Gallstones: an intestinal disease? (1/1828)

Current evidence suggests that impaired intestinal motility may facilitate gallstone formation by influencing biliary deoxycholate levels or by modulating interdigestive gall bladder motility (fig 2), although a primary intestinal defect in gallstone pathogenesis has not yet been demonstrated. In the cold war period, most interesting events, from a political point of view, occurred at the border between capitalist and communist systems, near the iron curtain. Similarly, the gall bladder and biliary tract can be viewed as the border between liver and intestinal tract, where many interesting things occur with profound impact on both systems. Combined efforts by researchers in the field of hepatology and gastrointestinal motility should brake down the Berlin wall of ignorance of one of the most common diseases in the Western world.  (+info)

Response of adipose tissue lipoprotein lipase to the cephalic phase of insulin secretion. (2/1828)

Modulation of lipoprotein lipase (LPL) allows a tissue-specific partitioning of triglyceride-derived fatty acids, and insulin is a major modulator of its activity. The present studies were aimed to assess in rats the contribution of insulin to the response of adipose tissue and muscle LPL to food intake. Epididymal and retroperitoneal adipose LPL rose 65% above fasting values as early as 1 h after the onset of a 30-min high-carbohydrate meal, with a second activity peak 1 h later that was maintained for an additional 2 h. Soleus muscle LPL was decreased by 25% between 0.5 and 4 h after meal intake. The essential contribution of insulin to the LPL response to food intake was determined by preventing the full insulin response to meal intake by administration of diazoxide (150 mg/kg body wt, in the meal). The usual postprandial changes in adipose and muscle LPL did not occur in the absence of an increase in insulinemia. However, the early (60 min) increase in adipose tissue LPL was not prevented by the drug, likely because of the maintenance of the early centrally mediated phase of insulin secretion. In a subsequent study, rats chronically implanted with a gastric cannula were used to demonstrate that the postprandial rise in adipose LPL is independent of nutrient absorption and can be elicited by the cephalic (preabsorptive) phase of insulin secretion. Obese Zucker rats were used because of their strong cephalic insulin response. After an 8-h fast, rats were fed a liquid diet ad libitum (orally, cannula closed), sham fed (orally, cannula opened), or fed directly into the stomach via the cannula during 4 h. Insulinemia increased 10-fold over fasting levels in ad libitum- and intragastric-fed rats and threefold in sham-fed rats. Changes in adipose tissue LPL were proportional to the elevation in plasma insulin levels, demonstrating that the cephalic-mediated rise in insulinemia, in the absence of nutrient absorption, stimulates adipose LPL. These results demonstrate the central role of insulin in the postprandial response of tissue LPL, and they show that cephalically mediated insulin secretion is able to stimulate adipose LPL.  (+info)

Inhibition of carbohydrate-mediated glucagon-like peptide-1 (7-36)amide secretion by circulating non-esterified fatty acids. (3/1828)

Two studies were performed to assess the entero-insular axis in simple obesity and the possible effect of variations in the level of circulating non-esterified fatty acids (NEFA) on one of the components of the entero-insular axis, glucagon-like peptide-1 [(7-36) amide]. In the first study, we compared the entero-pancreatic hormone response to oral carbohydrate in obese and lean women. Obese subjects demonstrated hyperinsulinaemia and impaired glucose tolerance but this was not associated with an increased secretion of either glucose-dependent insulinotropic polypeptide or glucagon-like peptide-1 (GLP-1). These findings therefore provide no support for the hypothesis that overactivity of the entero-insular axis contributes to the hyperinsulinaemia seen in obesity. Indeed, the plasma GLP-1 response to carbohydrate was markedly attenuated in obese subjects, confirming previous observations. In the second study, in which carbohydrate-stimulated GLP-1 responses were again evaluated in obese and lean women, circulating NEFA levels were modulated using either heparin (to increase serum NEFA) or acipimox (to reduce serum NEFA). Treatment with acipimox resulted in complete suppression of NEFA levels and in a markedly higher GLP-1 response than the response to carbohydrate alone or to carbohydrate plus heparin. We suggest that higher fasting and postprandial NEFA levels in obesity may tonically inhibit nutrient-mediated GLP-1 secretion, and that this results in attenuation of the GLP-1 response to carbohydrate. However, although serum NEFA levels post-acipimox were similarly suppressed in both lean and obese subjects, the GLP-1 response was again significantly lower in obese subjects, suggesting the possibility of an intrinsic defect of GLP-1 secretion in obesity. The reduction of GLP-1 levels in obesity may be important both in relation to its insulinotropic effect and to its postulated role as a satiety factor.  (+info)

Impaired endothelial function following a meal rich in used cooking fat. (4/1828)

OBJECTIVES: The purpose of this study was to test the hypothesis that intake of used cooking fat is associated with impaired endothelial function. BACKGROUND: Diets containing high levels of lipid oxidation products may accelerate atherogenesis, but the effect on endothelial function is unknown. METHODS: Flow-mediated endothelium-dependent dilation and glyceryl trinitrate-induced endothelium-independent dilation of the brachial artery were investigated in 10 men. Subjects had arterial studies before and 4 h after three test meals: 1) a meal (fat 64.4 g) rich in cooking fat that had been used for deep frying in a fast food restaurant; 2) the same meal (fat 64.4 g) rich in unused cooking fat, and 3) a corresponding low fat meal (fat 18.4 g) without added fat. RESULTS: Endothelium-dependent dilation decreased between fasting and postprandial studies after the used fat meal (5.9 +/- 2.3% vs. 0.8 +/- 2.2%, p = 0.0003), but there was no significant change after the unused fat meal (5.3 +/- 2.1% vs. 6.0 +/- 2.5%) or low fat meal (5.3 +/- 2.3% vs. 5.4 +/- 3.3%). There was no significant difference in endothelium-independent dilation after any of the meals. Plasma free fatty acid concentration did not change significantly during any of the meals. The level of postprandial hypertriglyceridemia was not associated with change in endothelial function. CONCLUSIONS: Ingestion of a meal rich in fat previously used for deep frying in a commercial fast food restaurant resulted in impaired arterial endothelial function. These findings suggest that intake of degradation products of heated fat contribute to endothelial dysfunction.  (+info)

The influence of the colon on postprandial glucagon-like peptide 1 (7-36) amide concentration in man. (5/1828)

Glucagon-like peptide (7-36) amide (GLP-1) is an incretin hormone of the enteroinsular axis released rapidly after meals despite the fact that GLP-1 secreting cells (L-cells) occur predominantly in the distal gut. The importance of these colonic L-cells for postprandial GLP-1 was determined in healthy control subjects and in ileostomy patients with minimal small bowel resection (<5 cm). Subjects were fed a high complex carbohydrate test meal (15.3 g starch) followed by two carbohydrate-free, high fat test meals (25 g and 48.7 g fat respectively). Circulating levels of glucose, insulin, glucagon, glucose insulinotrophic peptide (GIP) and GLP-1 were measured over a 9-h postprandial period. For both subject groups the complex carbohydrate test meal failed to elicit a rise in either GIP or GLP-1. However, both hormones were elevated after the fat load although the GLP-1 concentration was significantly reduced in the ileostomist group when compared with controls (P=0.02). Associated with this reduction in circulating GLP-1 was an elevation in glucagon concentration (P=0.012) and a secondary rise in the plasma glucose concentration (P=0.006). These results suggest that the loss of colonic endocrine tissue is an important determinant in the postprandial GLP-1 concentration. Ileostomists should not be assumed to have normal enteroinsular function as the colon appears to have an important role in postprandial metabolism.  (+info)

Effect of the glycemic index and content of indigestible carbohydrates of cereal-based breakfast meals on glucose tolerance at lunch in healthy subjects. (6/1828)

BACKGROUND: Diets with a low glycemic index (GI) have been shown to improve glucose tolerance in both healthy and diabetic subjects. Two potential mechanisms are discussed in relation to long-term metabolic effects: a decreased demand for insulin in the postprandial phase and formation of short-chain fatty acids from fermentation of indigestible carbohydrates in the colon. OBJECTIVE: The objective was to study the effect of the GI and the indigestible carbohydrate--resistant starch (RS) and dietary fiber (DF)--content of cereal-based breakfasts on glucose tolerance at a second meal (lunch) in healthy subjects. DESIGN: The effects of 7 test breakfasts with known GIs (GI: 52-99) and RS + DF contents (2-36 g) were evaluated. White-wheat bread was used as a reference breakfast (high GI, low RS + DF content). Glucose and insulin responses after the second meal were measured in healthy subjects. In addition, the satiating capacity of 4 of the 7 test breakfasts was estimated before and during the second meal. RESULTS: Two of the 4 low-GI breakfasts improved glucose tolerance at the second meal. Only these 2 breakfasts were capable of postponing the in-between-meal fasting state. There was no measurable effect of fermentable carbohydrates on glucose tolerance at the second meal. The highest satiety score was associated with the barley breakfast that had a low GI and a high RS + DF content. CONCLUSIONS: Glucose tolerance can improve in a single day. Slow absorption and digestion of starch from the breakfast meal, but not the content of indigestible carbohydrates in the breakfast meal, improved glucose tolerance at the second meal (lunch).  (+info)

Net postprandial utilization of [15N]-labeled milk protein nitrogen is influenced by diet composition in humans. (7/1828)

The aim of this study was to follow the fate of dietary nitrogen to assess the postprandial utilization of purified milk protein and to determine the acute influence of energy nutrients. For this purpose, a [15N]-labeling dietary protein approach was used. Twenty-five subjects swallowed an ileal tube and ingested [15 N]-milk protein alone or supplemented with either milk fat or sucrose. The absorption and postprandial deamination of dietary protein was monitored for 8 h. Sucrose delayed the absorption of protein longer than fat, but the ileal digestibility did not differ among groups (94.5-94.8%). Sucrose, but not fat, significantly reduced the postprandial transfer of [15N]-milk nitrogen to urea. Consequently, the net postprandial protein utilization (NPPU) of milk protein calculated 8 h after meal ingestion was 80% when ingested either alone or supplemented with fat and was significantly greater with sucrose (NPPU = 85%). This study shows that energy nutrients do not affect the nitrogen absorption but modify the metabolic utilization of dietary protein in the phase of nitrogen gain. Our method provides information concerning the deamination kinetics of dietary amino acids and further allows the detection of differences of dietary protein utilization in acute conditions. The diet composition should be carefully considered, and protein quality must be determined under optimal conditions of utilization.  (+info)

Enhanced postprandial energy expenditure with medium-chain fatty acid feeding is attenuated after 14 d in premenopausal women. (8/1828)

BACKGROUND: Medium-chain triacylglycerols (MCTs) are reported to enhance human energy expenditure (EE), although few studies have involved women and the duration of such effects is only known for periods of approximately 7 d. OBJECTIVE: This study was conducted to determine whether women consuming mixed, MCT-enriched or long-chain triacylglycerol (LCT)-enriched diets showed changes in EE or substrate oxidation after 7 and 14 d. DESIGN: Twelve nonobese, premenopausal women were fed isoenergetic mixed diets enriched in either MCTs or LCTs during separate, 14-d feeding periods. Each meal contained 40% of energy as fat (80% of which was the treatment fat), 45% as carbohydrate, and 15% as protein. On days 7 and 14 of each trial, basal metabolic rate (BMR, kJ/min), total energy expenditure (TEE, kJ/min), and thermic effect of feeding (deltakJ/min) after a standardized breakfast were measured by respiratory gas exchange. RESULTS: On day 7, the mean (+/-SEM) BMR (3.58+/-0.11 kJ/min) with the MCT diet was greater (P = 0.0003) than that with the LCT diet (3.43+/-0.11 kJ/min). The mean postprandial TEE on day 7 was significantly greater (P = 0.04) with the MCT diet (4.36+/-0.04 kJ/min) than with the LCT diet (4.23+/-0.04 kJ/min); by day 14, postprandial TEE was still greater with the MCT diet, but not significantly so. No significant differences in the thermic effect of feeding were evident between diets. CONCLUSIONS: Results from this longest controlled MCT feeding study to date suggest that short-term feeding of MCT-enriched diets increases TEE, but this effect could be transient with continued feeding.  (+info)