP) 51.7 kcal), low-dose sucrose ((LC) 17.2 kcal) and high-dose sucrose ((HC) 51.7 kcal), over a period of 90 min. Food intake was determined during an ad libitum meal. Visual analogue score questionnaires for hunger and satiety and blood samples were collected at regular intervals. RESULTS Ileal infusion of lipid, protein and carbohydrate resulted in a significant reduction in food intake compared with control (HL: 464.3±90.7 kcal, P<0.001; HP: 458.0±78.6 kcal, P<0.005; HC: 399.0±57.0 kcal, P<0.0001 vs control: 586.7±70.2 kcal, P<0.001, respectively). A reduction in energy intake was still apparent when the caloric amount of infused nutrients was added to the amount eaten during the ad libitum meal.Secretion of cholecystokinin and peptide YY but not of glucagon-like peptide-1 (7-36) was increased during ileal perfusion of fat, carbohydrates and protein. During ileal perfusion of all macronutrients, a delay in gastric emptying and intestinal transit was observed, but differences were not significant compared with control. CONCLUSION Apart from lipids, also sucrose and casein reduce food intake on ileal infusion, thereby activating the ileal brake. In addition to food intake, also satiety and GI peptide secretion were affected.
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Affiliation(s)
- M van Avesaat
- 1] Top Institute of Food and Nutrition, Wageningen, The Netherlands [2] Division of Gastroenterology and Hepatology, Department of Internal Medicine, NUTRIM, Maastricht University Medical Center, Maastricht, The Netherlands
| | - F J Troost
- 1] Top Institute of Food and Nutrition, Wageningen, The Netherlands [2] Division of Gastroenterology and Hepatology, Department of Internal Medicine, NUTRIM, Maastricht University Medical Center, Maastricht, The Netherlands
| | - D Ripken
- 1] Top Institute of Food and Nutrition, Wageningen, The Netherlands [2] The Netherlands Organisation for Applied Scientific Research, TNO, Zeist, The Netherlands [3] Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - H F Hendriks
- 1] Top Institute of Food and Nutrition, Wageningen, The Netherlands [2] The Netherlands Organisation for Applied Scientific Research, TNO, Zeist, The Netherlands
| | - A A M Masclee
- 1] Top Institute of Food and Nutrition, Wageningen, The Netherlands [2] Division of Gastroenterology and Hepatology, Department of Internal Medicine, NUTRIM, Maastricht University Medical Center, Maastricht, The Netherlands
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29
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Hansen HS. Role of anorectic N-acylethanolamines in intestinal physiology and satiety control with respect to dietary fat. Pharmacol Res 2014; 86:18-25. [PMID: 24681513 DOI: 10.1016/j.phrs.2014.03.006] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 03/17/2014] [Accepted: 03/18/2014] [Indexed: 02/06/2023]
Abstract
Anandamide is a well-known agonist for the cannabinoid receptors. Along with endogenous anandamide other non-endocannabinoid N-acylethanolamines are also formed, apparently in higher amounts. These include mainly oleoylethanolamide (OEA), palmitoyelethanolamide (PEA) and linoleoylethanolamide (LEA), and they have biological activity by themselves being anorectic and anti-inflammatory. It appears that the major effect of dietary fat on the level of these molecules is in the gastrointestinal system, where OEA, PEA and LEA in the enterocytes may function as homeostatic signals, which are decreased by prolonged consumption of a high-fat diet. These lipid amides appear to mediate their signaling activity via activation of PPARα in the enterocyte followed by activation of afferent vagal fibers leading to the brain. Through this mechanism OEA, PEA and LEA may both reduce the consumption of a meal as well as increase the reward value of the food. Thus, they may function as homeostatic intestinal signals involving hedonic aspects that contribute to the regulation of the amounts of dietary fat to be ingested.
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Affiliation(s)
- Harald S Hansen
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, 2100 Copenhagen, Denmark.
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30
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Hua KF, Yang SM, Kao TY, Chang JM, Chen HL, Tsai YJ, Chen A, Yang SS, Chao LK, Ka SM. Osthole mitigates progressive IgA nephropathy by inhibiting reactive oxygen species generation and NF-κB/NLRP3 pathway. PLoS One 2013; 8:e77794. [PMID: 24204969 PMCID: PMC3810132 DOI: 10.1371/journal.pone.0077794] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2013] [Accepted: 09/04/2013] [Indexed: 12/31/2022] Open
Abstract
Renal reactive oxygen species (ROS) and mononuclear leukocyte infiltration are involved in the progressive stage (exacerbation) of IgA nephropathy (IgAN), which is characterized by glomerular proliferation and renal inflammation. The identification of the mechanism responsible for this critical stage of IgAN and the development of a therapeutic strategy remain a challenge. Osthole is a pure compound isolated from Cnidiummonnieri (L.) Cusson seeds, which are used as a traditional Chinese medicine, and is anti-inflammatory, anti-apoptotic, and anti-fibrotic both in vitro and in vivo. Recently, we showed that osthole acts as an anti-inflammatory agent by reducing nuclear factor-kappa B (NF-κB) activation in and ROS release by activated macrophages. In this study, we examined whether osthole could prevent the progression of IgAN using a progressive IgAN (Prg-IgAN) model in mice. Our results showed that osthole administration resulted in prevention of albuminuria, improved renal function, and blocking of renal progressive lesions, including glomerular proliferation, glomerular sclerosis, and periglomerular mononuclear leukocyte infiltration. These findings were associated with (1) reduced renal superoxide anion levels and increased Nrf2 nuclear translocation, (2) inhibited renal activation of NF-κB and the NLRP3 inflammasome, (3) decreased renal MCP-1 expression and mononuclear leukocyte infiltration, (4) inhibited ROS production and NLRP3 inflammasome activation in cultured, activated macrophages, and (5) inhibited ROS production and MCP-1 protein levels in cultured, activated mesangial cells. The results suggest that osthole exerts its reno-protective effects on the progression of IgAN by inhibiting ROS production and activation of NF-κB and the NLRP3 inflammasome in the kidney. Our data also confirm that ROS generation and activation of NF-κB and the NLRP3 inflammasome are crucial mechanistic events involved in the progression of the renal disorder.
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Affiliation(s)
- Kuo-Feng Hua
- Department of Biotechnology and Animal Science, National Ilan University, Ilan, Taiwan, Republic of China
| | - Shun-Min Yang
- Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Tzu-Yang Kao
- Department of Biotechnology and Animal Science, National Ilan University, Ilan, Taiwan, Republic of China
| | - Jia-Ming Chang
- Department of Pharmacology, Institute for Drug Evaluation Platform, Development Center for Biotechnology, Taipei, Taiwan, Republic of China
| | - Hui-Ling Chen
- IND Core Team, Institute for Drug Evaluation Platform, Development Center for Biotechnology, Taipei, Taiwan, Republic of China
| | - Yung-Jen Tsai
- Department of Pharmacology, Institute for Drug Evaluation Platform, Development Center for Biotechnology, Taipei, Taiwan, Republic of China
| | - Ann Chen
- Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Sung-Sen Yang
- Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Louis Kuoping Chao
- Department of Cosmeceutics, China Medical University, Taichung, Taiwan, Republic of China
| | - Shuk-Man Ka
- Graduate Institute of Aerospace and Undersea Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- * E-mail:
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31
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Peters HPF, Bouwens ECM, Schuring EAH, Haddeman E, Velikov KP, Melnikov SM. The effect of submicron fat droplets in a drink on satiety, food intake, and cholecystokinin in healthy volunteers. Eur J Nutr 2013; 53:723-9. [DOI: 10.1007/s00394-013-0576-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Accepted: 08/02/2013] [Indexed: 02/07/2023]
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Shin HS, Ingram JR, McGill AT, Poppitt SD. Lipids, CHOs, proteins: can all macronutrients put a 'brake' on eating? Physiol Behav 2013; 120:114-23. [PMID: 23911804 DOI: 10.1016/j.physbeh.2013.07.008] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Revised: 01/09/2013] [Accepted: 07/23/2013] [Indexed: 01/18/2023]
Abstract
The gastrointestinal (GI) tract and specifically the most distal part of the small intestine, the ileum, has become a renewed focus of interest for mechanisms targeting appetite suppression. The 'ileal brake' is stimulated when energy-containing nutrients are delivered beyond the duodenum and jejunum and into the ileum, and is named for the feedback loop which slows or 'brakes' gastric emptying and duodeno-jejunal motility. More recently it has been hypothesized that the ileal brake also promotes secretion of satiety-enhancing GI peptides and suppresses hunger, placing a 'brake' on food intake. Postprandial delivery of macronutrients to the ileum, other than unavailable carbohydrates (CHO) which bypass absorption in the small intestine en route to fermentation in the large bowel, is an uncommon event and hence this brake mechanism is rarely activated following a meal. However the ability to place a 'brake' on food intake through delivery of protected nutrients to the ileum is both intriguing and challenging. This review summarizes the current clinical and experimental evidence for activation of the ileal brake by the three food macronutrients, with emphasis on eating behavior and satiety as well as GI function. While clinical studies have shown that exposure of the ileum to lipids, CHOs and proteins may activate GI components of the ileal brake, such as decreased gut motility, gastric emptying and secretion of GI peptides, there is less evidence as yet to support a causal relationship between activation of the GI brake by these macronutrients and the suppression of food intake. The predominance of evidence for an ileal brake on eating comes from lipid studies, where direct lipid infusion into the ileum suppresses both hunger and food intake. Outcomes from oral feeding studies are less conclusive with no evidence that 'protected' lipids have been successfully delivered into the ileum in order to trigger the brake. Whether CHO or protein may induce the ileal brake and suppress food intake has to date been little investigated, although both clearly have GI mediated effects. This review provides an overview of the mechanisms and mediators of activation of the ileal brake and assesses whether it may play an important role in appetite suppression.
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Affiliation(s)
- H S Shin
- Human Nutrition Unit, University of Auckland, Auckland, New Zealand; School of Biological Sciences, University of Auckland, Auckland, New Zealand
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Mackie AR, Rafiee H, Malcolm P, Salt L, van Aken G. Specific food structures supress appetite through reduced gastric emptying rate. Am J Physiol Gastrointest Liver Physiol 2013; 304:G1038-43. [PMID: 23578786 PMCID: PMC3680687 DOI: 10.1152/ajpgi.00060.2013] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 04/05/2013] [Indexed: 01/31/2023]
Abstract
The aim of this study was to determine the extent to which gastric layering and retention of a meal could be used to reduce appetite using the same caloric load. Liquid (control) and semi-solid (active) meals were produced with the same protein, fat, carbohydrate, and mass. These were fed to 10 volunteers on separate days in a crossover study, and subjective appetite ratings, gastric contents, and plasma cholecystokinin (CCK) were assessed over a period of 3 h. The active meal showed food boluses in the stomach persisting for ~45 min, slower emptying rates, and lower plasma CCK levels over the first hour. After the first hour, both gastric emptying rates and plasma CCK levels were similar for both systems and slightly increased compared with the unfed situation. Despite the lower plasma CCK levels for the active meal over the first hour, this meal reduced appetite more than the control meal over the 3 h of the study. For a moderately increased plasma CCK level in the fed state, appetite was correlated with the volume of gastric contents rather than gastric emptying rates or plasma CCK. This suggests that enhanced gastric retention was the key factor in decreasing appetite and was probably mediated by a combination of intestinal nutrient sensing and increased viscosity in the stomach.
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Affiliation(s)
- Alan R Mackie
- Institute of Food Research, Norwich Research Park, Norwich, UK.
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Overeating makes the gut grow fonder; new insights in gastrointestinal satiety signaling in obesity. Curr Opin Gastroenterol 2013; 29:177-83. [PMID: 23295637 DOI: 10.1097/mog.0b013e32835d9fe0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE OF REVIEW As the prevalence of overweight and obesity increases, there is a growing need to develop effective treatment strategies in addition to bariatric surgery. Research has focused on understanding the pathophysiologic mechanisms that contribute to the occurrence and maintenance of obesity and overweight, and on how bariatric surgery is able to overcome these obstacles. In this review, new insights in the gastrointestinal regulatory mechanisms in obesity and bariatric surgery will be discussed. RECENT FINDINGS Diet-induced obesity (DIO) leads to changes in gut peptide secretion and other gastrointestinal responses to nutrients. These changes reduce satiety signaling and therefore complicate loss of body weight. Weight loss by dietary restriction does not restore gastrointestinal responses to nutrients to normal, but alters these responses to further complicate weight loss. Only bariatric surgery is able to overcome these changes by mechanisms that are hitherto unclear but may involve altered gut peptide secretion or changes in bile acid metabolism. SUMMARY DIO alters nutrient-induced gastrointestinal signaling in a way that facilitates further weight gain and complicates weight loss. A better understanding of these mechanisms and the way bariatric surgery can overcome these changes is crucial in developing effective treatment strategies.
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Lutz TA. The interaction of amylin with other hormones in the control of eating. Diabetes Obes Metab 2013; 15:99-111. [PMID: 22862822 DOI: 10.1111/j.1463-1326.2012.01670.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2012] [Revised: 07/20/2012] [Accepted: 07/28/2012] [Indexed: 11/30/2022]
Abstract
Twenty years of research established amylin as an important control of energy homeostasis. Amylin controls nutrient and energy fluxes by reducing energy intake, by modulating nutrient utilization via an inhibition of postprandial glucagon secretion and by increasing energy disposal via a prevention of compensatory decreases of energy expenditure in weight reduced individuals. Like many other gastrointestinal hormones, amylin is secreted in response to meals and it reduces eating by promoting meal-ending satiation. Not surprisingly, amylin interacts with many of these hormones to control eating. These interactions seem to occur at different levels because amylin seems to mediate the eating inhibitory effect of some of these gastrointestinal hormones, and the combination of some of these hormones seems to lead to a stronger reduction in eating than single hormones alone. Amylin's effect on eating is thought to be mediated by a stimulation of specific amylin receptors in the area postrema. Secondary brain sites that were defined to mediate amylin action - and hence potential additional sites of interaction with other hormones - include the nucleus of the solitary tract, the lateral parabrachial nucleus, the lateral hypothalamic area and other hypothalamic nuclei. The focus of this review is to summarize the current knowledge of amylin interactions in the control of eating. In most cases, these interactions have only been studied at a descriptive rather than a mechanistic level and despite the clear knowledge on primary sites of amylin action, the interaction sites between amylin and other hormones are often unknown.
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Affiliation(s)
- T A Lutz
- Institute of Veterinary Physiology, University of Zurich, Zurich, Switzerland.
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Rebello CJ, Liu AG, Greenway FL, Dhurandhar NV. Dietary strategies to increase satiety. ADVANCES IN FOOD AND NUTRITION RESEARCH 2013; 69:105-82. [PMID: 23522796 DOI: 10.1016/b978-0-12-410540-9.00003-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Obesity has a multifactorial etiology. Although obesity is widespread and associated with serious health hazards, its effective prevention and treatment have been challenging. Among the currently available treatment approaches, lifestyle modification to induce a negative energy balance holds a particularly larger appeal due to its wider reach and relative safety. However, long-term compliance with dietary modifications to reduce energy intake is not effective for the majority. The role of many individual nutrients, foods, and food groups in inducing satiety has been extensively studied. Based on this evidence, we have developed sample weight-loss meal plans that include multiple satiating foods, which may collectively augment the satiating properties of a meal. Compared to a typical American diet, these meal plans are considerably lower in energy density and probably more satiating. A diet that exploits the satiating properties of multiple foods may help increase long-term dietary compliance and consequentially enhance weight loss.
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Affiliation(s)
- Candida J Rebello
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
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Rebello CJ, Martin CK, Johnson WD, O'Neil CE, Greenway FL. Efficacy of Olibra: a 12-week randomized controlled trial and a review of earlier studies. J Diabetes Sci Technol 2012; 6:695-708. [PMID: 22768902 PMCID: PMC3440037 DOI: 10.1177/193229681200600326] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Intervention strategies that harness the body's appetite and satiety regulating signals provide a means of countering excessive energy intake. METHODS Eighty-two subjects were enrolled (18-60 years, body mass index: 25-40 kg/m(2)) in a randomized, placebo-controlled, double-blind, parallel trial. During a 12-week period, the effects of Olibra™ fat emulsion (2.1 g twice daily) on food intake, appetite, satiety, weight, and body composition were compared with those of a twice daily administered placebo (1.95 g milk fat). On days -7, 0, and 28, Olibra or the placebo added to 200 g of yogurt was served at breakfast and lunch. Food intake, appetite, and satiety were assessed after lunch and dinner. Body weight was measured on days -7, 0, 14, 28, 56, and 84. Body fat, waist circumference, and waist-hip ratio were determined on days 0 and 84. The Eating Inventory was administered at screening and on day 28. Data relating to 71 subjects were analyzed using analysis of covariance. RESULTS At 12 weeks, body weight was reduced in the test group (2.17 ± 0.46 kg standard error of the mean, p < .0001) and the control group (1.68 ± 0.42 kg, p < .0001). Waist circumference decreased by 2.93 ± 0.85 cm in the test group (p = .001) and by 1.78 ± 0.74 cm in the control group (p = .02). Differential weight and waist circumference reductions were not significant. Hunger scores (Eating Inventory) decreased more in the test group (p = .0082). Differential group effects were not significant for body fat, waist-hip ratio, food intake, appetite, and satiety. CONCLUSIONS At this dose, Olibra did not exert a consistent effect on food intake, appetite regulation, body weight, or body composition.
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Affiliation(s)
- Candida J Rebello
- Pennington Biomedical Research Center, Baton Rouge, Louisiana 70808, USA
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