Acute Effects of Substitution, and Addition, of Carbohydrates and Fat to Protein on Gastric Emptying, Blood Glucose, Gut Hormones, Appetite, and Energy Intake

Whey protein, when ingested on its own, load-dependently slows gastric emptying and stimulates gut hormone concentrations in healthy young men. The aim of this study was to determine the effects of substitution, and addition, of carbohydrate (dextrose) and fat (olive oil) to whey protein. In randomized, double-blind order, 13 healthy young men (age: 23 ± 1 years, body mass index: 24 ± 1 kg/m2) ingested a control drink (450 mL; ~2 kcal/‘control’) or iso-volumetric drinks containing protein/carbohydrate/fat: (i) 14 g/28 g/12.4 g (280 kcal/‘M280′), (ii) 70 g/28 g/12.4 g (504kcal/‘M504′), and (iii) 70 g/0 g/0 g (280 kcal/‘P280′), on 4 separate study days. Gastric emptying (n = 11, 3D-ultrasonography), blood glucose, plasma insulin, ghrelin, cholecystokinin (CCK) and glucagon-like peptide-1 (GLP-1) concentrations (0–180 min), appetite (visual analogue scales), and ad-libitum buffet-meal energy intake (180–210 min) were determined. Substitution of protein with carbohydrate and fat was associated with faster gastric emptying (lower 50% emptying time (T50)), reduced suppression of ghrelin, and stimulation of GLP-1 (all P < 0.001); while the addition of carbohydrate and fat to protein did not affect gastric emptying or gut hormone responses significantly. Total energy intake (i.e., drink plus meal) was greater after all caloric drinks than control (P < 0.001). In conclusion, substitution of whey protein with dextrose and olive oil accelerated gastric emptying. Higher protein content of a mixed macronutrient drink increased gut hormone and insulin responses.

Download Full-text

Effect of the Natural Sweetener Xylitol on Gut Hormone Secretion and Gastric Emptying in Humans: A Pilot Dose-Ranging Study

Nutrients ◽

10.3390/nu13010174 ◽

2021 ◽

Vol 13 (1) ◽

pp. 174

Author(s):

Anne Christin Meyer-Gerspach ◽

Jürgen Drewe ◽

Wout Verbeure ◽

Carel W. le Roux ◽

Ludmilla Dellatorre-Teixeira ◽

...

Keyword(s):

Uric Acid ◽

Gastric Emptying ◽

Blood Lipids ◽

Tap Water ◽

Hormone Secretion ◽

Gastrointestinal Symptoms ◽

Gut Hormones ◽

Double Blind ◽

Gut Hormone ◽

Dose Dependent

Sugar consumption is associated with a whole range of negative health effects and should be reduced and the natural sweetener xylitol might be helpful in achieving this goal. The present study was conducted as a randomized, placebo-controlled, double-blind, cross-over trial. Twelve healthy, lean volunteers received intragastric solutions with 7, 17 or 35 g xylitol or tap water on four separate days. We examined effects on: gut hormones, glucose, insulin, glucagon, uric acid, lipid profile, as well as gastric emptying rates, appetite-related sensations and gastrointestinal symptoms. We found: (i) a dose-dependent stimulation of cholecystokinin (CCK), active glucagon-like peptide-1 (aGLP-1), peptide tyrosine tyrosine (PYY)-release, and decelerated gastric emptying rates, (ii) a dose-dependent increase in blood glucose and insulin, (iii) no effect on motilin, glucagon, or glucose-dependent insulinotropic peptide (GIP)-release, (iv) no effect on blood lipids, but a rise in uric acid, and (v) increased bowel sounds as only side effects. In conclusion, low doses of xylitol stimulate the secretion of gut hormones and induce a deceleration in gastric emptying rates. There is no effect on blood lipids and only little effect on plasma glucose and insulin. This combination of properties (low-glycemic sweetener which stimulates satiation hormone release) makes xylitol an attractive candidate for sugar replacement.

Download Full-text

Energy intake, gastrointestinal transit, and gut hormone release in response to oral triglycerides and fatty acids in men with and without severe obesity

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.00310.2018 ◽

2019 ◽

Vol 316 (3) ◽

pp. G332-G337 ◽

Cited By ~ 4

Author(s):

Carsten Dirksen ◽

Jesper Graff ◽

Stefan Fuglsang ◽

Jens F. Rehfeld ◽

Jens J. Holst ◽

...

Keyword(s):

Fatty Acids ◽

Oleic Acid ◽

Olive Oil ◽

Energy Intake ◽

Severe Obesity ◽

Gastrointestinal Transit ◽

Calorie Intake ◽

Double Blind ◽

Gut Hormone ◽

Ad Libitum

Dietary fat, and particularly fatty acids (FAs) from hydrolyzed triglycerides (TGs), reduces appetite, whereas paradoxically, a high-fat diet leads to excess calorie intake. We therefore hypothesized that the appetite-regulating effects of FAs are perturbed in obesity. Ten men with severe obesity [median body mass index (BMI) of 51.0 kg/m2(range of 47.9–69.0)] and 10 men without obesity [BMI of 24.6 kg/m2(range of 21.7–26.8)] were recruited for a double-blind randomized crossover study. On two occasions, participants were given isocaloric (2,660 kJ) and isovolemic (80 ml) loads of either oleic acid (long-chain FA) or olive oil (TG) containing radiolabeled lipid and water markers. Postload scintigraphy, blood sampling, and assessment of appetite were performed for 10 h, after which an ad libitum meal was served. Compared with olive oil, oleic acid slowed gastric mean emptying time (GMET) for lipids ( P < 0.001), accelerated orocoecal transit time (OCTT; P = 0.005), increased postload cholecystokinin section ( P < 0.001), and suppressed ad libitum energy intake ( P = 0.028) in men with severe obesity, and similar effects were seen in the nonobese group (no group × lipid interactions). However, independent of lipid loads, GMET and OCTT were slower (GMETlipidP = 0.046; GMETwaterP = 0.003; OCTT P = 0.001), and basal and postload secretion of glucagon-like peptide-1 (GLP-1) was attenuated ( P = 0.045 and P = 0.048, respectively) in men with severe obesity compared with men without obesity. We conclude that the more potent appetite-regulating effects of oleic acid versus olive oil are unimpaired in men with severe obesity. However, regardless of lipid formulations, severe obesity is associated with slowed gastrointestinal transit and attenuated GLP-1 secretion.NEW & NOTEWORTHY Orally ingested fatty acids more efficiently reduce appetite and energy intake than triglycerides also in men with severe obesity. Men with severe obesity have delayed gastrointestinal transit and attenuated early gut hormone responses after an oral lipid load compared with men without obesity.

Download Full-text

Effects of randomized whey-protein loads on energy intake, appetite, gastric emptying, and plasma gut-hormone concentrations in older men and women

American Journal of Clinical Nutrition ◽

10.3945/ajcn.117.154377 ◽

2017 ◽

pp. ajcn154377 ◽

Cited By ~ 15

Author(s):

Caroline Giezenaar ◽

Laurence G Trahair ◽

Natalie D Luscombe-Marsh ◽

Trygve Hausken ◽

Scott Standfield ◽

...

Keyword(s):

Gastric Emptying ◽

Whey Protein ◽

Energy Intake ◽

Older Men ◽

Men And Women ◽

Gut Hormone ◽

Older Men And Women

Download Full-text

Effects of varying combinations of intraduodenal lipid and carbohydrate on antropyloroduodenal motility, hormone release, and appetite in healthy males

AJP Regulatory Integrative and Comparative Physiology ◽

10.1152/ajpregu.90934.2008 ◽

2009 ◽

Vol 296 (4) ◽

pp. R912-R920 ◽

Cited By ~ 25

Author(s):

Radhika V. Seimon ◽

Kate L. Feltrin ◽

James H. Meyer ◽

Ixchel M. Brennan ◽

Judith M. Wishart ◽

...

Keyword(s):

Blood Glucose ◽

Energy Intake ◽

Peptide Yy ◽

Gut Hormones ◽

Double Blind ◽

Glucose Levels ◽

Gut Function ◽

Glucagon Like Peptide 1 ◽

Desire To Eat ◽

Healthy Males

Intraduodenal infusions of both lipid and glucose modulate antropyloroduodenal motility and stimulate plasma CCK, with lipid being more potent than glucose. Both stimulate glucagon-like peptide-1, but only lipid stimulates peptide YY (PYY), while only glucose raises blood glucose and stimulates insulin. When administered in combination, lipid and carbohydrate may, thus, have additive effects on energy intake. However, elevated blood glucose levels do not suppress energy intake, and the effect of insulin is controversial. We hypothesized that increasing the ratio of maltodextrin, a complex carbohydrate, relative to lipid would be associated with a reduction in effects on antropyloroduodenal pressures, gut hormones, appetite, and energy intake, when compared with lipid alone. Ten healthy males were studied on three occasions in double-blind, randomized order. Antropyloroduodenal pressures, plasma CCK, PYY and insulin, blood glucose, and appetite were measured during 90-min intraduodenal infusions of 1) 3 kcal/min lipid (L3), 2) 2 kcal/min lipid and 1 kcal/min maltodextrin (L2/CHO1), or 3) 1 kcal/min lipid and 2 kcal/min maltodextrin (L1/CHO2). Energy intake at a buffet lunch consumed immediately after the infusion was quantified. Reducing the lipid (thus, increasing the carbohydrate) content of the infusion was associated with reduced stimulation of basal pyloric pressures ( r = 0.76, P < 0.01), plasma CCK ( r = 0.66, P < 0.01), and PYY ( r = 0.98, P < 0.001), and reduced suppression of antral ( r = −0.64, P < 0.05) and duodenal ( r = −0.69, P < 0.05) pressure waves, desire-to-eat ( r = −0.8, P < 0.001), and energy intake ( r = 0.74, P < 0.01), with no differences in phasic (isolated) pyloric pressures. In conclusion, in healthy males, intraduodenal lipid is a more potent modulator of gut function, associated with greater suppression of energy intake, when compared with isocaloric combinations of lipid and maltodextrin.

Download Full-text

Gastric emptying, mouth-to-cecum transit, and glycemic, insulin, incretin, and energy intake responses to a mixed-nutrient liquid in lean, overweight, and obese males

AJP Endocrinology and Metabolism ◽

10.1152/ajpendo.00533.2012 ◽

2013 ◽

Vol 304 (3) ◽

pp. E294-E300 ◽

Cited By ~ 33

Author(s):

Radhika V. Seimon ◽

Ixchel M. Brennan ◽

Antonietta Russo ◽

Tanya J. Little ◽

Karen L. Jones ◽

...

Keyword(s):

Blood Glucose ◽

Gastric Emptying ◽

Energy Intake ◽

Gut Hormones ◽

Gastrointestinal Hormone ◽

Postprandial Glycemia ◽

Incretin Secretion ◽

Obese Subjects ◽

Insulin Responses ◽

The Impact

Observations relating to the impact of obesity on gastric emptying (GE) and the secretion of gut hormones are inconsistent, probably because of a lack of studies in which GE, gastrointestinal hormone release, and energy intake (EI) have been evaluated concurrently with previous patterns of nutrient intake. GE is known to be a major determinant of postprandial glycemia and incretin secretion in health and type 2 diabetes. The aims of this study were to determine the effects of a mixed-nutrient drink on GE, oro-cecal transit, blood glucose, insulin and incretin concentrations and EI, and the relationship between the glycemic response to the drink with GE in lean, overweight, and obese subjects. Twenty lean, 20 overweight, and 20 obese males had measurements of GE, oro-cecal transit, and blood glucose, insulin, GLP-1, and GIP concentrations for 5 h after ingestion of a mixed-nutrient drink (500 ml, 532 kcal); EI at a subsequent buffet lunch was determined. Habitual EI was also quantified. Glycemic and insulinemic responses to the drink were greater in the obese (both P < 0.05) when compared with both lean and overweight, with no significant differences in GE, intragastric distribution, oro-cecal transit, incretins, or EI (buffet lunch or habitual) between groups. The magnitude of the rise in blood glucose after the drink was greater when GE was relatively more rapid ( r = −0.55, P < 0.05). In conclusion, in the absence of differences in habitual EI, both GE and incretin hormones are unaffected in the obese despite greater glucose and insulin responses, and GE is a determinant of postprandial glycemia.

Download Full-text

Effects of Age on Acute Appetite-Related Responses to Whey-Protein Drinks, Including Energy Intake, Gastric Emptying, Blood Glucose, and Plasma Gut Hormone Concentrations—A Randomized Controlled Trial

Nutrients ◽

10.3390/nu12041008 ◽

2020 ◽

Vol 12 (4) ◽

pp. 1008 ◽

Cited By ~ 1

Author(s):

Caroline Giezenaar ◽

Kylie Lange ◽

Trygve Hausken ◽

Karen L. Jones ◽

Michael Horowitz ◽

...

Keyword(s):

Blood Glucose ◽

Gastric Emptying ◽

Energy Intake ◽

Older Men ◽

Younger Men ◽

Increase Energy Intake ◽

Protein Rich ◽

Desire To Eat ◽

G 28 ◽

Stimulation Of

Protein-rich supplements are used commonly to increase energy intake in undernourished older people. This study aimed to establish age effects on energy intake, appetite, gastric emptying, blood glucose, and gut hormones in response to protein-rich drinks. In a randomized double-blind, order, 13 older men (age: 75 ± 2 yrs, body mass index (BMI): 26 ± 1 kg/m2) and 13 younger (23 ± 1 yrs, 24 ± 1 kg/m2) men consumed (i) a control drink (~2 kcal) or drinks (450 mL) containing protein/fat/carbohydrate: (ii) 70 g/0 g/0 g (280 kcal/‘P280′), (iii) 14 g/12.4 g/28 g (280 kcal/‘M280′), (iv) 70 g/12.4 g/28 g (504 kcal/‘M504′), on four separate days. Appetite (visual analog scales), gastric emptying (3D ultrasonography), blood glucose, plasma insulin, ghrelin, cholecystokinin (CCK), glucagon-like peptide-1 (GLP-1) concentrations (0–180 min), and ad-libitum energy intake (180–210 min) were determined. Older men, compared to younger men, had higher fasting glucose and CCK concentrations and lower fasting GLP-1 concentrations (all p < 0.05). Energy intake by P280 compared to control was less suppressed in older men (increase: 49 ± 42 kcal) than it was in younger men (suppression: 100 ± 54 kcal, p = 0.038). After the caloric drinks, the suppression of hunger and the desire to eat, and the stimulation of fullness was less (p < 0.05), and the stimulation of plasma GLP-1 was higher (p < 0.05) in older men compared to younger men. Gastric emptying, glucose, insulin, ghrelin, and CCK responses were similar between age groups. In conclusion, ageing reduces the responses of caloric drinks on hunger, the desire to eat, fullness, and energy intake, and protein-rich nutrition supplements may be an effective strategy to increase energy intake in undernourished older people.

Download Full-text

Intragastric administration of the bitter tastant quinine lowers the glycemic response to a nutrient drink without slowing gastric emptying in healthy men

AJP Regulatory Integrative and Comparative Physiology ◽

10.1152/ajpregu.00294.2019 ◽

2020 ◽

Vol 318 (2) ◽

pp. R263-R273 ◽

Cited By ~ 4

Author(s):

Vida Bitarafan ◽

Penelope C. E. Fitzgerald ◽

Tanya J. Little ◽

Wolfgang Meyerhof ◽

Karen L. Jones ◽

...

Keyword(s):

Blood Glucose ◽

Gastric Emptying ◽

Energy Intake ◽

Plasma Glucose ◽

Postprandial Blood Glucose ◽

Intragastric Administration ◽

Glycemic Response ◽

Experimental Conditions ◽

Double Blind ◽

Healthy Men

The rate of gastric emptying and the release of gastrointestinal (GI) hormones are major determinants of postprandial blood-glucose concentrations and energy intake. Preclinical studies suggest that activation of GI bitter-taste receptors potently stimulates GI hormones, including glucagon-like peptide-1 (GLP-1), and thus may reduce postprandial glucose and energy intake. We evaluated the effects of intragastric quinine on the glycemic response to, and the gastric emptying of, a mixed-nutrient drink and the effects on subsequent energy intake in healthy men. The study consisted of 2 parts: part A included 15 lean men, and part B included 12 lean men (aged 26 ± 2 yr). In each part, participants received, on 3 separate occasions, in double-blind, randomized fashion, intragastric quinine (275 or 600 mg) or control, 30 min before a mixed-nutrient drink ( part A) or before a buffet meal ( part B). In part A, plasma glucose, insulin, glucagon, and GLP-1 concentrations were measured at baseline, after quinine alone, and for 2 h following the drink. Gastric emptying of the drink was also measured. In part B, energy intake at the buffet meal was quantified. Quinine in 600 mg (Q600) and 275 mg (Q275) doses alone stimulated insulin modestly ( P < 0.05). After the drink, Q600 and Q275 reduced plasma glucose and stimulated insulin ( P < 0.05), Q275 stimulated GLP-1 ( P < 0.05), and Q600 tended to stimulate GLP-1 ( P = 0.066) and glucagon ( P = 0.073) compared with control. Quinine did not affect gastric emptying of the drink or energy intake. In conclusion, in healthy men, intragastric quinine reduces postprandial blood glucose and stimulates insulin and GLP-1 but does not slow gastric emptying or reduce energy intake under our experimental conditions.

Download Full-text

Lesser suppression of energy intake by orally ingested whey protein in healthy older men compared with young controls

AJP Regulatory Integrative and Comparative Physiology ◽

10.1152/ajpregu.00213.2015 ◽

2015 ◽

Vol 309 (8) ◽

pp. R845-R854 ◽

Cited By ~ 24

Author(s):

Caroline Giezenaar ◽

Laurence G. Trahair ◽

Rachael Rigda ◽

Amy T. Hutchison ◽

Christine Feinle-Bisset ◽

...

Keyword(s):

Gastric Emptying ◽

Whey Protein ◽

Energy Intake ◽

Young Male ◽

Older Men ◽

Water Control ◽

Elderly Men ◽

Cumulative Energy ◽

Double Blind ◽

Protein Ingestion

Protein-rich supplements are used widely for the management of malnutrition in young and older people. Protein is the most satiating of the macronutrients in young. It is not known how the effects of oral protein ingestion on energy intake, appetite, and gastric emptying are modified by age. The aim of the study was to determine the suppression of energy intake by protein compared with control and underlying gastric-emptying and appetite responses of oral whey protein drinks in eight healthy older men (69–80 yr) compared with eight young male controls (18–34 yr). Subjects were studied on three occasions to determine the effects of protein loads of 30 g/120 kcal and 70 g/280 kcal compared with a flavored water control-drink (0 g whey protein) on energy intake (ad libitum buffet-style meal), and gastric emptying (three-dimensional-ultrasonography) and appetite (0–180 min) in a randomized, double-blind, cross-over design. Energy intake was suppressed by the protein compared with control ( P = 0.034). Suppression of energy intake by protein was less in older men (1 ± 5%) than in young controls (15 ± 2%; P = 0.008). Cumulative energy intake (meal+drink) on the protein drink days compared with the control day increased more in older (18 ± 6%) men than young (1 ± 3%) controls ( P = 0.008). Gastric emptying of all three drinks was slower in older men (50% gastric-emptying time: 68 ± 5 min) than young controls (36 ± 5 min; P = 0.007). Appetite decreased in young, while it increased in older ( P < 0.05). In summary, despite having slower gastric emptying, elderly men exhibited blunted protein-induced suppression of energy intake by whey protein compared with young controls, so that in the elderly men, protein ingestion increased overall energy intake more than in the young men.

Download Full-text