Continental Breakfast Research Articles

Clinicians Convene in Anaheim for Schools 2003 Conference

Clinicians Convene in Anaheim for Schools 2003 Conference

Oral Bioavailability of Gatifloxacin in Healthy Volunteers under Fasting and Fed Conditions

The effect of food on the pharmacokinetics of gatifloxacin given as a single oral dose of 400 mg under fasting and fed conditions was determined in 18 healthy male volunteers in an open, two-way, randomised cross-over study. Concomitant food intake did not significantly alter the peak plasma concentrations (C_max) or the area under the plasma concentration-time curve (AUC) of gatifloxacin. The mean C_max levels under fasting and fed conditions were 3.5 and 3.2 mg/l, respectively, after the 400-mg single dose of gatifloxacin. The corresponding mean AUC data were 32.8 mg × h/l (fasted) and 30.5 mg × h/l (fed). Moreover, the rate of absorption was not affected by food intake. The median T_max value was 2 h in both treatment periods. No clinically relevant adverse effects or changes in clinical laboratory test results, ECGs or physical examinations were observed. The results of this study indicate that gatifloxacin given as a single 400-mg oral dose was well tolerated in the presence or absence of food. Concomitant administration of a continental breakfast with a caloric content of 1,050 kcal had no effect on the bioavailability of gatifloxacin. It is suggested that gatifloxacin can be given without regard to meals.

Thirty-sixth Annual Meeting January 31–February 2, 2000 Greater Fort Lauderdale/Broward County Convention Center, Fort Lauderdale, Florida

Thirty-sixth Annual Meeting January 31–February 2, 2000 Greater Fort Lauderdale/Broward County Convention Center, Fort Lauderdale, Florida

Effect of Food on the Pharmacokinetics of Meloxicam after Oral Administration

The effect of food on the pharmacokinetic profile of the nonsteroidal anti-inflammatory drug meloxicam was investigated in 2 open, randomised, crossover studies conducted in 2 different groups of healthy male volunteers. A pilot study assessed the effect of a standardised continental breakfast on the pharmacokinetics of a single oral dose of meloxicam 30mg in 6 volunteers, while the other study investigated the pharmacokinetics of a single oral dose of meloxicam l5mg after a high-fat breakfast in 16 volunteers. The extent of meloxicam absorption was not affected by either the continental or the high-fat breakfast. Maximum plasma drug concentrations tended to be achieved earlier after food, and the onset of absorption was slightly delayed after the high-fat meal. However, none of these changes was considered clinically relevant and bioequivalence was demonstrated for both situations (fasted and after high-fat meal). Disposition parameters such as mean residence time, elimination half-life, total clearance or volume of distribution during the terminal phase did not change. Both doses of meloxicam were well tolerated in the fed and the fasting states. In conclusion, the single dose pharmacokinetics of oral meloxicam were not significantly affected by food, suggesting that the drug may be given with or after meals.

The Train Is Leaving the Station

It is 7 a.m. I am sitting in a heroically proportioned lecture hall trying to focus my eyes. On a table in front of me, slightly blurred, sits what was advertised as a continental breakfast: lukewarm coffee in a styrofoam cup and a Danish, which is “continental” only in the sense that it may be a leftover from D-day.I am recovering from a bad night on call. Several assaults by telephone designed to make me “aware” of a problem at a nursing home reduced the architecture of my sleep to rubble. REM-less, my mind wanders. I catch myself thinking . . .

Favourable glycaemic effects of a new balanced liquid diet for enteral nutrition — Results of a short-term study in 30 type II diabetic patients

A new fibre enriched (15 g/l soy polysaccharides) balanced liquid diet was developed containing 53% (of energy) as carbohydrate, 32% fat and 15% protein. 71% of carbohydrates in this formula consist of modified starch, 29% of fructose. The glycaemic response to this diabetes adapted diet (DD) was compared with an isoenergetic standard diet (SD) containing maltodextrins and sucrose and a typical continental breakfast (CB). 30 type II diabetics orally ingested isoenergetic amounts of these test diets in randomised order. Each diet contained 48 g carbohydrates. The 4 h postprandial (p.p.) observation period was characterised by a markedly improved response of blood glucose following ingestion of DD. This effect was seen as significantly reduced p.p. peaks (p < 0.00001 vs SD; p = 0.00001 vs CB) as well as diminished areas under the curve. (p < 0.00001 vs SD; p = 0.00001 vs CB). Similar results were obtained by evaluation of the corresponding insulin levels. The differences between the test diets were greater in insulin treated patients than in diabetics on sulfonylureas or a dietary regimen only. We conclude that this new balanced liquid diet can be helpful in maintaining a good glycaemic control in diabetics receiving artificial enteral nutrition and may be administered in a similar way to normal foods without changes in the patients antidiabetic therapy.

Effect of food on the pharmacokinetics of the active metabolite of the prodrug repirinast

AbstractThe effect of food on the pharmacokinetics of the active metabolite of the new antiasthmatic drug repirinast was investigated in two different studies after oral administration of 300mg of repirinast. In each study, 12 healthy volunteers received the repirinast dose under fasting or fed conditions in a crossover manner. In one study, a high-fat meal (American breakfast) was used and in another study, a low-fat, high-carbohydrate meal (continental breakfast) was used. Concentrations of the active metabolite in plasma and urine were determined by reversed-phase high-performance liquid chromatography with UV detection. After administration of repirinast with a low-fat and a high-fat meal, the relative bioavailability of the active metabolite increased by factors of 1.9 and 2.4, respectively, as expressed by area under the curve of concentration versus time from 0 to 12h. The amount excreted into urine doubled after drug administration with both types of food and accounted for ~8% of the dose under fasting conditions and ~16% of the dose under fed conditions. Maximum concentrations in plasma were different between the two studies: mean maximum concentrations in plasma increased by factors of 1.7 and 3.2 after administration of drug with a low-fat (drug intake immediately after breakfast) and a high-fat breakfast (drug intake just before breakfast), respectively, compared with fasting conditions.

Effect of a single oat bran cereal breakfast on serum cholesterol, lipoproteins, and apolipoproteins in patients with hyperlipoproteinemia type IIa.

Serum cholesterol-lowering effects of oat bran-enriched diets have been indicated in several studies in which oat bran was given several times a day. Concomitant changes in the daily diet, ie, a diminished energy intake or changes in the composition of fats in the diet, also have been reported and used to explain the hypocholesterolemic effect of oats. The present study was designed to replace only the conventional continental breakfast by a single oat bran cereal muesli containing 60 g of oat bran and to measure the effects of this dietetic modification on serum lipids in 13 patients with hypercholesterolemia type IIa. Compared with a 3-week baseline period, total serum cholesterol (7.38 +/- 0.35 mmol/L, mean +/- SEM) was reduced by 10.9, 8.4, and 9.7% in the first, second, and third week of oat bran ingestion (p < .01). High-density lipoprotein and low-density lipoprotein cholesterol as well as apolipoprotein A1 decreased to the same extent (8 to 11%; p < .05) during the oat bran period, whereas a pronounced reduction of 25.8% was seen for apolipoprotein B100 (p < .01), which is a major component of low-density lipoprotein. Dietary data obtained by 3-day food records at baseline, oat bran, and follow-up period did not show any differences between the study periods except for dietary fiber, which was increased from 21.9 g/day to 42.4 g/day (p < .002) during the test period because of the daily oat bran intake.(ABSTRACT TRUNCATED AT 250 WORDS)

Comparison of glycemic response and insulin requirements after mixed meals of equal carbohydrate content in healthy, type-1, and type-2 diabetic man

The postprandial insulin requirements after three mixed meals of equal carbohydrate and energy content were assessed in 10 type-1 and 12 type-2 diabetics by a glucose-controlled insulin infusion system. These were compared with the glycemic response to the same meals of 10 healthy individuals (glycemic index). In type-1 diabetics, we found the highest insulin requirements after consumption of a continental breakfast (low fibre, low protein, high fat). Ten percent less insulin was infused after milk (low fat, high protein) and 30% less after an English breakfast (high fibre, high protein). Type-2 diabetics showed no significant differences in insulin requirements between the three test meals. The glycemic response in healthy individuals had no relation to these insulin requirements. Continental and English breakfast had a similar glycemic effect, whereas milk produced only 30% of the blood glucose response observed after the continental breakfast. These results indicate that neither the carbohydrate content (exchange lists) nor the glycemic index enable prediction of postprandial insulin requirements in insulin-deficient diabetes. For this purpose, we propose the insulin-need index, elaborated by testing whole meals in closed-loop experiments with type-1 diabetics.

Pancreatic polypeptide is not involved in the regulation of the migrating motor complex in man.

The role of pancreatic polypeptide (PP) and motilin in the regulation of the migrating motor complex (MMC) was studied in normal subjects. Both plasma motilin and PP levels changed cyclically in the fasted state and were highest in the late phase II period preceding the activity front in the duodenum. A continental breakfast invariably disrupted the MMC and induced a fed pattern of motility. After the meal plasma motilin levels decreased whereas PP levels rose significantly. Infusion of pure porcine motilin during the fasted state induced an activity front and a rise in plasma PP levels. Infusion of bovine PP in doses producing plasma PP levels above the postprandial values neither induced an activity front nor prevented its occurrence. During PP infusion, however, plasma motilin levels were low, although the activity front was not inhibited. PP seems to have no clear role in the regulation of the motor component of the MMC of man. The role of motilin in the production of the activity front of the MMC is discussed.