Gastric emptying,gastric secretion and enterogastrone response after administration of milk proteins or their peptide hydrolysates in humans

Summary.Background: The influence of protein fractionation on gastric emptying and rate of appearance of their constituent amino acids in peripheral blood remains unknown.Aim of the study: To examine the influence of the degree of protein fractionation on gastric emptying, gastric secretion, amino acid absorption and enterogastrone response, after the intragastric administration of complete cow milk proteins or their respective peptide hydrolysates in man.Methods: Six healthy males were randomized to receive one of the following four solutions: whey whole protein (W), casein whole protein (C), whey peptide hydrolysate (WHY) or casein hydrolysate (CAHY). All solutions were matched for volume (600 mL), nitrogen content (9.3 g/L), energy density (1069–1092 kJ/L), osmolality (288–306 mosmol/kg), pH (6.9–7.0) and temperature (37 °C).Results: Solutions were emptied at similar rates, with mean half-times of (mean ± SEM) 21.4 ± 1.3, 19.3 ± 2.2, 18.0 ± 2.5 and 19.4 ± 2.8 min, for the WHY, CAHY, C and W, respectively. The rates of intestinal absorption of water and amino acids were similar with the exception of the casein protein solution, for which the speed of intestinal amino acid absorption was slower (p < 0.05). The peptide hydrolysates elicited about 50% more gastric secretion than the whole protein solutions (p < 0.05),which was accompanied by higher glucosedependent insulinotropic polipeptide (GIP) plasma levels during the first 20 min of the gastric emptying process. Similar glucagon-like peptide-1 (GLP-1) and peptide YY (PYY) plasma responses were elicited by the four solutions.Conclusions: The rate of gastric emptying and the plasma GLP-1 and PYY responses to feeding with cow milk protein solutions in humans are independent of the degree of protein fractionation and are not altered by small differences in the amino acid composition or protein solubility. In contrast, the GIP response is accentuated when milk proteins are delivered as peptide hydrolysates.     

Comparative Effects of the Branched-Chain Amino Acids,Leucine, Isoleucine and Valine,on Gastric Emptying,Plasma Glucose,C-Peptide and Glucagon in Healthy Men

(1) Background: Whey protein lowers postprandial blood glucose in health and type 2 diabetes, by stimulating insulin and incretin hormone secretion and slowing gastric emptying. The branched-chain amino acids, leucine, isoleucine and valine, abundant in whey, may mediate the glucoregulatory effects of whey. We investigated the comparative effects of intragastric administration of leucine, isoleucine and valine on the plasma glucose, C-peptide and glucagon responses to and gastric emptying of a mixed-nutrient drink in healthy men. (2) Methods: 15 healthy men (27 ± 3 y) received, on four separate occasions, in double-blind, randomised fashion, either 10 g of leucine, 10 g of isoleucine, 10 g of valine or control, intragastrically, 30 min before a mixed-nutrient drink. Plasma glucose, C-peptide and glucagon concentrations were measured before, and for 2 h following, the drink. Gastric emptying of the drink was quantified using ¹³C-acetate breath-testing. (3) Results: Amino acids alone did not affect plasma glucose or C-peptide, while isoleucine and valine, but not leucine, stimulated glucagon (p < 0.05), compared with control. After the drink, isoleucine and leucine reduced peak plasma glucose compared with both control and valine (all p < 0.05). Neither amino acid affected early (t = 0–30 min) postprandial C-peptide or glucagon. While there was no effect on overall gastric emptying, plasma glucose at t = 30 min correlated with early gastric emptying (p < 0.05). (4) Conclusion: In healthy individuals, leucine and isoleucine lower postprandial blood glucose, at least in part by slowing gastric emptying, while valine does not appear to have an effect, possibly due to glucagon stimulation.     

Short-term dietary supplementation with fructose accelerates gastric emptying of a fructose but not a glucose solution

ObjectiveShort-term dietary glucose supplementation has been shown to accelerate the gastric emptying rate of both glucose and fructose solutions. The aim of this study was to examine gastric emptying rate responses to monosaccharide ingestion following short-term dietary fructose supplementation.MethodsThe gastric emptying rate of a fructose solution containing 36 g of fructose and an equicaloric glucose solution containing 39.6 g glucose monohydrate were measured in 10 healthy non-smoking men with and without prior fructose supplementation (water control) using a randomized crossover design. Gastric emptying rate was assessed for a period of 1 h using the [¹³C]breath test with sample collections at baseline and 10-min intervals following drink ingestion. Additionally, appetite ratings of hunger, fullness, and prospective food consumption were recorded at baseline and every 10 min using visual analog scales.ResultsIncreased dietary fructose ingestion resulted in significantly accelerated half-emptying time of a fructose solution (mean = 48, SD = 6 versus 58, SD = 14 min control; P = 0.037), whereas the emptying of a glucose solution remained unchanged (mean = 85, SD = 31 versus 78, SD = 27 min control; P = 0.273). Time of maximal emptying rate of fructose was also significantly accelerated following increased dietary fructose intake (mean = 33, SD = 6 versus 38, SD = 9 min control; P = 0.042), while it remained unchanged for glucose (mean = 45, SD = 14 versus 44, SD = 14 min control; P = 0.757). No effects of supplementation were observed for appetite measures.ConclusionThree d of supplementation with 120 g/d of fructose resulted in an acceleration of gastric emptying rate of a fructose solution but not a glucose solution.     

Effects of protein on glycemic and incretin responses and gastric emptying after oral glucose in healthy subjects

BACKGROUND: Dietary interventions represent a promising therapeutic strategy to optimize postprandial glycemia. The addition of protein to oral glucose has been reported to improve the glycemic profile. OBJECTIVE: The aim of the current study was to evaluate the mechanisms by which protein supplementation lowers the blood glucose response to oral glucose. DESIGN: Nine healthy men were studied on 3 d each in a random order. Subjects consumed 300-mL drinks containing either 50 g glucose (Glucose), 30 g gelatin (Protein), or 50 g glucose with 30 g gelatin (Glucose + Protein) in water labeled with 150 mg [(13)C]acetate. Blood and breath samples were subsequently collected for 3 h to measure blood glucose and plasma insulin, glucagon-like peptide 1 (GLP-1), and glucose-dependent insulinotropic polypeptide (GIP) concentrations and gastric half-emptying time, which was calculated from (13)CO(2) excretion. RESULTS: The blood glucose response was less after Glucose + Protein than after Glucose (P < 0.005); GIP was lower (P < 0.005), and there were no significant differences in plasma insulin or GLP-1. Protein alone stimulated insulin, GLP-1, and GIP (P < 0.05 for each) without elevating blood glucose. The gastric half-emptying time was greater after Glucose + Protein than after Glucose (P < 0.05) and tended to be greater for Glucose than for Protein (P = 0.06). CONCLUSIONS: In healthy humans, the addition of protein to oral glucose lowers postprandial blood glucose concentrations acutely, predominantly by slowing gastric emptying, although protein also stimulates incretin hormones and non-glucose-dependent insulin release.     

Glucagon-like peptide-1 release and satiety after a nutrient challenge in normal-weight and obese subjects

The present study was conducted to assess whether glucagon-like peptide-1 (GLP-1) release and appetite after a breakfast with or without an additional galactose/guar gum stimulation is different in normal-weight compared with overweight/obese subjects. Twenty-eight overweight/obese (BMI 30.3 (sd 2.7) kg/m2; age 44.3 (sd 9.7) years) and thirty normal-weight subjects (BMI 22.8 (sd 1.4), age 31.5 (sd12.8) years) participated in a crossover study. Fasting and postprandial plasma GLP-1, insulin, glucose and free fatty acid concentrations were measured in response to either a galactose (50 g)/guar gum (2.5 g) load (836 kJ) and a standard breakfast (1.9 MJ; GG), or water (250 ml) and the standard breakfast (W) every 30 min relative to the ingestion for 120 min. Appetite was assessed using 100 mm visual analogue scales. GLP-1 concentrations were significantly increased after GG at 30 and 60 min compared with W in both groups. Plasma GLP-1 concentrations in the W condition were higher in normal-weight than overweight/obese subjects (P=0.03). No difference was observed in the GG condition between groups. Satiety was increased in normal-weight compared with overweight/obese subjects in the GG condition at 30 (P=0.02) and 60 (P=0.04) min. We conclude that after a standard breakfast with water, GLP-1 release was lower in the overweight/obese than the normal-weight subjects. However, postprandial GLP-1 release in overweight/obese subjects was no different from that of normal-weight subjects when galactose/guar gum was added to the breakfast. The latter was not mirrored by subjective feelings of satiety. Disturbed perception of the physiological feedback of a satiety hormone rather than disturbed feedback itself might contribute to obesity.     

The effects of fiber enrichment of pasta and fat content on gastric emptying,GLP-1, glucose,and insulin responses to a meal

OBJECTIVE: To assess whether the addition of viscous fiber at an amount recommended by the US FDA to allow a 'low saturated fat, cholesterol, soluble fiber and coronary heart disease', health claim label on a food package (1.7 g psyllium) and/or fat (30 g sunflower oil and 3 g sodium propionate) to a pasta meal would affect gastric emptying, postprandial glucose, insulin and GLP-1 concentrations. DESIGN: Ten subjects participated in a two-by-two single blind randomized crossover study. Four meals containing 50 g of available carbohydrate were consumed: pasta with or without psyllium enrichment served with a tomato sauce with (520 kcal per meal) and without (240 kcal per meal) fat. Blood samples were taken for 240 min following the meal and all subjects consumed a buffet meal at the end of the study. Gastric emptying was measured using the paracetamol absorption test. Blood was analysed for glucose, insulin, GLP-1. Visual analog scales were used to record feelings of hunger, pleasantness and nausea. RESULTS: The psyllium-enriched pasta had no significant effect on gastric emptying or the incremental area under the curve (IAUC) for GLP-1, insulin or glucose compared with the control pasta. The addition of polyunsaturated fat and sodium propionate significantly increased the IAUC for GLP-1 (P<0.001), delaying gastric emptying (P<0.002), and decreasing glucose (P<0.002). CONCLUSIONS: A dose of 1.7 g psyllium did not evoke measurable effects on gastric emptying, postprandial GLP-1, insulin or glucose metabolism. However the addition of 30 g of oil and 3 g of sodium propionate to the pasta did reduce gastric emptying, increase GLP-1 and reduce glucose and insulin concentrations. While this short-term study may have implications in terms of reducing the risk of diabetes and improving coronary risk factor profiles the long term effects of these nutrients need to be studied.     

Casein and whey exert different effects on plasma amino acid profiles,gastrointestinal hormone secretion and appetite

Protein, generally agreed to be the most satiating macronutrient, may differ in its effects on appetite depending on the protein source and variation in digestion and absorption. We investigated the effects of two milk protein types, casein and whey, on food intake and subjective ratings of hunger and fullness, and on postprandial metabolite and gastrointestinal hormone responses. Two studies were undertaken. The first study showed that energy intake from a buffet meal ad libitum was significantly less 90 min after a 1700 kJ liquid preload containing 48 g whey, compared with an equivalent casein preload (P<0.05). In the second study, the same whey preload led to a 28 % increase in postprandial plasma amino acid concentrations over 3 h compared with casein (incremental area under the curve (iAUC), P<0.05). Plasma cholecystokinin (CCK) was increased by 60 % (iAUC, P<0.005), glucagon-like peptide (GLP)-1 by 65 % (iAUC, P<0.05) and glucose-dependent insulinotropic polypeptide by 36 % (iAUC, P<0.01) following the whey preload compared with the casein. Gastric emptying was influenced by protein type as evidenced by differing plasma paracetamol profiles with the two preloads. Greater subjective satiety followed the whey test meal (P<0.05). These results implicate post-absorptive increases in plasma amino acids together with both CCK and GLP-1 as potential mediators of the increased satiety response to whey and emphasise the importance of considering the impact of protein type on the appetite response to a mixed meal.     

Effect of Muesli with 4 g Oat β-Glucan on Postprandial Blood Glucose,Gastric Emptying and Satiety in Healthy Subjects: A Randomized Crossover Trial

Objective: Products enriched with oat β-glucan have been shown to reduce postprandial glucose and insulinemic responses. The aim of this study was to evaluate the effect of an extruded muesli product based on oat β-glucan on the rate of gastric emptying, postprandial blood glucose and satiety in healthy subjects.

Methods: Gastric emptying rate (GER) was measured by standardized real-time ultrasonography. Twelve healthy subjects were assessed using a randomized crossover double blind trial. The meals were administered after 8 hours’ fasting after measuring the subject's normal fasting blood glucose level. Blood glucose measurements were made before, 30 and 60 min after the end of the meal. Satiety scores were estimated 15 and 90 min after the end of the meal. The GER was calculated as the percentage change in the antral cross-sectional area 15 and 90 minutes after ingestion of vanilla yoghurt with muesli containing 4 g oat β-glucan (GER1) or vanilla yoghurt with muesli containing cornflakes (GER2).

Results: The median values were 60% for GER1 and 44% for GER2. The effect of 4 g oat β-glucan on the rate of gastric emptying was not statistically significant compared with corn flakes. Muesli with 4 g oat β-glucan lowered the postprandial glucose response significantly compared to the cornflakes meal (p = 0.045). The effect of oat β-glucan on satiety was not statistically significantly.

Conclusions: The results of this study suggest that intake of muesli with 4 g oat β-glucan does not affect the gastric emptying rate or satiety but lowers the postprandial blood glucose response, indicating that the GER does not regulate the blood glucose level.     

Acute effects of different dietary polysaccharides added in milk on food intake,postprandial appetite and glycemic responses in healthy young females

In the present study we compared the postprandial glycemic and satiety responses of different dietary polysaccharides when added in milk (2% M.F.). The objective of this study was to evaluate different polysaccharides against postprandial glucose, appetite responses and food intake at subsequent meal. In a repeated measures design, 30 females (18–30 years) consumed 250?ml milk 2% M.F. (control), or milk with carrageenan (2.5?g), guar gum (2.5?g) and alginate (2.5?g), followed by an ad libitum pizza meal after 120?min. Alginate and guar gum addition resulted in lower caloric intake at subsequent pizza meal. The post-treatment (0–120?min) glucose and average appetite were suppressed by alginate and guar gum (p?p?相似文献   

Plasma Free Amino Acid Responses to Intraduodenal Whey Protein,and Relationships with Insulin,Glucagon-Like Peptide-1 and Energy Intake in Lean Healthy Men

This study determined the effects of increasing loads of intraduodenal (ID) dairy protein on plasma amino acid (AA) concentrations, and their relationships with serum insulin, plasma glucagon-like peptide-1 (GLP-1) and energy intake. Sixteen healthy men had concentrations of AAs, GLP-1 and insulin measured in response to 60-min ID infusions of hydrolysed whey protein administered, in double-blinded and randomised order, at 2.1 (P2.1), 6.3 (P6.3) or 12.5 (P12.5) kJ/min (encompassing the range of nutrient emptying from the stomach), or saline control (C). Energy intake was quantified immediately afterwards. Compared with C, the concentrations of 19/20 AAs, the exception being cysteine, were increased, and this was dependent on the protein load. The relationship between AA concentrations in the infusions and the area under the curve from 0 to 60 min (AUC_{0–60 min}) of each AA profile was strong for essential AAs (R² range, 0.61–0.67), but more variable for non-essential (0.02–0.54) and conditional (0.006–0.64) AAs. The AUC_{0–60 min} for each AA was correlated directly with the AUC_{0–60 min} of insulin (R² range 0.3–0.6), GLP-1 (0.2–0.6) and energy intake (0.09–0.3) (p < 0.05, for all), with the strongest correlations being for branched-chain AAs, lysine, methionine and tyrosine. These findings indicate that ID whey protein infused at loads encompassing the normal range of gastric emptying increases plasma concentrations of 19/20 AAs in a load-dependent manner, and provide novel information on the close relationships between the essential AAs, leucine, valine, isoleucine, lysine, methionine, and the conditionally-essential AA, tyrosine, with energy intake, insulin and GLP-1.     

Exendin-4, a GLP-1 receptor agonist, modulates the effect of macronutrients on food intake by rats

The hypothesis that peripheral GLP-1 modulates the effect of macronutrients on food intake in rats was tested by administration of its agonist, exendin-4. The effect of exendin-4 on food intake suppression and blood glucose after carbohydrate, fat and protein preloads was measured. Exendin-4 reduced the effect of glucose preloads on food intake only during the first 30 min (P = 0.01) of feeding, but had a more prolonged effect when given with corn oil (P < 0.01 at 0-0.5 h and 0-1 h, P = 0.055 at 0-2 h, and P = 0.07 at 0-3 h) and whey (P < 0.05 at 0-1 h, P = 0.06 at 0-2 h, and P = 0.07 at 0-3 h) preloads. Blood glucose measured over 2 h was reduced at 15 min when given with glucose (P < 0.01), unchanged when given with corn oil and increased at 60 and 120 min when given with whey (P < 0.01). Thus, the effect of exendin-4 on the feeding response depended on the composition of the macronutrient preloads and seems to be independent of blood glucose concentrations.     

Gastric emptying, glucose metabolism and gut hormones: evaluation of a common preoperative carbohydrate beverage

Objective

To study the gastric-emptying rate and gut hormonal response of two carbohydrate-rich beverages. A specifically designed carbohydrate-rich beverage is currently used to support the surgical patient metabolically. Fruit-based beverages may also promote recovery, due to natural antioxidant and carbohydrate content. However, gastric emptying of fluids is influenced by its nutrient composition; hence, safety of preoperative carbohydrate loading should be confirmed. Because gut hormones link carbohydrate metabolism and gastric emptying, hormonal responses were studied.

Methods

In eight volunteers, gastric emptying rates of both 400 mL of a ready-to-use beverage (A: Nutricia preOp; 50.4 g carbohydrates—mainly polysaccharides; 260 mOsm/kg) and 400 mL over-the-counter fruit-based lemonade (B: Roosvicee Original; 48 g carbohydrates—mainly fruit-associated saccharides; 805 mOsm/kg) were determined scintigraphically (using hepatate Tc-99^m) according to a crossover design. Plasma glucose, insulin, C-peptide, glucagon-like peptide (GLP-1), peptide YY, total glucagon, and ghrelin were studied.

Results

Gastric emptying showed no differences in residual volumes. Earlier onset in emptying for beverage A versus B was observed (trend), with significantly higher glucose, insulin, C-peptide, and glucagon responses at 15-90 min. GLP-1 was inversely related to residual volume.

Conclusion

Fruit-based lemonade is a safe alternative for preoperative purposes. It induces a more limited glucose, insulin, and C-peptide response. Later onset in gastric emptying (B versus A: trend), lower glucagon release, and differences in beverage content and osmolarity may have contributed to those differences. Efficient emptying was reflected by early GLP-1 levels.     

Effect of whey on blood glucose and insulin responses to composite breakfast and lunch meals in type 2 diabetic subjects

BACKGROUND: Whey proteins have insulinotropic effects and reduce the postprandial glycemia in healthy subjects. The mechanism is not known, but insulinogenic amino acids and the incretin hormones seem to be involved. OBJECTIVE: The aim was to evaluate whether supplementation of meals with a high glycemic index (GI) with whey proteins may increase insulin secretion and improve blood glucose control in type 2 diabetic subjects. DESIGN: Fourteen diet-treated subjects with type 2 diabetes were served a high-GI breakfast (white bread) and subsequent high-GI lunch (mashed potatoes with meatballs). The breakfast and lunch meals were supplemented with whey on one day; whey was exchanged for lean ham and lactose on another day. Venous blood samples were drawn before and during 4 h after breakfast and 3 h after lunch for the measurement of blood glucose, serum insulin, glucose-dependent insulinotropic polypeptide (GIP), and glucagon-like peptide 1 (GLP-1). RESULTS: The insulin responses were higher after both breakfast (31%) and lunch (57%) when whey was included in the meal than when whey was not included. After lunch, the blood glucose response was significantly reduced [-21%; 120 min area under the curve (AUC)] after whey ingestion. Postprandial GIP responses were higher after whey ingestion, whereas no differences were found in GLP-1 between the reference and test meals. CONCLUSIONS: It can be concluded that the addition of whey to meals with rapidly digested and absorbed carbohydrates stimulates insulin release and reduces postprandial blood glucose excursion after a lunch meal consisting of mashed potatoes and meatballs in type 2 diabetic subjects.     

Dietary guar gum effects on postprandial blood glucose, insulin and hydroxyproline in humans

Meals (425 kcal) containing various doses of guar gum (0, 2.5, 7.5 or 12.5 g) were ingested by nine healthy male subjects after a 12-h fast. The rise in blood glucose was higher after the control meal without guar gum than after the guar gum-containing meals, which all gave a similar rise in glucose. In contrast, increased doses of guar gum led to a greater reduction in the postprandial rise in insulin. The postprandial increase in serum hydroxyproline, an amino acid added to all meals, was decreased in a similar manner by all of the guar gum doses. Gastric emptying was measured after the control meal without guar gum and the meal containing 12.5 g of guar gum by monitoring 51Cr, which was added to the meals. Guar gum was found to reduce the variation between individuals, as well as the initial rate of gastric emptying, which correlated with changes in both serum hydroxyproline (rs = 0.93, P less than 0.01) and blood glucose (rs = 0.83, P less than 0.01). The effectiveness of guar gum in reducing postprandial response was lost after heating and homogenization for canning. A threshold in the reduction in rise of glucose or hydroxyproline was reached with the lowest dose (2.5 g) of viscous guar gum; larger doses had no additional effects. The reduced absorption seems to be an effect of a slower gastric emptying rate.     

Effect of guar gum on gastric emptying of test meals of varying energy content in growing pigs

1. Existing information on whether the action of guar gum in decreasing postprandial blood glucose concentrations is due, at least in part, to a reduced rate of gastric emptying is conflicting, possibly because three types of test meals have been used. In order to test whether the type of test meal used influences the action of guar gum, these three types of meal were compared, either without or with guar gum, in growing pigs. The meals were: a high-energy meal (HEM), a low-energy milky drink (LEMD) and a glucose drink (GD). 2. Six pigs were prepared with a simple gastric cannula which allowed complete removal of the stomach contents just before or 0.5, 1, 2 or 4 h after feeding. 3. The three types of test meal without guar gum gave rise to very different postprandial profiles of gastric pH and of digesta and dry matter (DM) emptying from the stomach. 4. Addition of guar gum to the GD significantly raised gastric pH at 0.5 and 1 h after feeding but, when it was added to HEM, gastric pH was only significantly raised 4 h after feeding. No significant effect on gastric pH was seen when guar gum was added to LEMD. 5. Although addition of guar gum to GD had no significant effect on the emptying of digesta from the stomach, when added to HEM the rate of emptying of digesta was significantly reduced 1, 2 and 4 h after feeding. Addition of guar gum to LEMD only significantly increased the amount of digesta remaining in the stomach 2 h after feeding. 6. There was no significant effect on the emptying of DM from the stomach when guar gum was added to either HEM or LEMD. However, addition of guar gum to GD significantly reduced the mean rate of emptying of DM 0.5 h after feeding. 7. Addition of guar gum to either LEMD or GD had no significant effect on the DM concentration of the evacuated gastric digesta. However, addition of guar gum to HEM significantly lowered the DM concentration of the evacuated gastric digesta 1, 2 and 4 h after feeding. 8. It was concluded that differences in test meal composition and also in the methods used to measure gastric emptying could account for the discrepancies previously reported. The results suggest that although guar gum may reduce the rate of gastric emptying under some conditions, this is unlikely to be the only mechanism by which it acts.     

Effect of Different Nutritional Supplements on Glucose Response of Complete Meals in Two Crossover Studies

Postprandial hyperglycemia is an important risk factor in the development and progression of type-2 diabetes and cardiometabolic diseases. Therefore, maintaining a low postprandial glucose response is key in preventing these diseases. Carbohydrate-rich meals are the main drivers of excessive glycemic excursions during the day. The consumption of whey protein premeals or mulberry leaf extract was reported to reduce postprandial glycemia through different mechanisms of action. The efficacy of these interventions was shown to be affected by the timing of the consumption or product characteristics. Two randomised crossover studies were performed, aiming to identify the optimal conditions to improve the efficacy of these nutritional supplements in reducing a glycemic response. The acute postprandial glycemic response was monitored with a continuous glucose monitoring device. The first study revealed that a preparation featuring 10 g of whey protein microgel reduced the postprandial glucose response by up to 30% (p = 0.001) and was more efficient than the whey protein isolates, independently of whether the preparation was ingested 30 or 10 min before a complete 320 kcal breakfast. The second study revealed that a preparation featuring 250 mg mulberry leaf extract was more efficient if it was taken together with a complete 510 kcal meal (−34%, p < 0.001) rather than ingested 5 min before (−26%, p = 0.002). These findings demonstrate that the efficacy of whey proteins premeal and mulberry leaf extracts can be optimised to provide potential nutritional solutions to lower the risk of type-2 diabetes or its complications.     

Co-Ingestion of Whey Protein with a Carbohydrate-Rich Breakfast Does Not Affect Glycemia,Insulinemia or Subjective Appetite Following a Subsequent Meal in Healthy Males

We aimed to assess postprandial metabolic and appetite responses to a mixed-macronutrient lunch following prior addition of whey protein to a carbohydrate-rich breakfast. Ten healthy males (age: 24 ± 1 years; body mass index (BMI): 24.5 ± 0.7 kg/m²) completed three trials in a non-isocaloric, crossover design. A carbohydrate-rich breakfast (93 g carbohydrate; 1799 kJ) was consumed with (CHO + WP) or without (CHO) 20 g whey protein isolate (373 kJ), or breakfast was omitted (NB). At 180 min, participants consumed a mixed-macronutrient lunch meal. Venous blood was sampled at 15 min intervals following each meal and every 30 min thereafter, while subjective appetite sensations were collected every 30 min throughout. Post-breakfast insulinemia was greater after CHO + WP (time-averaged area under the curve (AUC_{0–180 min}): 193.1 ± 26.3 pmol/L), compared to CHO (154.7 ± 18.5 pmol/L) and NB (46.1 ± 8.0 pmol/L; p < 0.05), with no difference in post-breakfast (0–180 min) glycemia (CHO + WP, 3.8 ± 0.2 mmol/L; CHO, 4.2 ± 0.2 mmol/L; NB, 4.2 ± 0.1 mmol/L; p = 0.247). There were no post-lunch (0–180 min) effects of condition on glycemia (p = 0.492), insulinemia (p = 0.338) or subjective appetite (p > 0.05). Adding whey protein to a carbohydrate-rich breakfast enhanced the acute postprandial insulin response, without influencing metabolic or appetite responses following a subsequent mixed-macronutrient meal.     

Impact of preloading either dairy or soy milk on postprandial glycemia,insulinemia and gastric emptying in healthy adults

Purpose

Milk protein ingestion reduces post-meal glycemia when consumed either before or together with carbohydrate foods. The aim of this study was to compare the effects of dairy and soy milk consumed either before (preload) or together with (co-ingestion) a carbohydrate (bread), on postprandial blood glucose, insulin and gastric emptying in healthy participants.

Methods

Twelve healthy Chinese male participants were studied on five separate occasions using a randomized crossover design. White wheat bread consumed with water was used as a reference meal. Capillary and venous bloods were sampled pretest and 3.5 h post-test meal for glucose and insulin measurement. Gastric emptying was measured using real-time ultrasonography.

Results

Co-ingestion of dairy milk or soy milk with bread lowered postprandial blood glucose response and glycemic index. Co-ingesting soy milk with bread increased insulin response and insulinemic index significantly compared to co-ingestion of dairy milk and preload treatments. Preloads (30 min prior to bread) significantly lowered postprandial glycemia and insulinemia compared to co-ingestion. Gastric emptying was slower after co-ingesting dairy milk with bread than after reference meal.

Conclusions

Preloading either soy milk or dairy milk results in greater reduction in glycemic response compared to co-ingestion alone. This dietary practice may have therapeutic advantage in communities consuming high GI diets. Optimal glucose control may have the potential for increasing the time of transition from prediabetes to type 2 diabetes in Asian communities.

Clinical trial registration

This trial was registered at clinicaltrials.gov as NCT 02151188.

     

Diet and physical activity are associated with suboptimal weight loss and weight regain 10–15 years after Roux-en-Y gastric bypass: A cross-sectional study

IntroductionSuboptimal weight loss (SWL) after bariatric surgery affects approximately 30% of the patients in the long-term. Diet and physical activity (PA) are likely to modulate long term weight loss outcomes after Roux-en-Y gastric bypass (RYGB).ObjectivesTo compare food habits and PA levels between those experiencing SWL and optimal weight loss (OWL), and between those experiencing weight regain (WR) and no weight regain (NWR), 10–15 years after RYGB, in addition to a pre-operative control group.MethodsParticipants were recruited from the Bariatric Surgery Observation Study (BAROBS), ≥ 10 y after RYGB. Food intake was assessed by a Food Frequency Questionnaire (FFQ) and PA levels with Sensewear armbands.Results75 participants (79% females) were recruited. Excess weight loss (EWL) was 17 ± 19% and 87 ± 22% in the SWL and OWL groups, respectively and WR was 31 ± 15% and 1 ± 11% in the WR and NWR groups, respectively (P < 0.001 for both). The OWL group reported a lower energy intake (P = 0.012) than the control group. The control group reported a higher intake of milk, cream and cheese than both SWL group (P = 0.008) and OWL group (P < 0.001). The SWL group reported a higher intake of processed meat products than the OWL group, while the OWL group reported a lower intake of sauces than both the SWL and the control groups (P < 0.001 and P = 0.005, respectively). The OWL group reported a lower intake of cakes, sugar and sweets than both SWL group (P = 0.035) and control group (P = 0.021). The WR group reported a lower PA duration (P = 0.046) compared with the NWR group. EWL was positively, and WR negatively, correlated with average PA duration.ConclusionA high intake of energy-dense foods and low PA is associated with poor weight loss outcomes, namely SWL and WR, 10–15 years after RYGB.     

Role of protein and carbohydrate sources on acute appetite responses in lean and overweight men

Dietary protein induces greater satiety compared with carbohydrate in lean subjects, which may involve appetite-regulatory gut hormones. Little is known about the duration of effect, influence of protein and carbohydrate source and relevance to non-lean individuals. We compared the effect of various dietary proteins and carbohydrates on post-prandial appetite ratings, ad libitum energy intake (EI) and appetite hormones in lean and overweight men. Three randomised double-blinded cross-over studies examined appetite response (appetite ratings, ghrelin, glucagon-like peptide-1 (GLP-1) and cholecystokinin) to liquid preloads over three to four hours followed by a buffet meal to assess ad libitum EI. The 1-MJ preloads contained ∼55 g of protein (whey, casein, soy and gluten), carbohydrate (glucose, lactose and fructose) or combined whey/fructose. EI was 10% higher following glucose preloads compared with protein preloads, observed at three hours but not four hours. Protein ingestion was followed by prolonged elevation of cholecystokinin and GLP-1 (two hours) and suppression of ghrelin (three to four hours) compared with glucose and independent of protein type. Replacing some whey with fructose attenuated the effect of protein on these hormones. Treatment effects on EI and appetite hormones were independent of bodyweight status, despite higher GLP-1 and lower ghrelin in overweight subjects. Protein-rich liquid preloads reduce EI over three hours in overweight men compared with glucose. These findings suggest a potential application for protein-rich drinks and/or foods to facilitate reduced EI. Future studies should explore additional dietary manipulations that may enhance this relationship, and confirm these effects within the context of energy-restricted dietary patterns.