Effect of postprandial posture on digestion and absorption of dietary carbohydrate

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.

Effect of evening exposure to dim or bright light on the digestion of carbohydrate in the supper meal

In a previous study we found that daytime exposure to bright as compared to dim light exerted a beneficial effect on the digestion of the evening meal. This finding prompted us to examine whether the digestion of the evening meal is also affected by evening light intensity. Subjects lived in light of 200 lux during the daytime (08:00-17:00 h) and took their evening meal at 17:00 h under 20 lux (evening dim-light condition: 17:00-02:00 h) or 2000 lux (evening bright-light condition: 17:00-02:00 h) until retiring at 02:00 h. Assessment of carbohydrate digestion of the evening meal was accomplished by a breath hydrogen test that is indicative of the malabsorption of dietary carbohydrate. Hydrogen excretion in the breath in the evening under the dim-light condition was significantly less than under the bright-light condition (p < 0.05). This finding is the opposite to that obtained in previous experiments in which subjects were exposed to the different intensities of light during the daytime, and indicates that the exposure to dim light in the evening exerts a better effect on carbohydrate digestion in the evening meal than does the exposure to bright light.

A combined 13CO2/H2 breath test can be used to assess starch digestion and fermentation in humans

Ingestion of starch from corn (naturally enriched with (13)C) should produce (13)CO(2) after small intestinal digestion and (13)CO(2) and H(2) from colonic fermentation. This study used a combined (13)CO(2)/H(2) breath test to assess the digestion and fermentation of resistant starch and to show that the test could detect changes in digestibility due to cooking. Volunteers consumed 40 g digestible cornstarch with water (n = 8), or 40 g resistant cornstarch in liquid (n = 12) or cooked into a pancake (n = 4). Interval breath sampling was performed and analyzed for (13)CO(2) and H(2). Ingestion of resistant starch produced a double-peaked (13)CO(2) excretion curve. The first increase in (13)CO(2) occurred at the same time as excretion from digestible starch (55 +/- 9 and 68 +/- 9 min, respectively), which was due to small intestinal digestion. The second increase in (13)CO(2) was accompanied by an increase in H(2) excretion (432 +/- 15 and 428 +/- 48 min, respectively), which was indicative of colonic bacterial fermentation. Cooking resistant starch increased its degree of digestion from 36 to 72%. The (13)CO(2)/H(2) breath test can be used to estimate digestion and fermentation of starches in different physiologic and pathologic conditions.

Effect of Post-prandial Posture on Orocecal Transit Time and Digestion of Milk Lactose in Humans

We examined the effect of post-prandial body posture on orocecal transit time and absorption of milk lactose using the breath hydrogen test. In this experiment, subjects ingested a cup of commercially available milk to which we had added a small amount of lactosucrose (an indigestible trisaccharide), and then they lay on their backs or sat on a chair for the first 4 hr (from 08:00 to 12:00). After four hours lying or sitting, they remained sedentary on a sofa for the second six hr (from 12:00 to 18:00). Participants' end alveolar breath samples were collected every 15 min from 08:00 to 12:30, then every 30 min from 13:00 to 18:00. The experiment was conducted on two consecutive days using a randomized, crossover study design. Examination showed that the orocecal transit time of the oligosaccharides (lactosucrose and milk lactose) under the post-prandial supine condition was significantly longer than that under the sitting condition. In addition, the amount of breath hydrogen excretion under the supine condition was significantly lower than under the sitting condition, indicating that the unabsorbed milk lactose moved into cecum under the supine condition is smaller than that under the sitting condition. These findings provide evidence that postprandial supine posture works more beneficially to digest and absorb milk lactose when compared to the sitting posture.