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Purpose: We determined the effects of different environmental temperatures on exercise-induced gastrointestinal (GI) damage and delayed gastric emptying (GE) rate. Methods: Eleven trained males completed three trials on different days, consisting of (1) exercise in a thermoneutral environment (CON, 23 °C), (2) exercise in a hot environment (HOT, 35 °C), and (3) exercise in a cold environment (COLD, 10 °C). The subjects performed high-intensity interval-type endurance exercises in all trials. Blood intestinal fatty acid binding protein (I-FABP) levels was determine before and after exercise. We evaluated Tmax (time when the 13C-excretion/h reached a maximum level) as an indication of the GE rate during post-exercise. Results: Rectal temperature during exercise was significantly higher (P < 0.001) in the HOT (38.7 ± 0.3 °C) trial compared with the CON (38.2 ± 0.3 °C) and COLD (38.2 ± 0.3 °C) trials, with no significant difference between the CON and COLD trials. Plasma I-FABP level after exercise (relative to the pre-exercise level) were significantly greater (P = 0.005) in the HOT trial (92.9 ± 69.6%) than in the CON (37.2 ± 31.6%) and COLD (37.6 ± 41.8%) trials. However, there was no significant difference between the CON and COLD trials. Moreover, the Tmax was delayed significantly (P = 0.006) in the HOT trial compared with the CON and COLD trials, with no significant difference between the CON and COLD trials. Conclusion: GI function following endurance exercise was similar between thermoneutral and cold environments, while endurance exercise in a hot environment exacerbated GI function compared with thermoneutral and cold environments. [ABSTRACT FROM AUTHOR]

Starch digestion rate and location in the gastrointestinal tract (GIT) are critical for human health. This review aims to present a comprehensive summary on our current understanding of physiological, biochemical, anatomical and geometrical factors of human digestive system that are related to in vivo starch digestibility. It is shown that all digestive compartments including mouth, stomach, small intestine, and large intestine play critical roles in regulating the overall starch digestion process. A proper investigation of starch digestion pattern should thus be based on the consideration of all these compartments. Main biological factors are summarized as oral mastication and salivation, gastric emptying and motility, small intestinal enzymes and motility, large intestinal resistant starch (RS)-microbiota interactions and gut-brain feedback control, as well as glucose adsorption and hormonal feedback control. However, connections among these biological factors in determining starch digestive behaviors remain elusive. This is due to the inherent complexity of human GIT anatomy, motility and biochemical conditions, as well as ethical, financial and technical issues in conducting clinical studies. Much technological and scientific efforts from both clinical studies and in vitro simulation models are required for a better understanding of in vivo starch digestion behaviors.

Objective: The present study aimed to use bedside ultrasound to evaluate the effects of metoclopramide on gastric motility in patients being treated for trauma in the emergency department. Methods: Fifty patients underwent an ultrasound immediately after attending the emergency department of Zhang Zhou Hospital due to trauma. The patients were randomly divided into two groups: a metoclopramide group (group M, n = 25) and a normal saline group (group S, n = 25). The cross-sectional area (CSA) of the gastric antrum was measured at 0, 30, 60, 90, and 120 min (T = time). The gastric emptying rate (GER, GER = -[(AareaTn/AareaTn-30) - 1] × 100), GER/min (GER divided by the corresponding interval time), gastric content properties, Perlas grade at different time points, T120 gastric volume (GV), and GV per unit of body weight (GV/W) were evaluated. The risk of vomiting, reflux/aspiration, and type of anesthetic treatment were also evaluated. Results: The differences between the two groups in the CSA of the gastric antrum at each time point were statistically significant (p < 0.001). The CSAs of the gastric antrum in group M were lower than those in group S, and the greatest difference between the two groups occurred at T30 (p < 0.001). The differences between the two groups in GER and GER/min were also statistically significant (p < 0.001); those differences in group M were higher than those in group S, and the greatest differences between the two groups occurred at T30 (p < 0.001). There were no obvious change trends in the properties of the gastric contents and the Perlas grades in either group, and the differences between the two groups were not statistically significant (p = 0.97). The differences between the two groups in the GV and GV/W at T120 were statistically significant (p < 0.001), as was the risk of reflux and aspiration at T120 (p < 0.001). Conclusion: When metoclopramide was used in satiated emergency trauma patients, it accelerated gastric emptying within 30 min and reduced the risk of accidental reflux. However, a normal gastric emptying level was not achieved, which can be attributed to the delaying effect of trauma on gastric emptying. [ABSTRACT FROM AUTHOR]

To determine the effects of heat acclimation on gastrointestinal (GI) damage and the gastric emptying (GE) rate following endurance exercise in a hot environment. Fifteen healthy men were divided into two groups: endurance training in hot (HOT, 35 °C, n = 8) or cool (COOL, 18 °C, n = 7) environment. All subjects completed 10 days of endurance training (eight sessions of 60 min continuous exercise at 50% of the maximal oxygen uptake ( V · O 2 max ). Subjects completed a heat stress exercise tests (HST, 60 min exercise at 60% V · O 2 max ) to evaluate the plasma intestinal fatty acid-binding protein (I-FABP) level and the GE rate following endurance exercise in a hot environment (35 °C) before (pre-HST) and after (post-HST) the training period. We assessed the GE rate using the 13C-sodium acetate breath test. The core temperature during post-HST exercise decreased significantly in the HOT group compared to the pre-HST (p = 0.004) but not in the COOL group. Both the HOT and COOL groups showed exercise-induced plasma I-FABP elevations in the pre-HST (p = 0.002). Both groups had significantly attenuated exercise-induced I-FABP elevation in the post-HST. However, the reduction of exercise-induced I-FABP elevation was not different significantly between both groups. GE rate following HST did not change between pre- and post-HST in both groups, with no significant difference between two groups in the post-HST. Ten days of endurance training in a hot environment improved thermoregulation, whereas exercise-induced GI damage and delay of GE rate were not further attenuated compared with training in a cool environment. [ABSTRACT FROM AUTHOR]

[Display omitted] Modifications to the small intestine and liver are known to occur during the symptomatic disease period of amyotrophic lateral sclerosis (ALS), a member of the motor neuron disease (MND) family of neurodegenerative disorders. How these modifications impact on oral absorption and pharmacokinetics of drugs remains unknown. In this study, model drugs representing different mechanisms of intestinal transport (caffeine for passive diffusion, digoxin for P-glycoprotein efflux, and sulfasalazine for breast cancer resistance protein efflux) were administered via oral gavage to postnatal day 114–120 male and female SOD1G93A mice (model of familial ALS) and wild-type (WT) littermates. Samples of blood, brain and spinal cord were taken at either 15, 30, 60 or 180 min after administration. In addition, the in vivo gastric emptying of 70 kDa fluorescein isothiocyanate-dextran (FITC-dextran) and the ex vivo intestinal permeability of caffeine were assessed. The area under the plasma concentration–time curves (AUC plasma) of digoxin and sulfasalazine were not significantly different between SOD1G93A and WT mice for both sexes. However, the AUC plasma of caffeine was significantly lower (female: 0.79-fold, male: 0.76-fold) in SOD1G93A compared to WT mice, which was associated with lower AUC brain (female: 0.76-fold, male: 0.80-fold) and AUC spinal cord (female: 0.81-fold, male: 0.82-fold). The AUC stomach of caffeine was significantly higher (female: 1.5-fold, male: 1.9-fold) in SOD1G93A compared to WT mice, suggesting reduced gastric emptying in SOD1G93A mice. In addition, there was a significant reduction in gastric emptying of FITC-dextran (0.66-fold) and ex vivo intestinal permeability of caffeine (0.52-fold) in male SOD1G93A compared to WT mice. Reduced systemic and brain/spinal cord exposure of caffeine in SOD1G93A mice may therefore result from alterations to gastric emptying and small intestinal permeability. Specific dosing requirements may therefore be required for certain medicines in ALS to ensure that they remain in a safe and effective concentration range. [ABSTRACT FROM AUTHOR]

Background Epidemiologic and some clinical studies support the view that whole grain foods have lower glycemic response than refined grain foods. However, from the perspective of food material properties, it is not clear why whole grain cereals containing mostly insoluble and nonviscous dietary fibers (e.g. wheat) would reduce postprandial glycemia. Objectives We hypothesized that glycemic response for whole grain wheat milled products would not differ from that of refined wheat when potentially confounding variables (wheat source, food form, particle size, viscosity) were matched. Our objective was to study the effect of whole grain wheat compared with refined wheat milled products on postprandial glycemia, gastric emptying, and subjective appetite. Methods Using a randomized crossover design, healthy participants (n  = 16) consumed 6 different medium-viscosity porridges made from whole grain wheat or refined wheat milled products, all from the same grain source and mill: whole wheat flour, refined wheat flour, cracked wheat, semolina, reconstituted wheat flour with fine bran, and reconstituted wheat flour with coarse bran. Postprandial glycemia, gastric emptying, and appetitive response were measured using continuous glucose monitors, the 13C-octanoic acid (8:0) breath test, and visual analog scale (VAS) ratings. Bayes factors were implemented to draw inferences about null effects. Results Little-to-no differences were observed in glycemic responses, with lower incremental AUC between 0 and 120 min glycemic responses only for semolina [mean difference (MD): −966 mg min/dL; 95% CI: −1775, −156 mg min/dL; P = 0.02) and cracked wheat (MD: −721 mg min/dL; 95% CI: −1426, −16 mg min/dL; P = 0.04) than for whole wheat flour porridge. Bayes factors suggested weak to strong evidence for a null effect (i.e. no effect of treatment type) in glycemic response, gastric emptying, and VAS ratings. Conclusions Although whole grain wheat foods provide other health benefits, they did not in their natural composition confer lower postprandial glycemia or gastric emptying than their refined wheat counterparts. This trial was registered at clinicaltrials.gov as NCT03467659. [ABSTRACT FROM AUTHOR]

Background and Objectives: To investigate the effects of oral preoperative regimens on gastric emptying time in relation to BMI in Chinese adults.Methods and Study Design: The enrolled 56 adults were divided into three groups (normal-weight, underweight, and overweight) and completed a regimen of two drinks after a 2-week interval. After drinking a carbohydrate regimen (CD, 50 g carbohydrates) or a carbohydrate glutamine regimen (CGD, 44 g carbohydrates and 6 g glutamine) labelled with 99mTc-DTPA (99mTc-diethylenetriaminepentaacetic acid), gastric emptying times T50 and T90 were measured using a curve derived from scintigraphic images.Results: T50 and T90 had no significant difference between the CD and CGD regimens. T50 was significantly delayed in the underweight participants (BMI <18.5 kg/m2, as Chronic Energy Deficiency, CED) compared with the normal-weight participants after drinking CD (p=0.003) or CGD (p=0.002), as well as T90 after CD (p=0.019). There was no difference in glucose concentrations between the three groups. There are negative correlations between body weight and gastric emptying time T50 (r=-0.461, p=0.016) or T90 (r=-0.553, p=0. 003) after drinking CD, as well as T50 (r=-0.553, p=0.003) after drinking CGD.Conclusions: Underweight adults should be careful to take oral preoperative regimens 2 hours before surgery and consider reducing the volume because of a slower gastric emptying rate. [ABSTRACT FROM AUTHOR]

Abstract Background Exercise reduces the amount of visceral adipose tissue (VAT) and the risk of cardiometabolic diseases. The underlying mechanisms responsible for these exercise-induced adaptations are unclear, but they may involve lipolytic actions of interleukin-6 (IL-6). Contracting skeletal muscles secrete IL-6, leading to increased circulating IL-6 levels in response to exercise. The aim of this study is to investigate whether IL-6 is involved in mediating the effects of exercise on visceral and epicardial adipose tissue volume and glycaemic control. Methods/design Seventy-five physically inactive males and females aged > 18 years with a waist-to-height ratio > 0.5 and/or waist circumference ≥ 88 cm (females) or ≥ 102 cm (males) are being recruited to participate in a 12-week intervention study. Participants are randomly allocated to one of five groups (1:1:1:1:1). Two groups consist of supervised endurance exercise training combined with the IL-6 blocker tocilizumab (ET) or saline used as placebo (EP), two groups consist of no exercise combined with tocilizumab (NT) or placebo (NP), and one group consists of resistance exercise and placebo (RP). Although the study is an exploratory trial, the primary outcome is change in VAT volume from before to after intervention, with secondary outcomes being changes in (1) epicardial adipose tissue, (2) pericardial adipose tissue and (3) gastric emptying. Depots of adipose tissue are quantitated by magnetic resonance imaging Gastric emptying and glucose metabolism are assessed using mixed-meal tolerance tests. Discussion Understanding the role of IL-6 in mediating the effects of exercise on visceral and epicardial adipose tissue and glycaemic control may lead to novel therapeutic approaches in the prevention of cardiometabolic diseases. Trial registration ClinicalTrials.gov, NCT02901496. Registered on 1 August 2016 and posted retrospectively on 15 September 2016.

Objective: To study the relationship between the amount of surgery-induced gastric volume reduction and long-term weight loss and glucose tolerance. Background data: Vertical sleeve gastrectomy (VSG) has recently surpassed gastric bypass to become the most popular surgical intervention to induce sustained weight loss. Besides inducing significant weight loss, VSG also improves glucose tolerance. Although no clear correlation has been observed between the size of the residual stomach and sustained weight loss, this begs the question whether less aggressive gastric volume reduction may provide sufficient efficacy when weight loss is not the major goal of the surgical intervention. Methods: A series of strategies to reduce gastric volume were developed and tested in Long Evans male rats, namely: VSG, Fundal (F)-Resection, Gastric Sleeve Plication (GSP), Fundal-Plication, and Fundal-Constrained. Results: All surgical interventions resulted in a reduction of gastric volume relative to sham, but none of the interventions were as effective as the VSG. Gastric volume was linearly correlated to increased gastric emptying rate as well as increased GLP-1 response. Overall, cumulative food intake was the strongest correlate to weight loss and was logarithmically related to gastric volume. Regression modeling revealed a nonlinear inverse relation between body weight reduction and gastric volume, confirming that VSG is the only effective long-term weight loss strategy among the experimental operations tested. Conclusions: The data suggest a minimum threshold volume of the residual stomach that is necessary to induce sustained weight loss. Although all gastric volume interventions increased the GLP-1 response, none of the interventions, except VSG, significantly improved glucose tolerance. In conclusion, if weight loss is the primary goal of surgical intervention, significant volume reduction is required, and this most likely requires excising gastric tissue. [ABSTRACT FROM AUTHOR]

Postprandial regulation of the gastric emptying (GE) rate plays an important role in food intake. Although oral sweetening with glucose may accelerate GE, the effects of different sweetness intensities of glucose (10% and 20%, w/v) and other energy sweeteners (e.g. fructose and sucrose) remain uncertain. The purpose of this study was to determine the effects of different glucose concentrations (Experiment 1) and different sugars with the same sweet taste intensity (Experiment 2) on postprandial GE. In both experiments, after ingesting a 200 kcal carbohydrate solution containing 50 g of maltodextrin, participants repeatedly sipped, but did not swallow, one of three (water, 10% and 20%, w/v glucose) or four (water and equally sweet 20%, w/v glucose, 12%, w/v fructose, and 14%, w/v sucrose) solutions for 1 min every 5 min over a 30 min period. GE was evaluated by measuring the temporal change in the cross-sectional area of the gastric antrum using ultrasound. In Experiment 1, oral stimulation with 20% (w/v) glucose resulted in greater GE than the control stimulus (i.e. water), but the effect of stimulation with 10% (w/v) glucose on GE was not different from that of the control stimulus. In Experiment 2, stimulation with 20% (w/v) glucose or 12% (w/v) fructose resulted in greater GE than the control stimulus. However, the effect of stimulation with 14% (w/v) sucrose on GE did not differ from that of the control stimulus. Consequently, oral stimulation with glucose or fructose solutions of moderate to high sweetness following a meal facilitates postprandial GE., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Objective: To explore the damage of cisplatin to the structure and function of cajal interstitial cells(ICCs)in gastric tissue and the protective effect of curcumin. Methods: Adult kunming male mice were randomly divided into control group (NC), cisplatin group(DDP)and cisplatin+curcumin group(DDP+Cur) with 10 mice in each group. Curcumin(200 mg/kg/d)mixed with the suspension by intragastric administration for a total period of 15 days. Intraperitoneal injection of cisplatin (2 mg/kg/d) was started from the last 5th day, for a total of 5 days. The weight gain and loss of each mouse on the last 5 days were calculated, and the gastric emptying rate of each mouse was measured after stopping the drug for 24 h. The ultrastructure of ICC in gastric tissue was detected by electron microscope and the expression ofAno1 protein and mRNAin gastric tissue, which specifically responded to the changes of ICCs, were detected also. Results: The weight and gastric emptying rate of mice were significantly decreased after injection of cisplatin (P<0.01). Compared with cisplatin group, cisplatin+curcumin group had less weight loss (P<0.01) and gastric emptying rate were significantly increased(P<0.05). After injection of cisplatin, ICCs in gastric tissue were damaged, especially the gap junctions between peripheral nerve and muscular cells were winden or even broken, and curcumin could alleviate these damage. In addation, the expression of Ano1mRNA and protein in cisplatin group decreased (P<0.01), while it was improved significantly in cisplatin+curcumin group (P<0.05). Conclusion: Curcumin can reduce cisplatin-induced structural damage of ICC by increasing the expression of Ano1 and incraesing the function of slow waves generation. [ABSTRACT FROM AUTHOR]

The ingestion of fructose is of interest due to previously reported differences in gastrointestinal, appetite, and metabolic effects when compared to glucose ingestion when ingested in liquid solution. The aim of this study was to examine these variables when fructose and glucose are added to a semi-solid meal. Seven healthy male participants completed three experimental trials involving the ingestion of 300 mL of semi-skimmed milk mixed with 40 g of instant porridge mix (CON) and with the addition of either 40 g of glucose (GLU) or fructose (FRU). Subjective feelings of appetite were assessed for 2 h after ingestion with blood samples collected at regular intervals. Gastric emptying rate was assessed using the 13C breath test method. Half emptying time was not different between trials (CON = 159 ± 51 min; GLU = 197 ± 46 min; FRU = 198 ± 67 min: P = 0.117). No differences were observed for any subjective measurements of appetite (P > 0.05) while blood glucose was elevated (P < 0.05) 20 min after ingestion on both GLU and FRU with this tending to be higher on GLU than FRU. FRU resulted in greater (P < 0.05) blood lactate concentrations than on the other trials. The results of this study demonstrate that gastric emptying rate of glucose and fructose is similar when ingested in a semi-solid meal. In addition, there is little difference in appetite response between these sugars, however, there are some differences in metabolic response which deserve further study.

Gastric emptying rate in humans is subject to large individual variability, but previous research on the influence of genetics is scarce. Variation in the glucagon-like peptide-1 receptor (GLP1R) gene is a plausible candidate gene to partially explain the high variance. This study aimed to investigate the influence of genetic variation in the GLP1R gene on gastric emptying rate of a glucose solution in humans. Forty eight healthy Caucasian males took part in this investigation. Gastric emptying rate of a 6% glucose solution was assessed using the 13C breath test method and a venous blood sample was obtained from each participant. Participants were genotyped for 27 Tag single nucleotide polymorphisms (SNPs) in the GLP1R locus using Sequenom MassARRAY iPLEX GOLD analysis and MALDI-TOF mass spectrometry. The time at which maximal emptying rate occurred (Tlag) was faster in participants with the CC genotype than in TT and TC genotypes for SNP rs742764: [median (quartiles) CC, 35 (30–36) min vs. TT, 43 (39–46) min, and TC, 41 (39–45) min; P < 0.01]. Tlag was also slower in participants with the AA genotype compared to the TT and TA genotypes for SNP rs2254336: [AA, 43 (39–49) min vs. TT, 36 (34–41) min, and TA, 39 (35–42) min; P < 0.05]. Analysis by phenotype also showed differences in half-emptying time (T12) and Tlag for SNPs rs9283907, rs2268657, and rs2254336. Several neighboring Tag SNPs within the GLP1R gene were found to be associated with gastric emptying rate, and should be further investigated.

This study examined the effects of post-resistance exercise protein ingestion timing on the rate of gastric emptying (GE) and blood glucose (BG) and plasma branched-chain amino acid (BCAA) responses. In all, eleven healthy participants randomly ingested 400 ml of a nutrient-rich drink containing 12 g carbohydrates and 20 g protein at rest (Con), at 5 min (post-exercise (PE)-5) or at 30 min (PE-30) after a single bout of strenuous resistance exercises. The first and second sets comprised ten repetitions at 50 % of each participant's one-repetition maximum (1RM). The third, fourth and fifth sets comprised ten repetitions at 75 % of 1RM, and the sixth set involved repeated repetitions until exhaustion. Following ingestion of the nutrient-rich drink, we assessed the GE rate using 13C-sodium acetate breath test and evaluated two parameters according to the T max-calc (time when the recovery per hour is maximised), which is a standard analytical method, and T 1/2 (time when the total cumulative dose of [13CO2] reaches one-half). T max-calc and T 1/2 were slower for the PE-5 condition than for either the PE-30 or Con condition (T max-calc; Con: 53 (sd 7) min, PE-5: 83 (sd 16) min, PE-30: 62 (sd 9) min, T 1/2; Con: 91 (sd 7) min, PE-5: 113 (sd 21) min, PE-30: 91 (sd 11) min, P <0·05). BG and BCAA responses were also slower for the PE-5 condition than for either the PE-30 or Con condition. Ingesting nutrients immediately after strenuous resistance exercise acutely delayed GE, which affected BG and plasma BCAA levels in blood circulation. [ABSTRACT FROM AUTHOR]

Gastroesophageal reflux disease (GERD) is an esophageal injury occurred when the stomach contents reflux abnormally into the esophagus. GERD complications include esophageal adenocarcinoma. Mosapride (MOS) is a safe prokinetic agent potentially used to treat GERD. Yet, its low solubility and bioavailability due to extensive first-pass metabolism limits its applications. This study aimed to formulate MOS nanostructured lipid carriers (MOS-NLCs) via the intranasal route to improve its bioavailability. Melt–emulsification low temperature–solidification technique using 23 full factorial design was adopted to formulate MOS-NLCs. Eight formulae were prepared and assessed in terms of entrapment efficiency (%EE), particle size, and in vitro release. Glycerol addition significantly reduced the particle sizes and improved %EE and %drug released. Surface modification using chitosan was applied. The optimized MOS surface-modified nanostructured lipid carriers (MOS-SMNLCs-F7)(stearic acid, 4% glycerol, 0.5% LuterolF127, 0.5% chitosan) showed low particle size 413.8 nm ± 11.46 nm and high %EE 90.19% ± 0.06% and a threefold increase in permeation of MOS with respect to the drug suspension. MOS-SMNLCs (F7) was also evaluated for its bioavailability compared with drug suspension and commercial product. Statistical analysis revealed a significant increase in gastric emptying rate to be 21.54 ± 1.88 contractions/min compared with10.02 ± 0.62 contractions/min and 8.9 ± 0.72 contractions/min for drug suspension and oral marketed product respectively. Pharmacokinetic studies showed 2.44-fold rise in bioavailability as compared to MOS suspension and 4.54-fold as compared to the oral marketed product. In vitro/in vivo studies proven to level A correlation between in vitro permeation through sheep nasal mucosa and in vivo absorption. Therefore, MOS-SMNLCs could be considered a step forward towards enhancing the clinical efficacy of Mosapride. [ABSTRACT FROM AUTHOR]

Gastric emptying rate in humans is subject to large individual variability, but previous research on the influence of genetics is scarce. Variation in the glucagon-like peptide-1 receptor (GLP1R) gene is a plausible candidate gene to partially explain the high variance. This study aimed to investigate the influence of genetic variation in the GLP1R gene on gastric emptying rate of a glucose solution in humans. Forty eight healthy Caucasian males took part in this investigation. Gastric emptying rate of a 6% glucose solution was assessed using the 13C breath test method and a venous blood sample was obtained from each participant. Participants were genotyped for 27 Tag single nucleotide polymorphisms (SNPs) in the GLP1R locus using Sequenom MassARRAY iPLEX GOLD analysis and MALDI-TOF mass spectrometry. The time at which maximal emptying rate occurred (Tlag) was faster in participants with the CC genotype than in TT and TC genotypes for SNP rs742764: [median (quartiles) CC, 35 (30–36) min vs. TT, 43 (39–46) min, and TC, 41 (39–45) min; P < 0.01]. Tlag was also slower in participants with the AA genotype compared to the TT and TA genotypes for SNP rs2254336: [AA, 43 (39–49) min vs. TT, 36 (34–41) min, and TA, 39 (35–42) min; P < 0.05]. Analysis by phenotype also showed differences in half-emptying time (T12) and Tlag for SNPs rs9283907, rs2268657, and rs2254336. Several neighboring Tag SNPs within the GLP1R gene were found to be associated with gastric emptying rate, and should be further investigated. [ABSTRACT FROM AUTHOR]

Introduction: Sodium hydrosulfide (NaHS) has shown to enhance the gastric emptying rate in normal rats but till now its effect on gastric emptying of food stuffs in diabetic rats was not investigated. Therefore, this study designed to determine the role of an oral administration of NaHS on gastric emptying rate (GER) of glucose, albumin and olive oil in gastroparetic and normal rats. Methods: To evaluate the effect of NaHS on the gastric emptying of glucose, albumin and olive oil in normal rats, thirty-six normal rats randomly assigned in six experimental groups (6 per group). Three groups of rats considered as control. They received albumin, glucose or olive oil orally. Three other normal groups considered as NaHS-treated animals. These groups received NaHS (320 μg/kg, orally) 30 min prior to food stuffs. To investigate the effect of NaHS on the gastric emptying of food stuffs in diabetic rats, the same protocols carried out. Thirty min after intragastric administration of food stuffs, animals received acetaminophen (as a marker for gastric emptying rate). Results: The results showed that in normal and gastroparetic rats, an oral administration of NaHS accelerated gastric emptying of glucose, albumin and olive oil. The increased gastric emptying of glucose, albumin and olive oil in NaHSpretreated gastroparetic rats was 89.9, 92.3 and 60% respectively more than in corresponding's controls. Conclusion: The results showed that orally administration of NaHS can increase the gastric emptying of glucose, albumin and olive oil in diabetic rats. [ABSTRACT FROM AUTHOR]

It is well known that protein ingestion immediately after exercise greatly stimulates muscle protein synthesis during the postexercise recovery phase. However, immediately after strenuous exercise, the gastrointestinal (GI) mucosa is frequently injured by hypoperfusion in the organ/tissue, possibly resulting in impaired GI function (e.g., gastric emptying; GE). The aim of this study was to examine the effect of GI blood flow on the GE rate. Eight healthy young subjects performed an intermittent supramaximal cycling exercise for 30 min, which consisted of a 120% V̇o2peak for 20 s, followed by 20 W for 40 s. The subjects ingested 300 ml of a nutrient drink containing carbohydrate-protein at either 5 min postexercise in one trial (PE-5) or 30 min postexercise in another trial (PE-30). In the control trial (Con), the subjects ingested the same drink without exercise. The celiac artery blood flow (CABF) and superior mesenteric artery blood flow (SMABF) and GE rate were assessed by ultrasonography. Before drink ingestion in PE-5, CABF significantly decreased from baseline, whereas in PE-30, it returned to baseline. Following drink ingestion in PE-5, CABF did not change from baseline, but it significantly increased in PE-30 and Con. SMABF increased significantly later in PE-5 than in PE-30 and Con. The GE rate was consistently slower in PE-5 than in PE-30 and Con. In conclusion, the CABF response after exercise seems to modulate the subsequent GE rate and SMABF response. NEW & NOTEWORTHY A carbohydrate-protein drink was ingested at either 5 min (i.e., profoundly decreased celiac artery blood flow; CABF) or 30 min (i.e., already recovered CABF) postexercise. In the 5-min postexercise trial, the gastric emptying (GE) rate and superior mesenteric artery blood flow (SMABF) response were slower than those in the 30-min postexercise trial. The GE rate and SMABF response may be altered depending on the postexercise CABF response. [ABSTRACT FROM AUTHOR]

In this study we investigated the in vitro digestive behaviors of starch-based diets enriched with soluble fiber (pectin) and fruit powder (mango) varying with dry matter contents using a dynamic rat stomach and duodenum model. The changes in pH with respect to digestion time, gastric emptying, starch and protein hydrolysis as well as rheological and microstructural properties of the gastric and duodenal digesta were investigated. The effects of porcine gastric mucin on digestion were studied as well. The results showed that gastric digestion and emptying rate were decreased with increasing dry matter content of the diets. Both the dynamic and steady shear viscosity of the duodenal digesta was lower than the gastric digesta due to hydrolysis of starch and protein as well as dilution by added digestive juice. With the same dry matter content (20.35%), the rates of gastric emptying as well as starch and protein hydrolysis were higher in the control and mango diets compared to the pectin diet, illustrating the complex relationships among rheology, soluble dietary fiber and digestion. The addition of gastric mucin could delay the rates of gastric digestion and emptying by increasing digesta viscosity. The study emulates the complexity of heterogeneous diets during simulated gastric and duodenal digestion and suggests that the viscosity generated by either addition of mucin on the diet or naturally exerted by e.g. pectin could be the rate limiting factor for both gastric emptying and hydrolysis of starch and proteins. [ABSTRACT FROM AUTHOR]

Objective · To investigate the possible factors affecting the gastric emptying rate in patients with type 2 diabetes mellitus. Methods · 94 type 2 diabetic patients treated at the Department of Endocrinology of Renji Hospital affiliated to Shanghai Jiao Tong University School of Medicine from September 2013 to March 2014 were enrolled. The half gastric emptying time (T1/2) and retention at 120 min (R120 min) were measured. Results · Female patients had longer T1/2 (P=0.000) and higher R120 min (P=0.000) than male patients. The differences in age, duration of diabetes, BMI, blood glucose level, chronic diabetic complications, and gastrointestinal symptoms between normal and delayed gastric emptying groups were not statistically significant. Acarbose had no effect on the gastric emptying rate in type 2 diabetic patients. Conclusion · The gastric emptying rate in type 2 diabetic patients is associated with the gender and has no significant correlation with blood glucose level, chronic diabetic complications, gastrointestinal symptoms, and acarbose. [ABSTRACT FROM AUTHOR]

Aim: To study the gastric emptying 30 days after laparoscopic Nissen fundoplication (NF) in gastroesophageal reflux. Materials and Methods: Three patients were evaluated with 13 C-acetate breath test (ABT) performed pre and post-NF. The liquid test meal consisted of Racol TM mixed with 13 C-acetate. Results: In the patient without neurological impairment (NI), the preoperative t 1/2 ex and t lag were 0.900 and 0.510 hours, respectively. The postoperative t 1/2 ex and t lag were 0.959 and 0.586 hours, respectively. In one patient with NI, the preoperative t 1/2 ex and t lag were 1.828 and 1.092 hours, respectively. The postoperative t 1/2 ex and t lag were 2.081 and 1.025 hours, respectively. In the other patient with NI, the preoperative t 1/2 ex and t lag were 2.110 and 0.980 hours, respectively. The postoperative t 1/2 ex and t lag were 1.118 and 0.415 hours, respectively. Conclusions: Our findings suggest that 13 C-ABT parameters did not worsen in any of the children after laparoscopic NF.

Objective: The present study aimed to use bedside ultrasound to evaluate the effects of metoclopramide on gastric motility in patients being treated for trauma in the emergency department. Methods: Fifty patients underwent an ultrasound immediately after attending the emergency department of Zhang Zhou Hospital due to trauma. The patients were randomly divided into two groups: a metoclopramide group (group M, n = 25) and a normal saline group (group S, n = 25). The cross-sectional area (CSA) of the gastric antrum was measured at 0, 30, 60, 90, and 120 min (T = time). The gastric emptying rate (GER, G E R = - A a r e a T n / A a r e a T n - 30 - 1 × 100 ), GER/min (GER divided by the corresponding interval time), gastric content properties, Perlas grade at different time points, T120 gastric volume (GV), and GV per unit of body weight (GV/W) were evaluated. The risk of vomiting, reflux/aspiration, and type of anesthetic treatment were also evaluated. Results: The differences between the two groups in the CSA of the gastric antrum at each time point were statistically significant ( p < 0.001). The CSAs of the gastric antrum in group M were lower than those in group S, and the greatest difference between the two groups occurred at T30 ( p < 0.001). The differences between the two groups in GER and GER/min were also statistically significant ( p < 0.001); those differences in group M were higher than those in group S, and the greatest differences between the two groups occurred at T30 ( p < 0.001). There were no obvious change trends in the properties of the gastric contents and the Perlas grades in either group, and the differences between the two groups were not statistically significant ( p = 0.97). The differences between the two groups in the GV and GV/W at T120 were statistically significant ( p < 0.001), as was the risk of reflux and aspiration at T120 ( p < 0.001). Conclusion: When metoclopramide was used in satiated emergency trauma patients, it accelerated gastric emptying within 30 min and reduced the risk of accidental reflux. However, a normal gastric emptying level was not achieved, which can be attributed to the delaying effect of trauma on gastric emptying., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Lin, He, Cai, Lu, Lin, Lin and Huang.)

Background: How starch-based food structure can affect the rate and extent of digestion in the small intestine and resulting glycemic response is not properly understood. One possible explanation is that food structure influences gastric digestion, which subsequently determines digestion kinetics in the small intestine and glucose absorption. However, this possibility has not been investigated in detail., Objectives: Using growing pigs as a digestion model for adult humans, this study aimed to investigate how physical structure of starch-rich foods affects small intestinal digestion and glycemic response., Methods: Male growing pigs (21.7 ± 1.8 kg, Large White × Landrace) were fed one of the 6 cooked diets (250-g starch equivalent) with varying initial structures (rice grain, semolina porridge, wheat or rice couscous, or wheat or rice noodle). The glycemic response, small intestinal content particle size and hydrolyzed starch content, ileal starch digestibility, and portal vein plasma glucose were measured. Glycemic response was measured as plasma glucose concentration collected from an in-dwelling jugular vein catheter for up to 390 min postprandial. Portal vein blood samples and small intestinal content were measured after sedation and euthanasia of the pigs at 30, 60, 120, or 240 min postprandial. Data were analyzed with a mixed-model ANOVA., Results: The plasma glucose Δmax overall and iAUC overall for couscous and porridge diets (smaller-sized diets) were higher than that of intact grain and noodle diets (larger-sized diets): 29.0 ± 3.2 compared with 21.7 ± 2.6 mg/dL and 5659 ± 727 compared with 2704 ± 521 mg/dL⋅min, for the smaller-sized and larger-sized diets, respectively (P < 0.05). Ileal starch digestibility was not significantly different between the diets (P ≥ 0.05). The iAUC overall was inversely related to the starch gastric emptying half-time of the diets (r = -0.90, P = 0.015)., Conclusions: Starch-based food structure affected the glycemic response and starch digestion kinetics in the small intestine of growing pigs., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Background This study aimed to evaluate the role of H2S on gastric emptying rate ( GER) and also to determine the effect of gastric distention on mRNA and protein expression of cystathionine β-lyase ( CBS) and cystathionine γ-synthase ( CSE) in diabetic-gastroparetic and normal rats. Methods Adult normal rats intraperitoneally received either propargylglycine ( PAG), L-cysteine or Na HS 30 min prior to GER marker (acetaminophen) to investigate H2S involvement in GER and the same protocols were performed in diabetes-induced gastroparesis rats. The role of calcitonin gene related peptide ( CGRP) neurons in the prokinetic effect of endogenous H2S on GER was determined. The level of CBS and CSE expressions in response to gastric distention were also determined. The effect of H2S on frequency and tension of spontaneous contractions of gastric smooth muscle strips was investigated. Key Results Our results showed that: (i) H2S and L-cysteine increased GER in gastroparetic and normal rats. (ii) The increased levels of CSE expression in response to gastric distention in diabetic rats were lower than in normal rats. (iii) PAG inhibited the excitatory effect of capsaicin on GER and on tension of spontaneous contractions of strips. (iv) Hydrogen sulphide increased the frequency and tension of spontaneous contractions of gastric strip muscles in normal and diabetic rats. Conclusions & Inferences The results showed that delayed GER in diabetic rats can be due to down-regulation of H2S biosynthesis enzyme, CSE and suggested that a potential prokinetic role for H2S to treat the delayed gastric emptying in diabetic patients. [ABSTRACT FROM AUTHOR]

The mechanisms involved in the weight loss seen after vertical sleeve gastrectomy (VSG) are not clear. The rat stomach has two morphologically and functionally distinct proximal and distal parts. The rat model for VSG involves complete removal of the proximal part and 80% removal of the distal part along the greater curvature. The purpose of this study was to understand the potential independent contributions of removal of these distinct gastric sections to VSG outcomes. We prepared four surgical groups of male Long-Evans rats: VSG, sham surgery (control), selective proximal section removal (PR), and selective distal section removal (DR). Gastric emptying rate (GER) was highest after VSG compared with all other groups. However, PR, in turn, had significantly greater GER compared with both DR and sham groups. The surgery-induced weight loss followed the same pattern with VSG causing the greatest weight loss and PR having greater weight loss compared with DR and sham groups. The results were robust for rats fed regular chow or a high-fat diet. Body mass analysis revealed that the weight loss was due to the loss of fat mass, and there was no change in lean mass after the surgeries. In conclusion, removal of the proximal stomach contributes to most, but not all, of the physiological impact of VSG. [ABSTRACT FROM AUTHOR]

Intrauterine growth-restricted (IUGR) piglets have lower survival rates and are more likely to have empty stomachs 24 h after birth than normal piglets. Although hypoglycemia may result from low colostrum intake per se, it is not known if slow gastric emptying may be an additional risk factor for poor immunization and glucose absorption in IUGR piglets. It is estimated that IUGR piglets consume less colostrum per kilogram BW than normal-weight piglets within the first 24 h, which could be due to a slower gastric emptying rate and a compromised energy metabolism. Therefore, we hypothesized that the gastric emptying rate and blood glucose would be lower in IUGR piglets. We investigated gastric emptying rates in normal and IUGR piglets and blood glucose and rectal temperatures at birth and after 15, 30, 60, and 120 min. In addition, blood parameters relevant for metabolism were studied. Forty-eight piglets (24 normal and 24 IUGR) were classified at birth as either normal or IUGR on the basis of head morphology. Piglets were removed from the sow at birth before suckling, and birth weight was recorded. Pooled porcine colostrum was tube-fed to all piglets at 12 mL/kg BW as soon as possible after birth (t = 0 min). The piglets were randomly allocated to be euthanized at 15, 30, 60, and 120 min (all groups, n = 6) after bolus feeding, and the weights of the stomach and its residuals were recorded. There was no difference in gastric emptying rates between normal and IUGR piglets (P = 0.129); however, gastric DM residuals tended to by greater in IUGR piglets than normal piglets (P = 0.085). Overall, IUGR piglets had lower rectal temperatures (36.2°C ± 0.2°C vs. 37.5°C ± 0.2°C; P < 0.001) and plasma glucose levels (2.8 ± 0.2 vs. 4.1 ± 0.2 mmol; P < 0.001) than normal piglets. Interactions between piglet classification and time were observed in plasma values for NEFA, d-3-hydroxybutyrate, albumin, aspartate, and alanine amino transferase, with greater levels in normal piglets at 15 min (P < 0.05) and 30 min for bile acid (P < 0.05) compared to IUGR piglets. In conclusion, the gastric emptying rates between normal and IUGR piglets were similar, but gastric DM residuals tended to be greater in IUGR piglets. Differences were observed in blood values and rectal temperatures, with lower values in IUGR piglets. Therefore, it is likely that factors like hypothermia and possibly reduced metabolic function are more important during the first hours after birth than gastric retention per se. [ABSTRACT FROM AUTHOR]

A series of novel benzamide derivatives, altering the 4-fluorophenylalkyl moiety in cisapride, were synthesized as 5-HT 4 receptor agonists, and SAR of these analogs was examined on in vitro and in vivo prokinetic activities. These compounds were synthesized for high 5-HT 4 receptor binding affinities and low hERG affinities. Several types of analogs were obtained and screened for 5-HT 4 binding, hERG blocking, agonism, and gastric emptying assessment. Among the analogues, compound 23g showed promising results compared with the other analogs with respect to gastric emptying rates in rats. Therefore, we suggest that it may be a clinical candidate for the development of a potent prokinetic agent to treat GI disorders. [ABSTRACT FROM AUTHOR]

Background Both the amount and the rate of absorption of ethanol ( EtOH) from alcoholic beverages are key determinants of the peak blood alcohol concentration ( BAC) and exposure of organs other than gut and liver. Previous studies suggest EtOH is absorbed more rapidly in the fasting than in the postprandial state. The concentration of EtOH and the type of beverage may determine gastric emptying/absorption of EtOH. Methods The pharmacokinetics of EtOH were measured in 15 healthy men after consumption of 0.5 g of EtOH/kg body weight. During this 3-session crossover study, subjects consumed in separate sessions, beer (5.1% v/v), white wine (12.5% v/v), or vodka/tonic (20% v/v) over 20 minutes following an overnight fast. BAC was measured by gas chromatography at multiple points after consumption. Results Peak BAC (Cmax) was significantly higher ( p < 0.001) after vodka/tonic (77.4 ± 17.0 mg/dl) than after wine (61.7 ± 10.8 mg/dl) or beer (50.3 ± 9.8 mg/dl) and was significantly higher ( p < 0.001) after wine than beer. The time to Cmax occurred significantly earlier ( p < 0.01) after vodka/tonic (36 ± 10 minutes) compared to wine (54 ± 14 minutes) or beer (62 ± 23 minutes). Six subjects exceeded a Cmax of 80 mg/dl after vodka/tonic, but none exceeded this limit after beer or wine. The area under the concentration-time curve ( AUC) was significantly greater after drinking vodka/tonic ( p < 0.001) than after wine or beer. Comparison of AUCs indicated the relative bioavailability of EtOH was lower after drinking beer. Conclusions Findings indicate that BAC is higher after drinking vodka/tonic than beer or wine after fasting. A binge pattern is significantly more likely to result in BAC above 80 mg/dl after drinking vodka/tonic than beer or wine. Men drinking on an empty stomach should know BAC will vary depending on beverage type and the rate and amount of EtOH. [ABSTRACT FROM AUTHOR]

Abstract: Disorders of gastrointestinal motility are common, resulting in a decreased quality of life of individuals, and an economic burden. Gastrointestinal motility is categorized according to location within the gastrointestinal tract: stomach, small intestine, and colon, with the colon being the dominant compartment in determining overall gastrointestinal transit. Constipation results from gastrointestinal dysmotility and is a significant chronic health issue globally. Clinical studies in a range of adult populations consistently indicate that kiwifruit are a highly effective dietary option to promote laxation. This, together with emerging evidence for the putative effects of kiwifruit in beneficially promoting gastric emptying and digesta mixing, suggests that kiwifruit are physiologically active throughout the gastrointestinal tract. Although the mechanisms of this action remain unknown, the unique behavior of kiwifruit fiber during digestion and the potential action of bioactive components in kiwifruit may contribute to the effectiveness of kiwifruit in modulating gastrointestinal motility. [Copyright &y& Elsevier]

Aim: To study the gastric emptying 30 days after laparoscopic Nissen fundoplication (NF) in gastroesophageal reflux. Materials and Methods: Three patients were evaluated with 13C-acetate breath test (ABT) performed pre and post-NF. The liquid test meal consisted of Racol™ mixed with 13C-acetate. Results: In the patient without neurological impairment (NI), the preoperative t1/2ex and t lag were 0.900 and 0.510 hours, respectively. The postoperative t1/2ex and t lag were 0.959 and 0.586 hours, respectively. In one patient with NI, the preoperative t1/2ex and t lag were 1.828 and 1.092 hours, respectively. The postoperative t1/2ex and t lag were 2.081 and 1.025 hours, respectively. In the other patient with NI, the preoperative t1/2ex and t lag were 2.110 and 0.980 hours, respectively. The postoperative t1/2ex and t lag were 1.118 and 0.415 hours, respectively. Conclusions: Our findings suggest that 13C-ABT parameters did not worsen in any of the children after laparoscopic NF. [ABSTRACT FROM AUTHOR]

Many studies assessed gastric retention over time utilizing different models, mostly with scintigraphic measures at varied endpoints from limited number of normal volunteers. With a standardized 4-h gastric emptying (GE) protocol, we compared model fit by the linear, power exponential (PE), and modified power exponential (MPE) models to contrast differences in GE among different groups based on clinical diagnosis and gender. We retrospectively collected 320 patient records with four consecutive hourly scintigraphic measures of percent intragastric residual at the Kansas University Medical Center. We obtained parameter estimates with the Bayesian hierarchical models using informative priors from previous research. The PE or MPE model captured the time dependent GE rate better than the linear model. The estimated GE rates more than doubled for those without gastroparesis compared to patients diagnosed with gastroparesis. Males tended to empty gastric content faster but were not significantly different from females at the 5% level. The point estimates and 95% credible interval for GE rates obtained with the PE and MPE models may provide an alternative diagnostic tool for clinicians since it utilizes gastric emptying scintigraphy measures at multiple endpoints which may be sensitive to different aspects of the disease. No agreement in lag phases was obtained by the three models based on respective definitions from previous researches, but similar results would be obtained with the PE and MPE models if both defined lag phase by back projecting the regression lines to the same gastric retention level. [ABSTRACT FROM AUTHOR]

The article presents a study that investigated the pharmacokinetics and dose proportionality of the receptor agonist mosapride citrate orally administered in horses. Seven healthy Thoroughbred horses were fasted for 12 hours before they were dosed with distilled water and mosapride citrate. Researchers measured concentrations of serum mosapride and its metabolite by liquid chromatography/tandem mass spectrometry (LC/MS/MS). They found differences in the pharmacokinetic profiles of mosapride in horses and humans.

Abstract: The absorption sites of mizoribine (an imidazole nucleoside) and ribavirin (a purine nucleoside) in the small intestine were evaluated in rats. The intestinal absorption of mizoribine is known to be mediated by rat concentrative nucleoside transporter (CNT)1 and CNT2. In contrast, the absorption mechanism of ribavirin in rats is not yet fully understood. Thus, the intestinal absorption of ribavirin was characterized firstly. In in-situ jejunum loop studies, the absorption percentage of ribavirin at a dose of 25mg/kg was significantly lower than those after 1mg/kg and 5mg/kg doses. Coadministration of adenosine, inosine and mizoribine, but not thymidine and gemcitabine, significantly suppressed the intestinal absorption of ribavirin, indicating that ribavirin absorption is mediated by CNT2 in rats. In in-situ loop studies, mizoribine and ribavirin were absorbed to the same extents both in the proximal and distal small intestine. In vivo study was carried out using mizoribine, in which the gastric emptying rates altered by a subcutaneous injection of metoclopramide or scopolamine butylbromide exerted no significant effects on the values of peak plasma level (Cmax), area under the plasma concentration–time profile from 0 to 6h (AUC0–6), and urinary excretion percentage of mizoribine given orally, though the time to reach Cmax (Tmax) of mizoribine was altered by each treatment. In conclusion, mizoribine and ribavirin were found to be absorbed efficiently to the same extents from the whole small intestine. Also, the altered gastric emptying rates exerted no significant effects on the oral bioavailabilities of mizoribine and ribavirin. [Copyright &y& Elsevier]

Celiac disease (CD) patients show a number of gastrointestinal motor abnormalities. Ghrelin, a gastric peptide implicated in short-term feeding control and long-term body weight regulation, has been recently considered a key regulator of gastric motility. The aim of this study was to evaluate the gastric emptying rate of solids and the density of ghrelin-immunopositive cells in adult CD patients before and at least 1 year after starting a gluten-free diet. Twenty CD patients (M 8/F 12; mean age 36 years) and 10 controls underwent endoscopy with gastric and duodenal biopsies and 13C-octanoic acid breath test to measure gastric emptying of solids. Celiac disease patients repeated the protocol at least 1 year after starting gluten-free diet. Ghrelin tissue levels were evaluated by immunohistochemistry on gastric mucosa specimens. Gastric emptying time was normal in all control subjects ( t1/2 = 89 ± 16 min) while it was delayed in CD patients prior to gluten-free diet ( t1/2 = 252 ± 101 min; P < 0.005). The mean number of ghrelin-positive cells/field (×400) was 14.4 ± 2.7 in controls and 25.3 ± 5.7 in CD patients respectively ( P < 0.0001). Gluten withdrawal was effective in normalizing gastric emptying time in all CD patients (97 ± 14 min; P < 0.0001) and resulted in a significant reduction of the density of ghrelin-immunopositive cells (19.8 ± 5.4; P < 0.0001). The density of ghrelin-positive cells correlated directly with the degree of duodenal damage ( P < 0.001) and inversely with the body mass index of CD patients ( P < 0.0001). However, in neither CD patients nor controls, a correlation between tissue ghrelin levels and gastric emptying rate was detected. In conclusion, tissue ghrelin level does not correlate with gastric emptying rate in adult CD patients and in controls. [ABSTRACT FROM AUTHOR]

Abstract: Aims: To develop a model for simulations of processes in the oral glucose tolerance test (OGTT), using tools of the theory of dynamic systems. Methods: Frequent sampling OGTT was performed in 13 healthy subjects (6 males and 7 females). Subsequently, employing glucose and insulin concentration–time profiles of the subjects, the model was developed. Results: In all subjects the model was able to simulate influences of the insulin plasma concentration and gastric emptying rate on glucose concentration and to determine time profiles of glucose fractions retained in stomach. Conclusions: The approach presented represents an opportunity for building models for data analyses in OGTT. [Copyright &y& Elsevier]

The role of carbohydrates in health and disease has received a high profile in recent years, in particular the glycaemic index (GI) as a physiological classification of carbohydrate foods. A common carbohydrate source in the UK is white bread, which is considered to have a high GI value and low satiety value. In the present study, the possibility of favourably altering the GI of white bread by manipulating bread structure (loaf form) was investigated. In a randomised repeated-measures design, ten subjects were tested for glycaemic and satiety responses to four loaves of varying volume, but of consistent macronutrient content. Peak plasma glucose levels and GI values were shown to be significantly reduced by lowering loaf volume (P=0??007, P<0??001 respectively). In addition, a greater satiety index (SI) was seen with decreased loaf volume (P<0??001). In conclusion, the present study demonstrates that reducing the volume of white bread, which is generally considered to be high-GI and low-SI, can favourably alter metabolic and appetite responses. Relatively small differences in the GI of regularly consumed starch foods have been shown to have beneficial effects on health. [ABSTRACT FROM PUBLISHER]

Longitudinal studies indicate that milk and fermented milk products lower basal plasma cholesterol concentrations, despite their high content of saturated fat, and therefore have favourable health effects. However, there have been few studies on the postprandial effects of milk products. The present study compared the effect of whole milk with a fermented milk, A-38, on postprandial carbohydrate and lipid metabolism, gastric emptying and appetite. Eight healthy young men participated. On the two test days, they arrived fasting for collection of baseline values before consuming the meals, which for a 75 kg subject consisted of 1??4 litre milk or fermented milk, plus 165 mg [13C]acetate (for later determination of gastric emptying by a [13C]acetate breath test). Lactose (15 g) was added to the A-38 meal to equalize the lactose content. Postprandially the A-38 meal resulted in a slower gastric emptying rate than milk (P>0??001). Furthermore, the A-38 meal resulted in a greater increase and a quicker decrease of the triacylglycerol content in all lipoprotein fractions (LDL-fraction, P>0??05; other fractions, P>0??001) and of the gastrointestinal hormones (cholecystokinin and peptide YY, P>0??05; gastric inhibitory polypeptide and glucagon-like polypeptide-1, P>0??001). There were no significant differences in appetite sensations (measured by visual analogue scale) or in the glucose and insulin response (P<0??10). The slower emptying rate of the liquid phase after the A-38 meal is probably due to the higher viscosity of A-38. The lower and more prolonged triacylglycerol response after the milk meal might be caused by coagulation of milk in the stomach. [ABSTRACT FROM PUBLISHER]

Summary: The forestomach of rats and mice adapts the digestive regime of rats and mice from “food intake in bulks” to a “steady state digestion”. It stores well chewed and salivated food in amounts as needed for one to three hours or longer. The forestomach supplies its content for further digestion independently from its filling degree but in relation to the host''s actual energy need during the light period or lipid metabolism during the dark period. Postprandial hyperglycemia and glycogen increase in the liver is lacking. Animals ingest most of their daily food during darkness. Meal frequency increases while the amount of food stored in the forestomach is hardly influenced. However, extremely high food demand or limitation of feeding time leads to increased filling per meal of the forestomach by four times and more, but in relation to “eating for calories”. The brain''s appetite-regulating-network and signals which mechanically record the distension of the forestomach-stomach-cavity determine the ingested volume. In leptin-deficient Lepob/Lepob mice the filling volume of the forestomach per meal increases up to five times during the night and twice during the day. The frequency of meals declines. Emptying of the forestomach is controlled by a local feed back loop between duodenal reabsorption and the tension of the forestomach muscle fibres linked by humoral signals such as secretin and cholecystokinin. During storage in the forestomach food pap is subjected to digestion of starch, fat and chitin, but none of cellulose or protein can be observed. Microorganisms are without significance for the forestomach''s function as shown in germ-free animals. Lactobacillae dominate in the variety of organisms lodged there. They are authochthonous and attached to the surface of the wall as dense carpets. Their lactic acid may have preservation effect on the food stored. [Copyright &y& Elsevier]

Background: Foods with a low glycemic index are increasingly being acknowledged as beneficial for individuals with disorders related to the insulin resistance syndrome. The presence of certain salts of organic acids has been shown to lower the glycemic index of bread products and one of the suggested mechanisms is a lowered gastric emptying rate (GER). One obvious pitfall with many of the common techniques for GER measurement is that the food structure, and hence the gastric release of nutrients, may be affected by enclosure of the marker for gastric emptying, eg, paracetamol. Ultrasonography is a noninvasive method for which the above pitfall is to a large extent avoided. Objective: The main objective was to evaluate the use of ultrasonography to determine whether the lowered glycemic and insulinemic responses to bread ingestion after the addition of sodium propionate are explained by a specific effect of propionate on the GER. Design: The effect of sodium propionate in bread was evaluated in 9 healthy volunteers. Barley bread products, with or without added sodium propionate, were ingested as breakfast after an overnight fast. The GER was monitored for 2 h by ultrasonography; during this period, capillary blood was withdrawn repeatedly for measurement of blood glucose and insulin. Results: The GER of the barley bread decreased markedly after the addition of sodium propionate and was accompanied by lowered glycemic and insulinemic responses. Conclusion: The lowered glycemic response to ingestion of bread with added sodium propionate appears to be related to a lowered GER. [ABSTRACT FROM AUTHOR]

Background: In vertical banded gastroplasty (VBG), a small proximal gastric pouch is created, which is believed to fill rapidly and to empty slowly. Methods: In 13 patients who underwent VBG, gastric emptying rate was measured. A radiolabelled solid test meal was used before and 2 weeks after operation. From a region of interest above the whole stomach, the proximal pouch and the distal stomach, half emptying time as well as retention percentage were derived. Results: All patients experienced early satiety and gastric fullness after ingestion of a small test meal. The proximal pouch emptied rapidly.The evacuation of the test meal from the whole gastric region as well as the distal stomach were not altered significantly by the operation. Conclusion: VBG is a safe operation which reduced weight significantly. Early satiety, however, induced by this technique, cannot be explained alone by slow emptying of the proximal pouch. The nature of the outlet of the pouch as well as the behavior of its wall must be considered. [ABSTRACT FROM AUTHOR]

This study examines the involvement of gastric emptying and mucosal folds in the adaptive cytoprotection of different mild irritants against 100% ethanolinduced gastric mucosal damage. Pre-exposure to either 20% ethanol, 5% NaCl or 0.3M HCl significantly reduced the gastric mucosal damage caused by 100% ethanol in rats. Administration of either one of the three mild irritants increased the basal gastric residual volume and decreased the area occupied by gastric mucosal folds, but only 20% ethanol reduced the gastric emptying rate. Indomethacin (5 mg/kg, s.c.) pretreatment did not affect ethanol ulceration and gastric emptying rate when given by itself, but reversed the flattening of mucosal folds produced by the three mild irritants, and abolished the protective effect of 20% ethanol. These results suggest that the gastric adaptive cytoprotection induced by the three mild irritants acts through luminal dilution of the noxious agent, possibly caused by gastric retention. The reduction of mucosal folds could also contribute to the anti-lesion action of 20% ethanol. It is therefore suggested that the protective actions of the three mild irritants act through different mechanisms. [ABSTRACT FROM AUTHOR]