Disintegration of solid foods in human stomach

Chemical effects of nitrite reduction during digestion of cured cooked and recooked meat on nitrosation, nitrosylation and oxidation

Nitrites are food additives used in meatfor their bacteriological, technological and sensory properties.However, they are suspected to be involved in the formation of various mutagenic nitroso compounds (NOCs).With a view to reducing the use of nitrite in meat products to improve the healthiness thereof, the formation of NOCs was studied during dynamic in vitro digestion ofcooked and recooked meats preparedwith various levels of nitrite. Residual nitrite and nitrate and NOCs were evaluated in the gastric and ileal compartments.In the absence of added nitrite, basalnitrosation and nitrosylation were detected, probably due to the oxidation of ammonium salts present in the gastric fluid. Nitrosamines, nitrosyl heme and nitrosothiols displayed different kinetics of formation and degradation,reflecting a possible transfer of nitric oxide from one substrate to another. A protective effect of nitrite on lipid oxidation was also observed during digestion.

Comparing gastric emptying of cellulose nanocrystals with sodium alginate and pectin using a dynamic in vitro stomach model

Cellulose nanocrystals (CNC) are increasingly recognized for their potential in various applications, including packaging, cosmetics, and biomedical engineering. Due to their gelation properties influenced by pH and ionic strength, CNC could impact gastric emptying and satiety, beneficial for managing obesity and diabetes. This study investigated the gastric emptying of CNC (4 % and 8 %, w/w) in comparison with sodium alginate (2 %, w/w) and pectin (2 %, w/w), exploring the effect of divalent cations (Ca2+ and Mg2+) using a dynamic gastric digestion model. CNC, in the presence of Ca2+ and Mg2+, formed a high-viscosity gel network under gastric conditions, leading to delayed gastric emptying. While alginate formed strong gels with Ca2+, it did not significantly delay gastric emptying due to the poor water-holding capacity of its gel network. Pectin showed minimal impact on gastric emptying. Among the treatments, the half-time (t1/2) of gastric emptying for 8 % CNC with Ca2+ was observed to be the longest at 215.4 ± 23.7 min, compared to the shortest times observed with pectin at 15.1 ± 1.4 min. The results suggest that different mechanisms are involved in the gastric emptying effect of different dietary fibers, and CNC is more effective than alginate and pectin assisting in promoting gastric retention and aiding in the management of body weight. This study also introduced a novel application of the dynamic gastric digestion model for estimating digestion energy expenditure, providing insights into the impact of dietary fiber on gastric emptying and satiety enhancement.

Observation and Analysis of In Vitro Digestibility of Different Breads Using a Human Gastric Digestion Simulator

The digestion behavior of a food bolus comprising bread particles in the presence of gastric peristalsis remains poorly understood. This study systematically investigated the effect of bread type on in vitro gastric digestion behavior using a human gastric digestion simulator (GDS) that is capable of quantitatively simulating gastric peristalsis. A food bolus consisting of 60 g of bread (white bread, bagel, German bread, French bread, or croissant), 15 mL of a simulated salivary fluid, and 240 mL of a simulated gastric fluid was used for gastric digestion in vitro using the GDS for 3 h at 37 °C. Direct observation of the gastric digestion behavior in the GDS vessel demonstrated that the structure and composition of breads considerably influenced the physical digestion processes of bread particles. These processes include their fracture, rubbing, disintegration, swelling owing to the penetration of gastric fluid, and release of fat from their surface. Fluorescence microscopy enabled an improved understanding of the variations in the microstructure and major component distribution of the breads during the gastric digestion in vitro. The results showed how the different breads influenced gastric digestibility in vitro through quantitative gastric peristalsis. The GDS can also be applicable to studying gastric digestibility in vitro of other types of bread.

Making in vitro conditions more reflective of in vivo conditions for research on the teleost gastrointestinal tract

To date, the majority of in vitro or ex vivo fish gastrointestinal research has been conducted under unrealistic conditions. In a living fish, ionic conditions, as well as levels of ammonia, pH, HCO3- and PCO2 differ considerably between the different regions of the gastrointestinal tract. These factors also differ from those of the saline often used in gut research. Furthermore, the oxygen gradient from the serosa to the gut lumen is rarely considered: in contrast to the serosa, the lumen is a hypoxic/anoxic environment. In addition, the gut microbiome plays a significant role in gut physiology, increasing the complexity of the in vivo gut, but replicating the microbial community for in vitro studies is exceptionally difficult. However, there are ways in which we can begin to overcome these challenges. Firstly, the luminal chemistry and PO2 in each gut compartment must be carefully considered. Secondly, although microbiological culture techniques are improving, we must learn how to maintain the microbiome diversity seen in vivo. Finally, for ex vivo studies, developing mucosal (luminal) solutions that more closely mimic the in vivo conditions will better replicate physiological processes. Within the field of mammalian gut physiology, great advances in 'gut-on-chip' devices are providing the tools to better replicate in vivo conditions; adopting and adapting this technology may assist in fish gut research initiatives. This Commentary aims to make fish gut physiologists aware of the various issues in replicating the in vivo conditions and identifies solutions as well as those areas that require further improvement.

A novel compartmental approach for modeling stomach motility and gastric emptying

The stomach, a central organ in the Gastrointestinal (GI) tract, regulates the processing of ingested food through gastric motility and emptying. Understanding the stomach function is crucial for treating gastric disorders. Experimental studies in this field often face difficulties due to limitations and invasiveness of available techniques and ethical concerns. To counter this, researchers resort to computational and numerical methods. However, existing computational studies often isolate one aspect of the stomach function while neglecting the rest and employ computationally expensive methods. This paper proposes a novel cost-efficient multi-compartmental model, offering a comprehensive insight into gastric function at an organ level, thus presenting a promising alternative. The proposed approach divides the spatial geometry of the stomach into four compartments: Proximal/Middle/Terminal antrum and Pyloric sphincter. Each compartment is characterized by a set of ordinary differential equations (ODEs) with respect to time to characterize the stomach function. Electrophysiology is represented by simplified equations reflecting the "slow wave behavior" of Interstitial Cells of Cajal (ICC) and Smooth Muscle Cells (SMC) in the stomach wall. An electro-mechanical coupling model translates SMC "slow waves" into smooth muscle contractions. Muscle contractions induce peristalsis, affecting gastric fluid flow velocity and subsequent emptying when the pyloric sphincter is open. Contraction of the pyloric sphincter initiates a retrograde flow jet at the terminal antrum, modeled by a circular liquid jet flow equation. The results from the proposed model for a healthy human stomach were compared with experimental and computational studies on electrophysiology, muscle tissue mechanics, and fluid behavior during gastric emptying. These findings revealed that each "ICC" slow wave corresponded to a muscle contraction due to electro-mechanical coupling behavior. The rate of gastric emptying and mixing efficiency decreased with increasing viscosity of gastric liquid but remained relatively unchanged with gastric liquid density variations. Utilizing different ODE solvers in MATLAB, the model was solved, with ode15s demonstrating the fastest computation time, simulating 180 s of real-time stomach response in just 2.7 s. This multi-compartmental model signifies a promising advancement in understanding gastric function, providing a cost-effective and comprehensive approach to study complex interactions within the stomach and test innovative therapies like neuromodulation for treating gastric disorders.

The gut-brain axis in appetite, satiety, food intake, and eating behavior: Insights from animal models and human studies

The gut-brain axis plays a pivotal role in the finely tuned orchestration of food intake, where both homeostatic and hedonic processes collaboratively control our dietary decisions. This interplay involves the transmission of mechanical and chemical signals from the gastrointestinal tract to the appetite centers in the brain, conveying information on meal arrival, quantity, and chemical composition. These signals are processed in the brain eventually leading to the sensation of satiety and the termination of a meal. However, the regulation of food intake and appetite extends beyond the realms of pure physiological need. Hedonic mechanisms, including sensory perception (i.e., through sight, smell, and taste), habitual behaviors, and psychological factors, exert profound influences on food intake. Drawing from studies in animal models and human research, this comprehensive review summarizes the physiological mechanisms that underlie the gut-brain axis and its interplay with the reward network in the regulation of appetite and satiety. The recent advancements in neuroimaging techniques, with a focus on human studies that enable investigation of the neural mechanisms underpinning appetite regulation are discussed. Furthermore, this review explores therapeutic/pharmacological strategies that hold the potential for controlling food intake.

Investigation of real-life drug intake behaviour in older adults and geriatric patients in Northern Germany - A biopharmaceutical perspective

Dosing conditions (type and amount of accompanying fluid, the type of food, the time of administration, and dosage form modifications such as crushing tablets) are critical and affect the performance of oral dosage forms in the gastrointestinal tract and thus bioavailability. Because older adults are the primary users of medications and are more susceptible to adverse effects, it is important to understand how they take their medications in order to reduce risks and increase benefits of the pharmacotherapy. The aim of the study was to investigate the real-life drug intake behaviour in geriatric patients and older adults and discuss their influence on drug absorption after oral administration. The data from two settings home vs. hospital and genders women vs. men were presented. A questionnaire study was performed among people aged at least 65 years from two settings (hospital vs. home), recruited mostly from community pharmacies and a regional hospital in Mecklenburg - Western Pomerania. The obtained data demonstrates that older adults and geriatric patients take their medications in the same way regardless of the setting and gender. There were no significant differences. Interviewed participants were mostly adherent to the doctor's recommendations and mostly took their medications in the same way every day. Medications are most commonly taken with a small (100 mL) or large (200 mL) glass of noncarbonated water, after food (during or after breakfast 64 % of intakes in the morning and during or after dinner 81 % of intakes in the evening). Meal usually consisted of bread, either with jam or honey (breakfast), or ham and cheese (dinner). All reported dosage form modifications were made to tablets. In almost all cases it was splitting the tablet, which was performed due to doctor's indication.

Impact of saliva incorporation on the rheological properties of in vitro gastric contents formulated from sour cream

Rheological properties of gastric contents depend on the food ingested, and on the volume and composition of secretions from the host, which may vary. This study investigates the impact of saliva regular incorporation in the stomach after a meal on the rheological properties of gastric contents, considering two levels of salivary flow (low = 0.5 and high = 1.5 mL/min). In vitro chymes were obtained by mixing sour cream, simulated gastric fluid, two different volumes of oral fluid (at-rest human saliva, SSF for Simulated Salivary Fluid or water) and adjusting pH at 3. Chymes samples were characterized at 37°C for their particle size and rheological properties. Overall, particle size distribution was not different between samples: incorporating a larger volume of saliva resulted in more heterogeneity, but the surface area moment D[3,2] and volume moment D[4,3] did not differ significantly with the oral fluid type. Shear viscosity of chyme samples was higher when saliva was incorporated, in comparison with water or SSF. In addition, as shown from data extracted atγ ̇ $$ \dot{\gamma} $$  = 20 s-1 the higher the fluid volume the lower the shear viscosity, which is attributed to a dilution effect. However, this dilution effect was attenuated in the case of saliva, most likely due to its composition in organic compounds (e.g., mucins) contributing to the rheological properties of this biological fluid. In these in vitro conditions, both saliva and the salivation rate had a significant but slight impact on the rheological properties of gastric contents (of the order of 1-5 mPa s atγ ̇ $$ \dot{\gamma} $$  = 20 s-1).

An unsupervised wavelet neural network model for approximating the solutions of non-linear nervous stomach model governed by tension, food and medicine

The human stomach is a complex organ. Its role is to degrade food particles by using mechanical forces and chemical reactions in order to release nutrients. All ingested items, including our nutrition, should first pass through the stomach, making it arguably the most crucial segment in the gastrointestinal tract. Computational and mathematical modeling of the stomach is an emerging field of biomechanics where several complex phenomena, such as solid mechanics of the gastric wall, gastric electrophysiology, and fluid mechanics of the digesta need to be addressed. Developing a meshfree comprehensive algorithm for solving the nervous stomach model that enables analysing the relationships between these phenomena remains one of the most significant challenges in biomechanics. This research dedicates to study the dynamics of nervous stomach model governed by a mathematical representation depending on three categories viz. Tension (T), Food (F) and Medicine (M), i.e. TFM model. In this regard, a machine learning paradigm, namely POLYnomial WinOwed with Gaussian (PolyWOG) Wavelet Neural Network (PWNN) model has been implemented for handling the non-linear TFM models. We compared the obtained outcomes of present work with results of a well-known numerical computing paradigm and an existing wavelet neural algorithm. Also, we have done statistical assessment studies at different testing points, which reveal that the proposed architecture is effective and accurate.

Delivery of Probiotic-Loaded Microcapsules in the Gastrointestinal Tract: A Review

Probiotics are live microorganisms that inhabit the gastrointestinal tract and confer health benefits to consumers. However, a sufficient number of viable probiotic cells must be delivered to the specific site of interest in the gastrointestinal tract to exert these benefits. Enhanced viability and tolerance to sublethal gastrointestinal stress can be achieved using appropriate coating materials and food matrices for orally consumed probiotics. The release mechanism and interaction of probiotic microcapsules with the gastrointestinal tract have been minimally explored in the literature to date. To the authors' knowledge, no review has been published to discuss the nature of release and the challenges in the targeted delivery of probiotics. This review addresses gastrointestinal-related complications in the formulation of targeted delivery and controlled release of probiotic strains. It investigates the impacts of environmental stresses during the transition stage and delivery to the target region in the gastrointestinal tract. The influence of factors such as pH levels, enzymatic degradation, and redox conditions on the release mechanisms of probiotics is presented. Finally, the available methods to evaluate the efficiency of a probiotic delivery system, including in vitro and in vivo, are reviewed and assessed. The paper concludes with a discussion highlighting the emerging technologies in the field and emphasising key areas in need of future study.

Delivery of encapsulated bioactive compounds within food matrices to the digestive tract: recent trends and future perspectives

Encapsulation technologies have achieved encouraging results improving the stability, bioaccessibility and absorption of bioactive compounds post-consumption. There is a bulk of published research on the gastrointestinal behavior of encapsulated bioactive food materials alone using in vitro and in vivo digestion models, but an aspect often overlooked is the impact of the food structure, which is much more complex to unravel and still not well understood. This review focuses on discussing the recent findings in the application of encapsulated bioactive components in fabricated food matrices. Studies have suggested that the integration of encapsulated bioactive compounds has been proven to have an impact on the physicochemical characteristics of the finished product in addition to the protective effect of encapsulation on the fortified bioactive compound. These products containing bioactive compounds undergo further structural reorganization during digestion, impacting the release and emptying rates of fortified bioactive compounds. Thus, by manipulation of various food structures and matrices, the release and delivery of these bioactive compounds can be altered. This knowledge provides new opportunities for designing specialized foods for specific populations.

The acute effect of a β-glucan-enriched oat bread on gastric emptying, GLP-1 response, and postprandial glycaemia and insulinemia: a randomised crossover trial in healthy adults

BACKGROUND

The cereal fibre β-glucan reduces postprandial glycaemia, however, the underlying mechanisms are not fully understood. Thus, the aim of this study was to investigate the acute effect of a β-glucan-enriched oat bread on gastric emptying half-time (T1/2), gastric emptying lag phase (Tlag), and gastric emptying rate (GER), and the secretion of glucagon-like peptide-1 (GLP-1) as potential means to influence postprandial glycaemia.

METHODS

A randomised crossover trial was conducted in 22 healthy adults (age 24.6 ± 3.1 years, BMI 23.1 ± 2.7 kg/m2) receiving 25 g available carbohydrates from a β-glucan-enriched oat bread or a control whole-wheat bread at two non-consecutive days. T1/2, Tlag, and GER were determined based on ultrasound measures of the cross-sectional gastric antrum area in the fasting state and 15, 30, 45, 60, 90, and 120 min postprandially. Capillary glucose, serum insulin, and plasma GLP-1 concentrations were measured at the same time points.

RESULTS

A biphasic pattern of gastric emptying with a distinct Tlag before the commencement of emptying was observed in most subjects for both bread types. While no differences in GER were evident (p = 0.562), consumption of the oat bread significantly increased T1/2 by 18 min and Tlag by 14 min compared with the whole-wheat bread (p = 0.005 and p = 0.010, respectively). In addition, the oat bread significantly reduced iAUC2h for glucose and insulin responses compared with the whole-wheat bread (p = 0.001 and p < 0.001, respectively). There were no significant differences in GLP-1 response between the two breads (p = 0.892).

CONCLUSION

The increased T1/2 and Tlag could offer a potential mechanism for the observed attenuation of postprandial glycaemia and insulinemia after consumption of the β-glucan-enriched oat bread compared with the whole-wheat bread.

TRIAL REGISTRATION

 The study is registered at clinicaltrails.gov (NCT04571866).

The forensic value of the gastric content in head trauma injuries: A case report

We present the case of a 69 years old man who was hit by a car while crossing the road. A CT scan of the skull and brain showed fracture of the left occipital bone, bilateral hemispheric subarachnoid hemorrhage, right frontal-temporal-parietal subdural hematoma with a shift of midline structures of 18 mm and complete obliteration of the third ventricle. He showed signs of anisocoria, absence of mobility of all 4 limbs and was immediately intubated and admitted to intensive care. The neurosurgeon was immediately consulted. He underwent drainage of subdural hematoma and two decompressive craniotomies, but died 15 days after the initial trauma. At autopsy, the stomach was full of a greenish poltaceous material. This gave us vital information in reconducting the actual brain death of the man to the immediacy of the investment, helping in the process of ruling out any possible profiles of professional liability.

Effect of marination in lemon juice on beef tenderization and in vitro gastric digestibility

BACKGROUND

There is limited knowledge regarding digestion and absorption of nutrients after cooked marinated meat is ingested. Most of the previous studies on food gastric digestion have focused on chemical digestion and did not reflect upon physical digestion driven by peristalsis. In the present study, we examined the effects of marinating beef in lemon juice on gastric digestibility using a human gastric digestion simulator (GDS) that mimics peristaltic motion called antral contraction waves.

RESULTS

Beef thigh slices were marinated in 100% lemon juice for 1 h and then grilled; an image of a stained tissue sample revealed that muscle tissue contraction (i.e. that usually occurs upon cooking) was suppressed. The measurement of physical properties using a rheometer and texture analyzer showed that the meat marinated in lemon juice had a soft texture. In vitro digestion experiments using the GDS revealed that the extent of both physical digestion driven by peristalsis and chemical digestion catalyzed by digestive enzymes was enhanced by the lemon juice marinade.

CONCLUSION

The results of the present study suggest that marinating beef in lemon juice affects nutrient digestibility. An integrated evaluation of tissue structure, physical properties and GDS digestion to analyze meat digestion would enhance our understanding of the effects of seasoning and cooking methods on meat. © 2023 Society of Chemical Industry.

Effect of Food Viscosity on Drug Dissolution

PURPOSE

The purpose of the present study was to investigate the effect of food viscosity on the dissolution rate of a drug. There are two types of viscosity, macroviscosity and microviscosity. Macroviscosity affects the diffusion layer thickness, whereas microviscosity affects the molecular diffusion coefficient. The mass transfer coefficient (kc) in the intrinsic dissolution rate (IDR) depends on the viscosity (η) as kc ∝ ηa (a is an exponent on η). In theory, for rotating flow over a disk, if a thickener increases only macroviscosity, a = -1/6, and if it increases both macroviscosity and microviscosity equally, a = -7/6.

METHOD

Benzocaine was used as a model drug. Hydroxypropyl cellulose (HPC) and methylcellulose (MC) were employed as control thickeners that increase only macroviscosity. Sucrose was employed as a control thickener for both macroviscosity and microviscosity. The FDA breakfast homogenate (BFH) was diluted with distilled water or 1 mM HCl with/without pepsin digestion. The IDR value was measured by the paddle-over-disk method.

RESULTS

The η value of 30% BFH distilled water was 209 mPa∙s, about 300 times higher than distilled water. It was further increased by HCl (430 mPa∙s), and reduced by pepsin digestion (35 mPa∙s). The kc value was little affected by BFH (a = 0.00 to -0.09), slightly less than those in HPC (a = -0.19) and MC (a = -0.21). Sucrose decreased the kc value more significantly (a = -0.70).

CONCLUSION

The IDR and kc values of benzocaine were little affected by BFH, suggesting that BFH increased only macroviscosity.

Biomechanical characterization of the passive porcine stomach

The complex mechanics of the gastric wall facilitates the main digestive tasks of the stomach. However, the interplay between the mechanical properties of the stomach, its microstructure, and its vital functions is not yet fully understood. Importantly, the pig animal model is widely used in biomedical research for preliminary or ethically prohibited studies of the human digestion system. Therefore, this study aims to thoroughly characterize the mechanical behavior and microstructure of the porcine stomach. For this purpose, multiple quasi-static mechanical tests were carried out with three different loading modes, i.e., planar biaxial extension, radial compression, and simple shear. Stress-relaxation tests complemented the quasi-static experiments to evaluate the deformation and strain-dependent viscoelastic properties. Each experiment was conducted on specimens of the complete stomach wall and two separate layers, mucosa and muscularis, from each of the three gastric regions, i.e., fundus, body, and antrum. The significant preconditioning effects and the considerable regional and layer-specific differences in the tissue response were analyzed. Furthermore, the mechanical experiments were complemented with histology to examine the influence of the microstructural composition on the macrostructural mechanical response and vice versa. Importantly, the shear tests showed lower stresses in the complete wall compared to the single layers which the loose network of submucosal collagen might explain. Also, the stratum arrangement of the muscularis might explain mechanical anisotropy during tensile tests. This study shows that gastric tissue is characterized by a highly heterogeneous microstructure with regional variations in layer composition reflecting not only functional differences but also diverse mechanical behavior. STATEMENT OF SIGNIFICANCE: Unfortunately, only few experimental data on gastric tissue are available for an adequate material parameter and model estimation. The present study therefore combines layer- and region-specific stomach wall mechanics obtained under multiple loading conditions with histological insights into the heterogeneous microstructure. On the one hand, the extensive data sets of this study expand our understanding of the interplay between gastric mechanics, motility and functionality, which could help to identify and treat associated pathologies. On the other hand, such data sets are of high relevance for the constitutive modeling of stomach tissue, and its application in the field of medical engineering, e.g., in the development of surgical staplers and the improvement of bariatric surgical interventions.

Food for thought: Physiological considerations for nutritional ergogenic efficacy

Top-class athletes have optimized their athletic performance largely through adequate training, nutrition, recovery, and sleep. A key component of sports nutrition is the utilization of nutritional ergogenic aids, which may provide a small but significant increase in athletic performance. Over the last decade, there has been an exponential increase in the consumption of nutritional ergogenic aids, where over 80% of young athletes report using at least one nutritional ergogenic aid for training and/or competition. Accordingly, due to their extensive use, there is a growing need for strong scientific investigations validating or invalidating the efficacy of novel nutritional ergogenic aids. Notably, an overview of the physiological considerations that play key roles in determining ergogenic efficacy is currently lacking. Therefore, in this brief review, we discuss important physiological considerations that contribute to ergogenic efficacy for nutritional ergogenic aids that are orally ingested including (1) the impact of first pass metabolism, (2) rises in systemic concentrations, and (3) interactions with the target tissue. In addition, we explore mouth rinsing as an alternate route of ergogenic efficacy that bypasses the physiological hurdles of first pass metabolism via direct stimulation of the central nervous system. Moreover, we provide real-world examples and discuss several practical factors that can alter the efficacy of nutritional ergogenic aids including human variability, dosing protocols, training status, sex differences, and the placebo effect. Taking these physiological considerations into account will strengthen the quality and impact of the literature regarding the efficacy of potential ergogenic aids for top-class athletes.

Milk coagulation and gastric emptying in women experiencing gastrointestinal symptoms after ingestion of cow's milk

BACKGROUND

Gastrointestinal symptoms after drinking milk are often attributed to lactose intolerance or cow's milk allergy. However, some individuals without either condition still report gastrointestinal symptoms after drinking milk. This may be caused by gastric emptying (GE) rate or gastric protein coagulation. This study aimed to compare GE rate and protein coagulation after milk consumption between individuals reporting gastrointestinal symptoms and those without symptoms using a novel gastric MRI approach.

METHODS

Thirty women were included in this case-control study, of whom 15 reported gastrointestinal symptoms after drinking milk and 15 were controls. Participants underwent gastric MRI before and up to 90 min after consumption of 250 mL cow's milk. Gastric content volume and image texture of the stomach contents were used to determine GE and changes in the degree of coagulation.

KEY RESULTS

GE half-time did not differ between the groups (gastrointestinal symptom group 66 ± 18 min; control group 61 ± 14 min, p = 0.845). The gastrointestinal symptom group reported symptoms from 30 min onwards and rated pain highest at 90 min. The control group reported no symptoms. Image texture analyses showed a significantly higher percentage of coagulum and lower percentage of liquid in the group in the GI symptom group (MD 11%, 95% CI [3.9, 17], p = 0.003). In vitro data suggests that pH and proteolytic enzyme activity influence the coagulum structure.

CONCLUSIONS AND INFERENCES

Gastric milk coagulation and emptied fraction of stomach content may differ between individuals experiencing symptoms after milk consumption, possibly due to differences in pH and proteolytic enzyme activity.

SNAPIG: a model to study nutrient digestion and absorption kinetics in growing pigs based on diet and ingredient properties

Current feed formulation and evaluation practices rely on static values for the nutritional value of feed ingredients and assume additivity. Hereby, the complex interplay among nutrients in the diet and the highly dynamic digestive processes are ignored. Nutrient digestion kinetics and diet × animal interactions should be acknowledged to improve future predictions of the nutritional value of complex diets. Therefore, an in silico nutrient-based mechanistic digestion model for growing pigs was developed: "SNAPIG" (Simulating Nutrient digestion and Absorption kinetics in PIGs). Aiming to predict the rate and extent of nutrient absorption from diets varying in ingredient composition and physicochemical properties, the model represents digestion kinetics of ingested protein, starch, fat, and non-starch polysaccharides, through passage, hydrolysis, absorption, and endogenous secretions of nutrients along the stomach, proximal small intestine, distal small intestine, and caecum + colon. Input variables are nutrient intake and the physicochemical properties (i.e. solubility, and rate and extent of degradability). Data on the rate and extent of starch and protein hydrolysis of different ingredients per digestive segment were derived from in vitro assays. Passage of digesta from the stomach was modelled as a function of feed intake level, dietary nutrient solubility and diet viscosity. Model evaluation included testing against independent data from in vivo studies on nutrient appearance in (portal) blood of growing pigs. When simulating diets varying in physicochemical properties and nutrient source, SNAPIG can explain variation in glucose absorption kinetics (postprandial time of peak, TOP: 20-100 min observed vs 25-98 min predicted), and predict variation in the extent of ileal protein and fat digestion (root mean square prediction errors (RMSPE) = 12 and 16%, disturbance error = 12 and 86%, and concordance correlation coefficient = 0.34 and 0.27). For amino acid absorption, the observed variation in postprandial TOP (61 ± 11 min) was poorly predicted despite accurate mean predictions (58 ± 34 min). Recalibrating protein digestion and amino acid absorption kinetics require data on net-portal nutrient appearance, combined with observations on digestion kinetics, in pigs fed diets varying in ingredient composition. Currently, SNAPIG can be used to forecast the time and extent of nutrient digestion and absorption when simulating diets varying in ingredient and nutrient composition. It enhances our quantitative understanding of nutrient digestion kinetics and identifies knowledge gaps in this field of research. Already useful as research tool, SNAPIG can be coupled with a postabsorptive metabolism model to predict the effects of dietary and feeding-strategies on the pig's growth response.

Reducing starch digestibility of white rice by structuring with hydrocolloids

Controlling starch digestion in high glycaemic index staple foods such as white rice is of interest as it has been associated with reduced risk for conditions such as obesity and type-2 diabetes mellitus. Addition of hydrocolloids has been proposed to reduce the rate of post-prandial glucose by controlling the rate of starch hydrolysis. In this work, the potential of a range of hydrocolloids to modify starch digestibility when added (at 1 % maximum concentration) during cooking of white rice was first investigated. Low acyl gellan gum (LAG) showed the highest potential (in-vitro estimated Glycaemic Index reduced by about 20 %, from 94 in the control to 78 in the LAG rice) and was investigated further. While the grains of rice control and rice with LAG appeared similar, SEM images revealed a gel-like layer (a few micrometers in thickness) on the surface of the treated samples. Addition of LAG appeared to also have an effect on the breakdown of a simulated cm-sized bolus. During gastric digestion, bolus breakdown of the rice control was completed after 30 min, while the rice LAG bolus appeared intact after 1 h of observation. This was attributed to strengthening of the LAG gel in the acidic environment of the stomach. During intestinal digestion, rice samples containing 1 % LAG appeared to be less susceptible to breakdown when seen under a microscope and in environmental SEM, while they showed larger rice particle aggregates, compared to rice control. Overall, LAG showed potential to control starch digestion kinetics of white rice with a mechanism that may involve formation of a protective layer on the rice grains (um) that reduces bolus break down (cm) and enzymatic hydrolysis (nm). Outcomes of this work will be used to identify conditions for further relevant in-vitro and in-vivo investigations.

Inclusion of Oat Polar Lipids in a Solid Breakfast Improves Glucose Tolerance, Triglyceridemia, and Gut Hormone Responses Postprandially and after a Standardized Second Meal: A Randomized Crossover Study in Healthy Subjects

Previously, it has been indicated that oat polar lipids included in a liquid meal may have the potential to beneficially modulate various cardiometabolic variables. The purpose of this study was to evaluate the effects of oat polar lipids in a solid food matrix on acute and second meal glucose tolerance, blood lipids, and concentrations of gut-derived hormones. The oat polar lipids were consumed at breakfast and effects on the biomarkers were investigated in the postprandial period and following a standardized lunch. Twenty young, healthy subjects consumed in total four different breakfast meals in a crossover study design. The breakfasts consisted of 1. White wheat bread (WWB) with an added 7.5 g of oat polar lipids (PLL); 2. WWB with an added 15 g of oat polar lipids (PLH); 3. WWB with and added 16.6 g of rapeseed oil (RSO) as a representative of commonly consumed oils; and 4. WWB consumed alone, included as a reference. All products with added lipids contained equivalent amounts of fat (16.6 g) and available carbohydrates (50 g). Rapeseed oil was added to the oat polar lipid meals to equal 16.6 g of total fat. The standardized lunch was composed of WWB and meatballs and was served 3.5 h after the breakfast. Test variables (blood glucose, serum insulin, triglyceride (TG), free fatty acids (FFA), ghrelin, GLP-1, PYY, and GIP) were measured at fasting and repeatedly during the 5.5 h after ingestion of the breakfast. After breakfast, PLH substantially lowered postprandial glucose and insulin responses (iAUC 0-120 min) compared with RSO and WWB (p < 0.05). Furthermore, a reduced glycaemic response to lunch (210-330 min) was observed following the PLH breakfast compared to all of the other breakfasts served (p < 0.05). Oat polar lipids (PLH) significantly reduced TG and ghrelin and increased circulating gut hormones GLP-1 and PYY compared to RSO (p < 0.05). The results show that exchanging part of the dietary lipids with oat polar lipids has the potential to improve postprandial blood glucose regulation and gut hormones and thus may have a preventive effect against type 2 diabetes.

Effect of chewing ability on in vivo oral digestive characteristics and in vitro gastrointestinal starch hydrolysis of three different types of cooked rice

Chewing ability has a strong effect on food digestion. However, little is known about the relationship between the food mastication degree and the subsequent gastric emptying. This study was to explore the effects of individual chewing ability (strong and weak) on the in vivo oral processing characteristics and in vitro dynamic gastrointestinal starch hydrolysis of three types of rice (japonica rice, indica rice and waxy rice). Results showed that the swallowable bolus in the weak chewing group had larger holes and a looser microstructure with more small rice particles, while the strong chewing ones obtained a bolus with higher saliva content (up to 28%) and starch hydrolysis degree (up to 13.55%). Moreover, the gastric retention and starch hydrolysis of the strong chewing ability group were higher in the artificial gastric dynamic system (AGDS). The indica rice particles with the higher degree of fragmentation contacted enzymes easier and hydrolyzed quicker, thus emptying through the stomach faster (81.76%). However, the oral chewing properties of rice mainly influenced the starch digestion in the stomach and the initial stage of the small intestine (∼5 min). This study suggested that the chewing ability and rice variety can influence the bolus properties, which in turn affected the gastric emptying and the degree of starch hydrolysis during digestion.

Colon-targeted delivery of polyphenols: construction principles, targeting mechanisms and evaluation methods

Polyphenols have received considerable attention for their promotive effects on colonic health. However, polyphenols are mostly sensitive to harsh gastrointestinal environments, thus, must be protected. It is necessary to design and develop a colon-targeted delivery system to improve the stability, colon-targeting and bioavailability of polyphenols. This paper mainly introduces research on colon-targeted controlled release of polyphenols. The physiological features affecting the dissolution, release and absorption of polyphenol-loaded delivery systems in the colon are first discussed. Simultaneously, the types of colon-targeted carriers with different release mechanisms are described, and colon-targeting assessment models that have been studied so far and their advantages and limitations are summarized. Based on the current research on polyphenols colon-targeting, outlook and reflections are proposed, with the goal of inspiring strategic development of new colon-targeted therapeutics to ensure that the polyphenols reach the colon with complete bioactivity.

Properties of cell wall polysaccharides of raw nectarine fruits after treatment under conditions that modulate gastric digestion

The results of the study of the physicochemical properties of the high-molecular-weight soluble and insoluble components of nectarine cell walls obtained by fruit treatment under conditions that modulate of gastric digestion are presented. Homogenized nectarine fruits were sequentially treated by natural saliva and simulated gastric fluid (SGF) at pH 1.8 and 3.0. The isolated polysaccharides were compared with polysaccharides obtained by sequential extraction of nectarine fruit with cold, hot, and acidified water, solutions of ammonium oxalate and sodium carbonate. As a result, high-molecular-weight water-soluble pectic polysaccharides, weakly bound in the cell wall, were dissolved in the simulated gastric fluid, regardless of pH. Homogalacturonan (HG) and rhamnogalacturonan-I (RG-I) were identified in all pectins. It was shown that their quantity and ability to form highly viscous solutions determine high values of the rheological characteristics of the nectarine mixture formed under simulated gastric conditions. The modifications occurring with the insoluble components under the influence of acidity of SGF were importance. They determined difference in the physicochemical properties of both the insoluble fibres and the nectarine mixtures.

Physically defined long-term and short-term synapses for the development of reconfigurable analog-type operators capable of performing health care tasks

Extracting valuable information from the overflowing data is a critical yet challenging task. Dealing with high volumes of biometric data, which are often unstructured, nonstatic, and ambiguous, requires extensive computer resources and data specialists. Emerging neuromorphic computing technologies that mimic the data processing properties of biological neural networks offer a promising solution for handling overflowing data. Here, the development of an electrolyte-gated organic transistor featuring a selective transition from short-term to long-term plasticity of the biological synapse is presented. The memory behaviors of the synaptic device were precisely modulated by restricting ion penetration through an organic channel via photochemical reactions of the cross-linking molecules. Furthermore, the applicability of the memory-controlled synaptic device was verified by constructing a reconfigurable synaptic logic gate for implementing a medical algorithm without further weight-update process. Last, the presented neuromorphic device demonstrated feasibility to handle biometric information with various update periods and perform health care tasks.

Biocompatible smart micro/nanorobots for active gastrointestinal tract drug delivery

INTRODUCTION

Oral delivery is the most commonly used route of drug administration owing to good patient compliance. However, the gastrointestinal (GI) tract contains multiple physiological barriers that limit the absorption efficiency of conventional passive delivery systems resulting in a low drug concentration reaching the diseased sites. Micro/nanorobots can convert energy to self-propulsive force, providing a novel platform to actively overcome GI tract barriers for noninvasive drug delivery and treatment.

AREAS COVERED

In this review, we first describe the microenvironments and barriers in the different compartments of the GI tract. Afterward, the applications of micro/nanorobots to overcome GI tract barriers for active drug delivery are highlighted and discussed. Finally, we summarize and discuss the challenges and future prospects of micro/nanorobots for further clinical applications.

EXPERT OPINION

Micro/nanorobots with the ability to autonomously propel themselves and to load, transport, and release payloads on demand are ideal carriers for active oral drug delivery. Although there are many challenges to be addressed, micro/nanorobots have great potential to introduce a new era of drug delivery for precision therapy.

Induced Expression of the Acinetobacter sp. Oxa Gene in Lactobacillus acidophilus and Its Increased ZEN Degradation Stability by Immobilization

Zearalenone (ZEN, ZEA) contamination in various foods and feeds is a significant global problem. Similar to deoxynivalenol (DON) and other mycotoxins, ZEN in feed mainly enters the body of animals through absorption in the small intestine, resulting in estrogen-like toxicity. In this study, the gene encoding Oxa, a ZEN-degrading enzyme isolated from Acinetobacter SM04, was cloned into Lactobacillus acidophilus ATCC4356, a parthenogenic anaerobic gut probiotic, and the 38 kDa sized Oxa protein was expressed to detoxify ZEN intestinally. The transformed strain L. acidophilus pMG-Oxa acquired the capacity to degrade ZEN, with a degradation rate of 42.95% at 12 h (initial amount: 20 μg/mL). The probiotic properties of L. acidophilus pMG-Oxa (e.g., acid tolerance, bile salt tolerance, and adhesion properties) were not affected by the insertion and intracellular expression of Oxa. Considering the low amount of Oxa expressed by L. acidophilus pMG-Oxa and the damage to enzyme activity by digestive juices, Oxa was immobilized with 3.5% sodium alginate, 3.0% chitosan, and 0.2 M CaCl₂ to improve the ZEN degradation efficiency (from 42.95% to 48.65%) and protect it from digestive juices. The activity of immobilized Oxa was 32-41% higher than that of the free crude enzyme at different temperatures (20-80 °C), pH values (2.0-12.0), storage conditions (4 °C and 25 °C), and gastrointestinal simulated digestion conditions. Accordingly, immobilized Oxa could be resistant to adverse environmental conditions. Owing to the colonization, efficient degradation performance, and probiotic functionality of L. acidophilus, it is an ideal host for detoxifying residual ZEN in vivo, demonstrating great potential for application in the feed industry.

Estimation of glucose rate of appearance in portal vein circulation using a phenomenological-based model

The joint work of the stomach and the small intestine plays a fundamental role in human digestion. In the stomach, food is turned into a semi-fluid mixture that is slowly released into the small intestine, where most enzymatic reactions occur, and nutrients are absorbed as they become available. This whole process is closely related to glucose homeostasis, mainly because of the appearance of glucose in the portal system and the energetic expenditure of the process itself. The current phenomenological-based model describes such effects of the digestive process on blood glucose concentration. It considers enzymatic and mechanical transformations, energetic expenditure, and the impact of macro-nutrients, fiber, and water on overall digestion and glucose absorption. The model estimates the rate of glucose appearance in the portal vein and is intended to be further integrated into existing models for other human organs and used in model-based systems such as an artificial pancreas with automated insulin delivery.

Polysaccharide-based structured lipid carriers for the delivery of curcumin: An in vitro digestion study

The present work aimed at studying the in vitro digestion fate of κ-carrageenan (KC) or agar (AG) emulsion gels (EG), and KC oil-filled aerogels (OAG) in terms of their structural changes, lipolysis kinetics and curcumin bioaccessibility. On the one hand, both EG and aerogels showed large (70-200 µm) and heterogeneous particles after gastric conditions, indicating the release of bulk oil and gelled material. Nonetheless, this material release in the stomach phase was lower in the case of EG-AG and OAG-KC compared to EG-KC. After small intestinal conditions, EG and oil-filled aerogels presented a wide range of particle sizes probably due to the presence of undigested lipid material, gelled structures, as well as lipid digestion products. For the most part, adding curcumin to the structures' lipid phase did not cause of the structural modifications that occurred at the different in vitro digestion phases. On the other hand, the lipolysis kinetics was different depending on the type of structure. Amongst emulsion-gels, those formulated with κ-carrageenan presented a slower and lower lipolysis kinetics compared to those formulated with agar, which could be attributed to their higher initial hardness. Overall, the addition of curcumin in the lipid phase decreased the lipolysis in all the structures, which evidenced its interference in the lipid digestion process. The curcumin bioaccessibility reached high values (≈ 100 %) for all the studied structures, presenting a high solubility in intestinal fluids. This work unravels the implications of microstructural changes of emulsion-gels and oil-filled aerogels during digestion and their impact on their digestibility and subsequent functionality.

Usefulness of the Beagle Model in the Evaluation of Paracetamol and Ibuprofen Exposure after Oral Administration to Pediatric Populations: An Exploratory Study

The present study aimed to explore the usefulness of beagle dogs in combination with physiologically based pharmacokinetic (PBPK) modeling in the evaluation of drug exposure after oral administration to pediatric populations at an early stage of pharmaceutical product development. An exploratory, single-dose, crossover bioavailability study in six beagles was performed. A paracetamol suspension and an ibuprofen suspension were coadministered in the fasted-state conditions, under reference-meal fed-state conditions, and under infant-formula fed-state conditions. PBPK models developed with GastroPlus v9.7 were used to inform the extrapolation of beagle data to human infants and children. Beagle-based simulation outcomes were compared with published human-adult-based simulations. For paracetamol, fasted-state conditions and reference-meal fed-state conditions in beagles appeared to provide adequate information for the applied scaling approach. Fasted-state and/or reference-meal fed-state conditions in beagles appeared suitable to simulate the performance of ibuprofen suspension in pediatric populations. Contrary to human-adult-based translations, extrapolations based on beagle data collected under infant-formula fed-state conditions appeared less useful for informing simulations of plasma levels in pediatric populations. Beagle data collected under fasted and/or reference-meal fed-state conditions appeared to be useful in the investigation of pediatric product performance of the two investigated highly permeable and highly soluble drugs in the upper small intestine. The suitability of the beagle as a preclinical model to understand pediatric drug product performance under different dosing conditions deserves further evaluation with a broader spectrum of drugs and drug products and comparisons with pediatric in vivo data.

Role of segmental contraction in the small intestinal digestion: A computational approach to study the physics behind the luminal mixing and transport

Segmentation is well known to digest the food rich in proteins, starch, and lipids; however, the mechanism leading to the digestion remains unclear. In this study, a theoretical model for segmental contractions of the small intestine is developed using lubrication method to explore the mechanisms involved. Here, the nonlinear partial differential equations governing the fluid flow were normalized in viscous regime and solved semi-analytically for a power law fluid under long wavelength approximation on a Matlab^TM platform. Study indicates that shearing is highest at the 1st and 4th mid-occlusion in comparison to 2nd and 3rd mid-occlusion. Parametric study indicates that the flow is sensitive to - the span of segmentation or wavelength of the wave, occlusion of the wave and frequency of the contraction; with shearing being highest for dilatants. Shearing is more prominent at higher occlusion (>50 %) and frequency (>6Hz). Further, mixing is more prominent at the steep regions of the wave; having intensity of mixing highest for the outer waves in comparison to waves at mid-region of the segmentation. The power demand is found to be greater in segmentation and has the following precedence - frequency, wavelength, flow behavior index, and occlusion (up to 80 %). Further, multiplicity of the wave gives rise to multiple zones of mixing which increases the rate of mixing of the contents. Suggesting that, the segmentation primarily serves the purpose of mixing. The study will be useful to explore novel therapeutic strategies of managing patients suffering from various motility-associated disorders of the small intestine.

Characterization of the Dynamic Gastrointestinal Digests of the Preserved Eggs and Their Effect and Mechanism on HepG2 Cells

Preserved eggs, an alkaline-fermented food, have been widely searched for their anti-inflammatory activity. Their digestive characteristics in the human gastrointestinal tract and anti-cancer mechanism have not been well explained. In this study, we investigated the digestive characteristics and anti-tumor mechanisms of preserved eggs using an in vitro dynamic human gastrointestinal-IV (DHGI-IV) model. During digestion, the sample pH dynamically changed from 7.01 to 8.39. The samples were largely emptied in the stomach with a lag time of 45 min after 2 h. Protein and fat were significantly hydrolyzed with 90% and 87% digestibility, respectively. Moreover, preserved eggs digests (PED) significantly increased the free radical scavenging activity of ABTS, DPPH, FRAP and hydroxyl groups by 15, 14, 10 and 8 times more than the control group, respectively. PED significantly inhibited the growth, cloning and migration of HepG2 cells at concentrations of 250-1000 μg/mL. Meanwhile, it induced apoptosis by up/down-regulating the expression of the pro-apoptotic factor Bak and the anti-apoptotic gene Bcl-2 in the mitochondrial pathway. PED (1000 μg/mL) treatment resulted in 55% higher ROS production than the control, which also led to apoptosis. Furthermore, PED down-regulated the expression of the pro-angiogenic genes HIF-1α and VEGF. These findings provided a reliable scientific reference for the study of the anti-tumor activity of preserved eggs.

Gastric devolution of transglutaminase-induced acid and rennet-induced casein gels using dynamic DIDGI® and static COST action INFOGEST protocols

Limited studies in the literature have compared in vitro dynamic and in vitro static protocols for modelling the gastric digestive process of food systems. This experiment explores the differences between two different in vitro approaches to the devolution of a transglutaminase-induced acid gel (TG, pH 5.1-5.3) and rennet-induced gel (RG, pH 6.5-6.7). Gels were exposed to a simulated oral phase, followed by either the dynamic DIDGI® or static COST action INFOGEST protocol to simulate gastric conditions. Protein hydrolysis was evident from 15 min onwards for TG exposed to the dynamic protocol where levels continued to increase at a steady rate. In contrast, RG exhibited a notable lag-phase before levels increased from around 60 min onwards. Under the static protocol, protein hydrolysis was observed for both TG and RG upon exposure to the gastric environment which continued to increase over time. Despite these differences, similar levels of protein hydrolysis were found for TG and RG at the gastric endpoint using either protocol demonstrating that both the dynamic DIDGI® and static COST action INFOGEST methods provide a suitable and comparable environment for the in vitro digestion of casein protein under simulated gastric conditions.

Biomarkers: Promising and valuable tools towards diagnosis, prognosis and treatment of Covid-19 and other diseases

The use of biomarkers as early warning systems in the evaluation of disease risk has increased markedly in the last decade. Biomarkers are indicators of typical biological processes, pathogenic processes, or pharmacological reactions to therapy. The application and identification of biomarkers in the medical and clinical fields have an enormous impact on society. In this review, we discuss the history, various definitions, classifications, characteristics, and discovery of biomarkers. Furthermore, the potential application of biomarkers in the diagnosis, prognosis, and treatment of various diseases over the last decade are reviewed. The present review aims to inspire readers to explore new avenues in biomarker research and development.

Methods for improving meat protein digestibility in older adults

This review explores the factors that improve meat protein digestibility and applies the findings to the development of home meal replacements with improved protein digestion rates in older adults. Various methods improve the digestion rate of proteins, such as heat, ultrasound, high pressure, or pulse electric field. In addition, probiotics aid in protein digestion by improving the function of digestive organs and secreting enzymes. Plant-derived proteases, such as papain, bromelain, ficin, actinidin, or zingibain, can also improve the protein digestion rate; however, the digestion rate is dependent on the plant enzyme used and protein characteristics. Sous vide processing improves the rate and extent of protein digestibility, but the protein digestion rate decreases with increasing temperature and heating time. Ultrasound, high pressure, or pulsed electric field treatments degrade the protein structure and increase the proteolytic enzyme contact area to improve the protein digestion rate.

Kreon® (Creon®) vs. Lipancrea®: In Vitro Comparison of Two Encapsulated Pancreatin Preparations

Kreon^® (Creon^®) and Lipancrea^® are pancreatic enzyme supplements indicated in the treatment of exocrine pancreatic insufficiency. In order to determine their interchangeability, an in vitro comparison of their physical properties and enzymatic activity was carried out. Capsule fill weight and particle size were also determined in order to establish their physical properties. Amylase, lipase and protease activities, lipase release at different pHs and the dissolution time of pellets were assessed for enzymatic analysis. The length range of Kreon^® and Lipancrea^® pellets was 1.1-2.2 mm and 1.5-2.8 mm, respectively. Protease activity was below the label claim for Lipancrea^® and above for Kreon^® presentations. Lipase and amylase activity were equal to or higher than the label claim in both preparations. In dissolution experiments simulating the stomach passage, significant release of lipase activity was observed for Lipancrea^® (% actual activity: 41% for Lipancrea^® 8000; 21% for Lipancrea^® 16000) after 60 min at pH 5.0. No release of lipase activity was observed for Kreon^® at that particular pH. Enzyme release for Lipancrea^® at pH 6.0 was generally slower than for Kreon^® and seemed to be influenced by the preceding incubation at lower pH. More than 85% of Kreon^® and Lipancrea^® dissolved in a pH 6.0 phosphate buffer within 20 min. Despite the similarities of the enzyme content on the respective labels, Kreon^® and Lipancrea^® differ in pellet size, enzymatic activity and release. This may impact their therapeutic efficacy and, therefore, may limit their interchangeability.

Leite AZ, Correa-Giannella ML, Nery M, Queiroz MS. Diet consistency modification improves postprandial glycemic and gastroparesis symptoms

Abstract

Diabetic gastroparesis (DGP) is an autonomic neuropathy resulting from long-standing poorly controlled diabetes, and it is also linked to fluctuations in glycemic control due to variability on nutrient absorption.

Objectives

Considering the scarcity of information, the aim of this study was to identify the impact of modifications on diet consistency on post-prandial glucose variability using a continuous glucose monitoring (CGM) and its effect on the perception and severity of gastrointestinal symptoms.

Methods

This proof-of-concept study was carried out in a cross-sectional cohort of six individuals with type 1 diabetes mellitus with confirmed diagnosis of DGP. Two types of diet were used to evaluate glycemic control and DGP symptoms, general consistency standard meal (SD) and modified consistency test diet (MD), associated with an application of rapid acting insulin at the time of food intake. Glycemic control was evaluated by CGM, and the Gastroparesis Cardinal Symptom Index (GCSI) was applied after meals.

Results

The CGM curve was different for MD + insulin and SD + insulin. There was a smaller increment of interstitial glucose with 2 h after MD + insulin, returning almost to the basal level 4 h later. Patients scored significantly lower GCSI after MD + insulin compared to the same index after they received SD + insulin. Moreover, there was a decrease in important clinical scores present in the index, like: "Not able to finish meal", "Loss of appetite" and "Stomach or belly feels larger".

Conclusion

This study showed that a modified diet can improve postprandial glycemic excursion and the perception and severity of gastroparesis symptoms.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40200-022-01117-w.

Alginate Particles for Encapsulation of Phenolic Extract from Spirulina sp. LEB-18: Physicochemical Characterization and Assessment of In Vitro Gastrointestinal Behavior

Encapsulation can be used as a strategy to protect and control the release of bioactive extracts. In this work, an extract from Spirulina sp. LEB-18, rich in phenolic compounds, was encapsulated in biopolymeric particles (i.e., composed of alginate) and characterized concerning their thermal behavior using differential scanning calorimetry (DSC), size, morphology, swelling index (S), and encapsulation efficiency (EE%); the release profile of the phenolic compounds at different pHs and the particle behavior under in vitro gastrointestinal digestion were also evaluated. It was shown that it is possible to encapsulate the phenolic extract from Spirulina sp. LEB-18 in alginate particles with high encapsulation efficiency (88.97%). It was also observed that the particles are amorphous and that the encapsulated phenolic compounds were released at a pH 7.2 but not at pH 1.5, which means that the alginate particles are able to protect the phenolic compounds from the harsh stomach conditions but lose their integrity under intestinal pH conditions. Regarding bioaccessibility, it was observed that the encapsulated phenolic compounds showed higher bioaccessibility compared to phenolic compounds in free form. This work increases the knowledge about the behavior of alginate particles encapsulating phenolic compounds during in vitro gastrointestinal digestion. It also provides essential information for designing biopolymeric particle formulations encapsulating phenolic compounds for application in pharmaceutical and food products.

Effect of stomach motility on food hydrolysis and gastric emptying: Insight from computational models

The peristaltic motion of stomach walls combines with the secretion of digestive enzymes to initiate the process that breaks down food. In this study, the mixing, breakdown, and emptying of a liquid meal containing protein is simulated in a model of a human stomach. In this model, pepsin, the gastric enzyme responsible for protein hydrolysis, is secreted from the proximal region of the stomach walls and allowed to react with the contents of the stomach. The velocities of the retropulsive jet induced by the peristaltic motion, the emptying rate, and the extent of hydrolysis are quantified for a control case as well as for three other cases with reduced motility of the stomach, which may result from conditions such as diabetes mellitus. This study quantifies the effect of stomach motility on the rate of food breakdown and its emptying into the duodenum and we correlate these observations with the mixing in the stomach induced by the wall motion.

Current in Vitro and Animal Models for Understanding Foods: Human Gut-Microbiota Interactions

The food-gut microbiota interaction is an important regulator of human health. Numerous in vitro and animal models have thus been developed in order to simulate the specific food-gut microbiota and/or host-gut microbiota interactions in the human colon. This review summarizes the design principles of each model and discusses their advantages and weaknesses in terms of studying food-gut microbiota interactions. In vitro fermentation models appear to be reliable methods to investigate various aspects involved in the food-gut microbiota interactions in humans. However, many physiological perspectives lack appreciation of these models, such as peristaltic movement, biochemical conditions, and gastrointestinal anatomy. Animal models provide more physiological relevance to human trials compared to in vitro models. However, they may have gastrointestinal tract aspects that are distinct from human subjects. This review contains important information that can help the development of more advanced models to study food-gut microbiota interactions in humans.

The solution properties of galactomannan after simulated digestion of guar fortified bread predict the extent of postprandial insulin reduction in healthy adult overweight subjects

Coil overlap occurs when random coil polysaccharides such as cereal beta-glucan or galactomannan in solution are abundant enough and large enough to entangle with one another to form networks. It was recently shown that this concept applied to in vitro digested cereal-based foods could predict the efficacy of the food to reduce postprandial glycaemia. In the current study we further investigate the role of coil overlap for prediction of glycaemic and insulinaemic responses using four guar fortified breads (10-15% wheat flour replacement level) with galactomannans of different weight-average molecular weight (M_w). The breads, including a wheat flour control, were tested in a randomised crossover study in 12 overweight adults. Addition of guar reduced postprandial serum insulin, but not glucose responses. The extent of postprandial insulin reduction correlated with the solution properties of galactomannan after in vitro digestion. A significantly greater reduction in insulin response was observed for two of the breads where the galactomannan M_w and concentration in solution after in vitro digestion was above coil overlap, in contrast to two other breads, which resulted in digests containing galactomannan below coil overlap and a significantly lower reduction of postprandial insulin. Further in vitro digestion experiments focusing on amylolysis of starch with kinetic modelling showed a greater proportion of slowly digested starch in breads with galactomannan above coil overlap than below. A combination of the molecular weight of dietary fibre in a food and its soluble concentration are key parameters explaining its physiological efficiency in the upper gastrointestinal tract.

Computational modeling of drug dissolution in the human stomach: Effects of posture and gastroparesis on drug bioavailability

The oral route is the most common choice for drug administration because of several advantages, such as convenience, low cost, and high patient compliance, and the demand and investment in research and development for oral drugs continue to grow. The rate of dissolution and gastric emptying of the dissolved active pharmaceutical ingredient (API) into the duodenum is modulated by gastric motility, physical properties of the pill, and the contents of the stomach, but current in vitro procedures for assessing dissolution of oral drugs are limited in their ability to recapitulate this process. This is particularly relevant for disease conditions, such as gastroparesis, that alter the anatomy and/or physiology of the stomach. In silico models of gastric biomechanics offer the potential for overcoming these limitations of existing methods. In the current study, we employ a biomimetic in silico simulator based on the realistic anatomy and morphology of the stomach (referred to as "StomachSim") to investigate and quantify the effect of body posture and stomach motility on drug bioavailability. The simulations show that changes in posture can potentially have a significant (up to 83%) effect on the emptying rate of the API into the duodenum. Similarly, a reduction in antral contractility associated with gastroparesis can also be found to significantly reduce the dissolution of the pill as well as emptying of the API into the duodenum. The simulations show that for an equivalent motility index, the reduction in gastric emptying due to neuropathic gastroparesis is larger by a factor of about five compared to myopathic gastroparesis.

Spinning-enabled wireless amphibious origami millirobot

Wireless millimeter-scale origami robots have recently been explored with great potential for biomedical applications. Existing millimeter-scale origami devices usually require separate geometrical components for locomotion and functions. Additionally, none of them can achieve both on-ground and in-water locomotion. Here we report a magnetically actuated amphibious origami millirobot that integrates capabilities of spinning-enabled multimodal locomotion, delivery of liquid medicine, and cargo transportation with wireless operation. This millirobot takes full advantage of the geometrical features and folding/unfolding capability of Kresling origami, a triangulated hollow cylinder, to fulfill multifunction: its geometrical features are exploited for generating omnidirectional locomotion in various working environments through rolling, flipping, and spinning-induced propulsion; the folding/unfolding is utilized as a pumping mechanism for controlled delivery of liquid medicine; furthermore, the spinning motion provides a sucking mechanism for targeted solid cargo transportation. We anticipate the amphibious origami millirobots can potentially serve as minimally invasive devices for biomedical diagnoses and treatments.

Wireless millirobots are promising as minimally invasive biomedical devices. Here, the authors design a magnetically actuated amphibious millirobot that integrates spinning-enabled locomotion, targeted drug delivery, and cargo transportation by utilizing geometrical features and folding/unfolding capability of the Kresling origami.