Effect of oral or intragastric delivery of the bitter tastant quinine on food intake and appetite sensations: a randomised crossover trial.

Tim Klaassen,Freddy J Troost,Ellen Wilms,Annick M E Alleleyn,Daniel Keszthelyi,Aalt Bast,Adrian A M Masclee

doi:10.1017/s0007114520002536

Tim Klaassen, Freddy J Troost + Show 5 more

Open Access

https://doi.org/10.1017/s0007114520002536

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Abstract

Stimulation of gastrointestinal taste receptors affects eating behaviour. Intraduodenal infusion of tastants leads to increased satiation and reduced food intake, whereas intraileal infusion of tastants does not affect eating behaviour. Currently, it is unknown whether oral- or intragastric administration of tastants induces a larger effect on eating behaviour. This study investigated the effects of oral- and/or intragastric administration of quinine on food intake, appetite sensations and heart rate variability (HRV). In a blinded randomised crossover trial, thirty-two healthy volunteers participated in four interventions with a 1-week washout: oral placebo and intragastric placebo (OPGP), oral quinine and intragastric placebo (OQGP), oral placebo and intragastric quinine (OPGQ) and oral quinine and intragastric quinine (OQGQ). On test days, 150 min after a standardised breakfast, subjects ingested a capsule containing quinine or placebo and were sham-fed a mixture of quinine or placebo orally. At 50 min after intervention, subjects received an ad libitum meal to measure food intake. Visual analogue scales for appetite sensations were collected, and HRV measurements were performed at regular intervals. Oral and/or intragastric delivery of the bitter tastant quinine did not affect food intake (OPGP: 3273·6 (sem 131·8) kJ, OQGP: 3072·7 (sem 132·2) kJ, OPGQ: 3289·0 (sem 132·6) kJ and OQGQ: 3204·1 (sem 133·1) kJ, P = 0·069). Desire to eat and hunger decreased after OQGP and OPGQ compared with OPGP (P < 0·001 and P < 0·05, respectively), whereas satiation, fullness and HRV did not differ between interventions. In conclusion, sole oral sham feeding with and sole intragastric delivery of quinine decreased desire to eat and hunger, without affecting food intake, satiation, fullness or HRV.

Highlights

Since 1975, the prevalence of obesity has nearly tripled, being a major healthcare problem worldwide[1], urging the need for non-invasive treatment strategies
This study investigated the effects of oral- v. intragastric v. synchronous oral- and intragastric delivery of the bitter tastant quinine on eating behaviour in healthy subjects, with ad libitum food intake as primary outcome and heart rate variability (HRV), appetite sensations and GI-complaints as secondary outcomes
No differences in ad libitum food intake were observed after oral sham feeding with quinine, intragastric delivery of quinine or combined oral sham feeding withand intragastric delivery of quinine v. placebo (placebo: 3273·6 (SEM 131·8) kJ, oral sham feeding with quinine: 3072·7 (SEM 132·2) kJ, intragastric delivery of quinine: 3289·0 (SEM 132·6) kJ, oral sham feeding with- and intragastric delivery of quinine: 3204·1 (SEM 133·1) kJ, P = 0·069) (Fig. 2)

Summary

Introduction

Since 1975, the prevalence of obesity has nearly tripled, being a major healthcare problem worldwide[1], urging the need for non-invasive treatment strategies. It has been shown that intestinal infusion of macronutrients reduces food intake that is accompanied by the release of GI peptides, generally called the intestinal brake[5,6,7], which is operable in a proximal to distal intestinal gradient[8]. Another way to perceive food constituents in the gut is via taste receptors, which are expressed throughout the entire GI tract[9,10,11] and have been shown to trigger the release of GI peptides in vitro[12,13,14,15].

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