Postprandial Acid Research Articles

Postprandial Plasma Amino Acid Responses Between Standard Whey Protein Isolate and Whey Protein Isolate Plus Novel Technology.

Background:Muscle mass is an important determinant of metabolic health and physical function. It has previously been demonstrated that the postprandial rise in circulating essential amino acids (EAA) acts as the main stimulus for muscle protein synthesis (MPS). This study investigated postprandial plasma amino acid (AA) responses of 2 different forms of whey protein isolate (WPI) with iso-caloric and iso-nitrogenous profiles to investigate plasma concentrations of EAA.Methods:In all, 12 healthy men (n = 12) between 19 and 32 years of age were recruited for a randomized, cross-over design, which involved consumption of protein supplements on 2 testing days separated by a 6-day washout period between conditions. On each testing day, subjects consumed either 29.6 g of WPI or WPI + io (whey protein isolate plus Ingredient Optimized Protein®) mixed with 236 mL of water. Plasma EAA and branch chain amino acid (BCAA) concentrations were assessed from whole body donated by subjects at pre-consumption and 30, 60, 90, 120, and 180 minutes post consumption.Results:Plasma levels of total EAA concentration was significantly greater in WPI + io at 30, 60, 90, and 120 minutes post consumption (P < .01, P < .001, P < .01, and P < .01, respectively). Plasma levels of total BCAA concentration was significantly greater in WPI + io at 30, 60, 90, and 120 minutes post consumption (P < .01, P < .001, P < .01, and P < .05, respectively) compared with WPI. For leucine, only WPI + io had elevated levels compared with pre-test at 90 minutes post consumption (P < .001).Discussion:Both conditions significantly elevated EAA, BCAA, and leucine from basal levels. However, we conclude that the consumption of the treated WPI significantly raises plasma EAA, BCAA, and leucine to a greater extent compared with WPI with no treatment. Thus, supplementation with WPI that has undergone Ingredient Optimized® technology may be highly beneficial for those who partake in regular exercise, elderly individuals, or those affected by a reduced sensitivity to amino acids.

Fatty acid profiles of typical dietary lipids after gastrointestinal digestion and absorbtion: A combination study between in-vitro and in-vivo

The objective of the present study was to investigate the influences of dietary lipid composition on the gastrointestinal digestion and postprandial serum lipid profiles, and the connections between them. The in-vitro digestion results showed that maximum free fatty acid (FFA) release level of different lipid samples was PO (Palm oil) > RO (Rapeseed oil) > LINO (Linseed oil) > SO (Sunflower oil) > LO (Lard oil), and the first-order kinetics apparent rate constant was PO > SO ≈ RO > LO ≈ LINO, this may probably be ascribed to their specific lipid fatty acid composition and TAG structure. The individual FFA released during 240 min in-vitro digestion time was measured, and it showed that the release rate of short-chain saturated fatty acids (e.g. C16:0 in PO) were higher than the long-chain poly-unsaturated fatty acids (e.g. C18:3n-3 in LINO). Besides, the position of fatty acids within TAG molecules could also impose influences on the lipid hydrolysis process upon pancreas lipase in gastrointestinal tract using in-vitro digestion model. The postprandial serum fatty acid composition of the adult SD male rats were examined within 240 min after oral gavage administration, and the Pearson correlations between lipid fatty acid composition and the serum fatty acid profiles were analyzed. Certain correlations were summarized between lipid compositions (i.e. fatty acid composition and TAG structure), lipid digestion fates and serum fatty acid content in postprandial. The present work may provide some basic understandings of the connections among lipid compositions, lipid gastrointestinal digestion differences and the postprandial serum lipid profiles, and provide useful information about their nutritional and functional evaluation.

Postprandial plasma free amino acid profile and hepatic gene expression in juvenile barramundi (Lates calcarifer) is more responsive to feed consumption than to dietary methionine inclusion

The effects of dietary methionine (Met) supply on the postprandial pattern of plasma free amino acids and the differential expression of several genes associated with a number of sulfur amino acid and protein turnover pathways in the liver of juvenile barramundi (Lates calcarifer) was investigated. At the conclusion of a 49-day growth trial assessing the requirement for dietary Met, three treatments were selected (with deficient (DEF; 8.6 g kg−1), adequate (ADQ; 14.9 g kg−1) and excessive (EXC; 21.4 g kg−1)) levels of dietary Met, based on their respective growth responses. A peak occurred in plasma free Met at 2 h post-feeding in fish fed the DEF and ADQ diets and at 4 h post-feeding in fish in the EXC treatment. Liver samples collected at these timepoints, as well as those taken as a pre-feeding control, were analyzed for expression of genes involved in Met turnover (CGL, MAT-1, MAT-2a) and taurine biosynthetic pathways (CSAD, ADO, CDO), target of rapamycin inhibition (Redd-1), the somatotropic axis (GHR-II, IGFI, IGF-II) and protein turnover pathways (MUL-1, ZFAND-5). Markers of sulfur amino acid turnover were more significantly affected by time after feeding than by dietary Met level, suggesting production of these enzymes may be primarily regulated by the consumption of feed or protein, rather than by the dietary composition. Further, metabolised Met appeared likely to have been directed through S-Adenosylmethionine (SAM) dependent pathways, rather than converted to Cys, which may have contributed to the observed growth response. Both genes influencing the conversion of Met to SAM appear to be active at this lifestage in barramundi. Previously described markers of proteolytic pathways appear to be conserved in this species and we have confirmed that ZFAND-5 is a reliable biomarker of this process in barramundi. A number of important genes were investigated for the first time in this species and shown to be nutritionally regulated.

Hepatic fatty acid synthesis and partitioning: the effect of metabolic and nutritional state

When we consume dietary fat, a series of complex metabolic processes ensures that fatty acids are absorbed, transported around the body and used/stored appropriately. The liver is a central metabolic organ within the human body and has a major role in regulating fat and carbohydrate metabolism. Studying hepatic metabolism in human subjects is challenging; the use of stable isotope tracers and measurement of particles or molecules secreted by the liver such as VLDL-TAG and 3-hydroxybutyrate offers the best insight into postprandial hepatic fatty acid metabolism in human subjects. Diet derived fatty acids are taken up by the liver and mix with fatty acids coming from the lipolysis of adipose tissue, and those already present in the liver (cytosolic TAG) and fatty acids synthesised de novo within the liver from non-lipid precursors (known as de novo lipogenesis). Fatty acids are removed from the liver by secretion as VLDL-TAG and oxidation. Perturbations in these processes have the potential to impact on metabolic health. Whether fatty acids are partitioned towards oxidation or esterification pathways appears to be dependent on a number of metabolic factors; not least ambient insulin concentrations. Moreover, along with the phenotype and lifestyle factors (e.g. habitual diet) of an individual, it is becoming apparent that the composition of the diet (macronutrient and fatty acid composition) may play pivotal roles in determining if intra-hepatic fat accumulates, although what remains to be elucidated is the influence these nutrients have on intra-hepatic fatty acid synthesis and partitioning.

Postprandial bile acid levels in intestine and plasma reveal altered biliary circulation in chronic pancreatitis patients

Bile acid (BA) secretion and circulation in chronic pancreatitis (CP) patients with exocrine pancreatic insufficiency (EPI) were investigated by simultaneously measuring postprandial levels of individual BAs in duodenal contents and blood plasma using LC-MS/MS. CP patients and healthy volunteers (HVs) were intubated with gastric and duodenal tubes prior to the administration of a test meal and continuous aspiration of duodenal contents. Pancreatic lipase outputs in CP patients were very low (0.7 ± 0.2 mg) versus HVs (116.7 ± 68.1 mg; P < 0.005), thus confirming the severity of EPI. Duodenal BA outputs were reduced in CP patients (1.00 ± 0.89 mmol; 0.47 ± 0.42 g) versus HVs (5.52 ± 4.53 mmol; 2.62 ± 2.14 g; P < 0.15). Primary to secondary BA ratio was considerably higher in CP patients (38.09 ± 48.1) than HVs (4.15 ± 2.37; P < 0.15), indicating an impaired transformation of BAs by gut microbiota. BA concentrations were found below the critical micellar concentration in CP patients, while a high BA concentration peak corresponding to gallbladder emptying was evidenced in HVs. Conversely, BA plasma concentration was increased in CP patients versus HVs suggesting a cholangiohepatic shunt of BA secretion. Alterations of BA circulation and levels may result from the main biliary duct stenosis observed in these CP patients and may aggravate the consequences of EPI on lipid malabsorption.

Post-Prandial Acid Pocket as a Cause of GERD, Nausea and Vomiting Post Sleeve Gastrectomy

Introduction: Patients with complaints of gastro-esophageal reflux disease (GERD), nausea and vomiting post bariatric surgery are frequently referred to gastroenterology service for evaluation. These symptoms are worse in patients status post sleeve gastrectomy compared to Roux-en-Y gastric bypass (RYGB) as the former involves mechanical or functional narrowing of the incisura and removal of the angle of His. We found no reports of gastric emptying in the extant literature regarding GERD post bariatric surgery especially sleeve gastrectomy. Methods: We analyzed and summarized the gastric emptying studies of 10 patients referred to us status post bariatric surgery, both sleeve gastrectomy and RYGB, with complaints of nausea, vomiting, and heartburn. Results: In patient’s status post sleeve gastrectomy, 5 of 7 patients demonstrated normal or accelerated gastric emptying times with an average t1/2 of 44 minutes (normal 45 - 110 minutes). One of the three RYGB patients had delayed gastric emptying. None of the RYGB patients exhibited reflux on nuclear medicine gastric emptying study. However, sleeve gastrectomy patients exhibited fundic retention of tracer (2/7, Figure A), delayed esophageal emptying (4/7, Figure B), esophageal reflux (5/7) and to and fro motion in the esophagus and/or fundus (3/6). Of note is that 2 sleeve gastrectomy patients could not remain supine to complete all aspects of the nuclear medicine gastric emptying study without vomiting. Patients had partial response to proton pump inhibitors alone. One patient had revision of her sleeve gastrectomy; repeat nuclear medicine gastric emptying study showed improved gastric emptying, less retention of tracer in the fundus, and less reflux in the esophagus. She also had the most symptomatic improvement. Conclusion: In our experience, sleeve gastrectomy patients were more likely to complain of GERD, nausea, or vomiting than RYGB patients. Their nuclear medicine gastric emptying studies were also more abnormal. We hypothesize that the physiologic changes observed in the sleeve gastrectomy patients more than the RYGB patients represent an exacerbation of the acid pocket which is the unbuffered pool of acid that floats on top of ingested food after meals. It is known that proximal displacement of the acid pocket worsens GERD. The anatomical changes associated with sleeve gastrectomy and not RYGB are more likely to displace the acid pocket proximally.356 Figure 1 No Caption available.

Are heterozygous carriers for hereditary fructose intolerance predisposed to metabolic disturbances when exposed to fructose?

High fructose intake causes hepatic insulin resistance and increases postprandial blood glucose, lactate, triglyceride, and uric acid concentrations. Uric acid may contribute to insulin resistance and dyslipidemia in the general population. In patients with hereditary fructose intolerance, fructose consumption is associated with acute hypoglycemia, renal tubular acidosis, and hyperuricemia. We investigated whether asymptomatic carriers for hereditary fructose intolerance (HFI) would have a higher sensitivity to adverse effects of fructose than would the general population. Eight subjects heterozygous for HFI (hHFI; 4 men, 4 women) and 8 control subjects received a low-fructose diet for 7 d and on the eighth day ingested a test meal, calculated to provide 25% of the basal energy requirement, containing 13C-labeled fructose (0.35 g/kg), glucose (0.35 g/kg), protein (0.21 g/kg), and lipid (0.22 g/kg). Glucose rate of appearance (GRa, calculated with [6,6-2H2]glucose), fructose, net carbohydrate, and lipid oxidation, and plasma triglyceride, uric acid, and lactate concentrations were monitored over 6 h postprandially. Postprandial GRa, fructose, net carbohydrate, and lipid oxidation, and plasma lactate and triglyceride concentrations were not significantly different between the 2 groups. Postprandial plasma uric acid increased by 7.2% compared with fasting values in hHFI subjects (P<0.01), but not in control subjects (-1.1%, ns). Heterozygous carriers of hereditary fructose intolerance had no significant alteration of postprandial fructose metabolism compared with control subjects. They did, however, show a postprandial increase in plasma uric acid concentration that was not observed in control subjects in responses to ingestion of a modest amount of fructose. This trial was registered at the US Clinical Trials Registry as NCT02979106.

Low serum vitamin D level is associated with intrahepatic cholestasis of pregnancy.

Intrahepatic cholestasis of pregnancy (ICP) is a unique hepatic disorder of pregnancy and is related to adverse maternal and perinatal outcomes. The pathogenesis of the disease is not clear and appears to be multifactorial. There is increasing evidence that vitamin D (Vit D) plays a role in hepatobiliary homeostasis and in various liver diseases. We aimed to investigate the association between serum Vit D level and ICP. A total of 40 pregnant women with ICP and 40 healthy pregnant women were included in this controlled cross-sectional study. Their demographic characteristics, including age, body mass index (BMI), gestational week, gravidity and parity, and laboratory parameters, including 25(OH) Vit D3 levels, liver function tests, fasting and postprandial bile acid concentrations, were recorded. Gestational age at delivery, birth weight (BW), neonatal intensive care unit (NICU) admission, meconium staining of amniotic fluid and appearance pulse grimace activity respiration (APGAR) score at 5 min were obtained from medical records for assessment of perinatal outcomes. There was no significant difference between groups in terms of demographic characteristics. The mean serum 25(OH) Vit D3 level was significantly lower in pregnant women with ICP compared to control pregnant women (8.6 ± 4.9, 11.3 ± 6.1; P =0.033), and it was significantly lower in severe disease than mild disease (6.9 ± 2.1, 10.3 ± 6.2, respectively; P =0.029). We also found that lower serum 25(OH) Vit D3 levels were significantly and inversely correlated with fasting and postprandial bile acid levels. However, in subgroup analyses in ICP pregnant women, there was no difference in mean 25(OH) Vit D3 levels for women with or without perinatal complications. Our study suggests that low levels of 25(OH) Vit D3 were associated with ICP disease and its severity. However, further larger studies are needed to evaluate the effect of Vit D in the pathogenesis and outcome of the disease.

Early Effects of Sleeve Gastrectomy (SG) on Systemic and Organ-Specific Dietary Fatty Acid Uptake, Postprandial Free Fatty Acids (FFA), and Glucose Metabolism in Type 2 Diabetes (T2D)

Postprandial dietary fatty acid (FA) biodistribution is impaired in subjects with glucose intolerance, with decreased FA storage in adipose tissues (AT) and increased FA uptake by the myocardium. These abnormalities are improved after 1 year of lifestyle-induced weight loss. Bariatric surgery leads to early metabolic improvements before weight loss, but the early effects on dietary FA metabolism and biodistribution have never been studied. 9 subjects with T2D underwent a 6-hour postprandial metabolic protocol before and 12 days after SG. A liquid meal containing [U-13C]-palmitate and [2H]-glucose was ingested at time 0, with an IV perfusion of [3H]-glucose and [7,7,8,8-2H]-palmitate, allowing quantification of glucose absorption, endogenous glucose production (EGP), lipolysis and dietary FA spillover. A capsule containing a positron-emitting long-chain FA analog (18FTHA) was taken with the meal for the quantification of organ-specific dietary FA uptake using PET/CT (n=6). Twelve days after SG, whole body and hepatic insulin sensitivity increased significantly whereas fasting and postprandial EGP decreased. Postprandial GLP-1, GIP, PYY and glucagon were higher after vs. before SG. Postprandial AUC of FFA (175 vs. 228 mmol/Lx min; p&amp;lt; 0.05) and total FA oxidation were higher (p&amp;lt; 0.02 from 180 min to 360 min), but dietary FA oxidation was reduced after SG (p&amp;lt; 0.002 from 180 min to 360 min). After SG, uptake of dietary FA 6 hours after the meal was reduced in the myocardium (mean SUV 2.07± 0.66 vs. 1.36± 0.44; p=0.06) and was increased in visceral AT (mean SUV 0.24± 0.2 vs. 0.42± 0.2; p=0.03), without changes in other organs. In conclusion, there is reduced myocardial and increased visceral AT uptake of dietary FA associated with reduced dietary FA oxidation and increased FFA mobilization and oxidation, concomitant with reduced EGP and insulin sensitization in patients with T2D early after SG. Disclosure A. Carreau: None. C. Noll: None. B. Guerin: None. L. Biertho: Advisory Panel; Self; Novo Nordisk Inc.. Consultant; Self; Johnson &amp; Johnson Services, Inc., Valeant Pharmaceuticals International, Inc.. E.E. Turcotte: None. A. Tchernof: Research Support; Self; Johnson &amp; Johnson Services, Inc., Medtronic. A. Carpentier: Consultant; Self; UniQure, Janssen Pharmaceuticals, Inc., Siemens. Research Support; Self; Caprion, Merck Sharp &amp; Dohme Corp., GlaxoSmithKline plc., Novartis Pharmaceuticals Corporation, AstraZeneca, Bristol-Myers Squibb Company, Sanofi-Aventis, Pfizer Inc., Novo Nordisk Inc., Exelixis, Amgen Inc..

The effect of heat treatments and homogenisation of cows’ milk on gastrointestinal symptoms, inflammation markers and postprandial lipid metabolism

Dairy products are often reported as a source of stomach discomfort, and processing of cows' milk has been claimed to be one reason for this. To investigate the role of milk processing on adverse gastrointestinal symptoms, a cross-over, double blind clinical trial with fourteen milk sensitive subjects was set up. Pasteurised, pasteurised and homogenised, and ultra-high temperature-treated and homogenised milk, representing products from the mildest and hardest processing, were used as study meals. The amount, severity or duration of the reported symptoms or postprandial lipaemia did not differ, while significant differences were seen in the postprandial fatty acid composition of plasma between the milk types. The 92 inflammation markers measured in plasma did not differ between the subjects who consumed different types of milk. The results of the present study do not support the hypothesis that cows’ milk processing could induce gastrointestinal symptoms in milk sensitive but lactose tolerant subjects.

The effect of casein, hydrolyzed casein, and whey proteins on urinary and postprandial plasma metabolites in overweight and moderately obese human subjects

Casein and whey proteins differ in amino acid composition and absorption rate; however, the absorption rate of casein can be increased to mimic that of whey proteins by exogenous hydrolysis. In view of these compositional differences, we studied the metabolic responses to intake of casein, hydrolyzed casein, and whey proteins in overweight and moderately obese men and women by investigating select urinary and blood plasma metabolites. A total of 21 urinary and 23 plasma metabolites were identified by nuclear magnetic resonance spectroscopy. The postprandial plasma metabolites revealed a significant diet-time interaction for isoleucine (P = 0.001) and tyrosine (P = 0.001). The level of isoleucine and tyrosine peaked 90 min postprandially with a 1.4-fold difference following intake of whey proteins compared with either casein or hydrolyzed casein. A 1.2-fold higher urinary level of lactate was observed after intake of whey proteins compared with intake of intact casein (P < 0.01). The plasma metabolites revealed different amino acid profiles reflecting the amino acid composition of casein and whey proteins. Furthermore, the results support that casein hydrolysates neither affect the postprandial amino acid absorption rate nor the amino acid level compared with that of intact casein. The urinary lactate increases following whey protein intake might indicate a higher metabolism of glucogenic amino acids. © 2018 Society of Chemical Industry.

Dietary Amino Acid Availability and Anabolic Signaling Molecule Phosphorylation is Blunted in Maintenance Hemodialysis Patients

Skeletal muscle mass loss is a common feature in patients with renal failure receiving maintenance hemodialysis (MHD) therapy. Dietary protein (amino acids) is one of the main anabolic stimuli to skeletal muscle tissue in humans, and impairments to anabolic stimuli over time may lead to muscle mass loss. However, there are major gaps in our knowledge of how muscle mass is regulated by protein intake in MHD patients. PURPOSE: To compare dietary protein digestion and absorption kinetics and phosphorylation of anabolic signaling proteins after mixed meal ingestion in MHD patients and age- and BMI-matched controls. METHODS: 8 MHD patients (age: 56±5 y; BMI: 32±2 kg/m2) and 8 controls (age: 50±2 y; BMI: 31±1 kg/m2) received primed continuous infusions of L-[1-13C]leucine and ingested a mixed meal (546 kcal, 20 g protein, 59 g carbohydrate, 26 g fat) with protein provided as intrinsically L-[5,5,5-2H ]leucine labeled eggs. Breath, blood, and muscle biopsies were collected to determine amino acid concentrations, leucine enrichments, and phosphorylation of mTORC1 on Ser2448 during a 5 postprandial period. RESULTS: Postprandial release of dietary leucine into circulation over 5 h was reduced in MHD patients (41±5%) vs. controls (61±4%; P=0.03). The feeding-mediated increase in mTORC1 phosphorylation was blunted in MHD patients (0.6-fold above basal) vs. controls (1.1-fold above basal; P=0.006) at 5 h of the postprandial period. CONCLUSION: Our data demonstrated impaired kinetics of digestion/absorption of dietary proteins and reduced postprandial plasma amino acid availability in circulation after mixed meal ingestion in MHD patients when compared to age- and BMI-matched controls. This diminished dietary amino acid availability may have partly contributed to the blunted anabolic signaling mechanisms in MHD patients. Supported by the Egg Nutrition Center (ENC)

Effects of grain species, genotype and starch quantity on the postprandial plasma amino acid response in horses

Postprandial alterations of plasma amino acid (PAA) levels partly reflect a temporal contribution of the feed. How cereal grains affect PAA levels is not known. We hypothesized that a meal of cereal grains causes a temporal increase of PAA, affected by grain species, grain genotype and meal size. Six mares were used in three consecutive trials, receiving four oats, barley and maize genotypes, respectively. Individual grain genotypes were provided as 3 meal sizes corresponding to 1.0, 1.5 or 2.0 g starch/kg body weight. Meadow hay (1.5 kg/100 kg body weight) was offered daily. At the test days, 1 kg hay was fed 60 min prior to the grain meal. Blood samples were taken before grain feeding (0 min) and 30, 60, 90, 120, 180, 240 and 300 min thereafter. Subsequently, the remaining hay was offered. The genotype × starch quantity (i.e., meal size) interaction had a major effect on postprandial PAA concentrations (P < 0.05). Availability of amino acids (AA), ingested from different grain genotypes, apparently differed at both the digestive and post-digestive level. Thus, AA supply from grain feeding can better be assessed on the genotype level. The concentrations of most PAA increased rapidly with a postprandial maximum at around 30 min. Hay feeding might have an underrated capability for AA provision because increases of PAA levels were initialized already by ingestion of a 1 kg hay. It remains unclear which portion of the PAA kinetics response originates from hay feeding and which one from the cereal grain meal.

CD36 Modulates Fasting and Preabsorptive Hormone and Bile Acid Levels.

Abnormal fatty acid (FA) metabolism contributes to diabetes and cardiovascular disease. The FA receptor CD36 has been linked to risk of metabolic syndrome. In rodents CD36 regulates various aspects of fat metabolism, but whether it has similar actions in humans is unknown. We examined the impact of a coding single-nucleotide polymorphism in CD36 on postprandial hormone and bile acid (BA) responses. To examine whether the minor allele (G) of coding CD36 variant rs3211938 (G/T), which reduces CD36 level by ∼50%, influences hormonal responses to a high-fat meal (HFM). Obese African American (AA) women carriers of the G allele of rs3211938 (G/T) and weight-matched noncarriers (T/T) were studied before and after a HFM. Two-center study. Obese AA women. HFM. Early preabsorptive responses (10 minutes) and extended excursions in plasma hormones [C-peptide, insulin, incretins, ghrelin fibroblast growth factor (FGF)19, FGF21], BAs, and serum lipoproteins (chylomicrons, very-low-density lipoprotein) were determined. At fasting, G-allele carriers had significantly reduced cholesterol and glycodeoxycholic acid and consistent but nonsignificant reductions of serum lipoproteins. Levels of GLP-1 and pancreatic polypeptide (PP) were reduced 60% to 70% and those of total BAs were 1.8-fold higher. After the meal, G-allele carriers displayed attenuated early (-10 to 10 minute) responses in insulin, C-peptide, GLP-1, gastric inhibitory peptide, and PP. BAs exhibited divergent trends in G allele carriers vs noncarriers concomitant with differential FGF19 responses. CD36 plays an important role in the preabsorptive hormone and BA responses that coordinate brain and gut regulation of energy metabolism.

Postprandial Saturated Fatty Acids Increase the Risk of Type 2 Diabetes: A Cohort Study in a Chinese Population.

Experimental evidence suggests saturated fatty acids (SFAs) are associated with insulin resistance, but results from epidemiological studies on fasting SFAs-diabetes risk are inconsistent. We investigated SFA (fasting and 2-hour postprandial) profiles and diabetes risk. A total of 8940 participants were recruited for the Harbin People's Health Study in 2008. Serum SFAs (fasting and 2-hour postprandial) at baseline in Chinese men and women without diabetes were profiled, and type 2 diabetes was ascertained using World Health Organization criteria after 4 to 7 years of follow-up. Associations between 2-hour postprandial SFA (2h-SFA) and diabetes. At baseline, incident cases of diabetes were older with a higher body mass index and waist circumference. After a mean follow-up of 6.7 years, 658 incident cases of diabetes occurred. After propensity score computation and inverse probability of treatment weighting (IPTW) estimation, fasting SFAs were unrelated to diabetes risk but IPTW-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the highest tertile of 2-hour postprandial stearic acid (2h-SA), 2-hour postprandial palmitic acid (2h-PA), and 2h-SFA for diabetes risk were 2.50 (2.08 to 3.16), 1.56 (1.23 to 2.02), and 1.70 (1.34 to 2.17), respectively (P-trend < 0.0001). Similarly, 2h-SA/fasting SA, 2h-PA/fasting PA, and 2h-SFA/fasting SFA ratios [IPTW-adjusted OR (95% CI): 2.94 (2.39 to 3.58), 2.31 (1.80 to 2.93), and 2.42 (1.91 to 3.11), respectively; P-trend < 0.0001] predicted the diabetes risk. Higher serum 2h-SFA (but not fasting SFA) independently predicted diabetes risk.

The Characteristics of Postprandial Proximal Gastric Acid Pocket in Gastroesophageal Reflux Disease.

BackgroundPostprandial proximal gastric acid pocket (PPGAP) plays important roles in gastroesophageal reflux disease (GERD). In this study, we analyzed the characteristics of PPGAP in GERD.Material/MethodsThere were 17 normal participants and 20 GERD patients who completed a gastroesophageal reflux disease questionnaire (GerdQ) and underwent a gastroscopy, a high-resolution manometry, an esophageal 24-hour pH monitoring, and a station pull-through pH monitoring to assess their symptomatic degree, endoscopic change, acid exposure, and PPGAP.ResultsPPGAP was present in all participants. Compared with normal participants, the PPGAP in GERD patients was significantly different, thus the disappearing time was significantly later (p<0.001), the lasting time was significantly longer (p<0.001), the length was significantly longer (p<0.001), and the lowest pH and the mean pH were significantly lower (p<0.001). The length of PPGAP in GERD patients was positively correlated with GerdQ score (p<0.05). The disappearing time, the lasting time, and the length of PPGAP in GERD patients was positively correlated with the DeMeester score (p<0.01). The lowest pH and the mean pH of PPGAP in GERD patients was negatively correlated with the DeMeester score (p<0.001).ConclusionsPPGAP was generally present. PPGAP in GERD patients had characteristics of long time period, long length, and high acidity. Its length was positively correlated with subjective symptomatic degree. Its period, length, and acidity were positively correlated with the objective acid exposure. PPGAP seems to be the originator of acid reflux events and plays important roles in GERD.

Higher Fasting and Postprandial Free Fatty Acid Levels Are Associated With Higher Muscle Insulin Resistance and Lower Insulin Secretion in Young Non-Obese Women

BackgroundTo assess the relationship of the shape of glucose concentration curve during a standardized meal test to serum free fatty acid (FFA) concentrations, insulin resistance and insulin secretion in young non-obese women.MethodsThirty-five young women had a standardized meal for breakfast with measurement of glucose, insulin and FFA concentrations at 0 (fasting), 30, 60 and 120 min; the areas under the concentration curves were calculated (AUCg, AUCi and AUCffa, respectively). Meal-induced insulin response (MIR) was calculated as the ratio between the incremental insulin and glucose concentrations during the first 30 min of meal tests. In two women (group A), post-breakfast glucose (PBG) returned to levels below fasting plasma glucose (FPG) at 30 min; in 15 and 11 women, PBG returned to levels below FPG at 60 and 120 min (groups B and C, respectively). In the remaining seven women (group D), PBG never fell below FPG.ResultsDespite no difference in fasting insulin and AUCi, fasting FFA, AUCg and AUCffa were the lowest in group A, increased linearly from group B to C and plateaued in group D, whereas MIR might be the highest in group A, decreased from group B to C and plateaued in group D.ConclusionYoung women whose PBG returned to FPG more slowly had higher muscle insulin resistance and lower MIR associated with higher fasting and postprandial FFA levels compared with young women whose PBG returned to baseline more quickly.

Fast digestive proteins and sarcopenia of aging.

The speed of dietary protein digestion influences postprandial amino acid availability which is crucial for improving altered anabolic response of skeletal muscle one feature of sarcopenia during aging. By analogy with carbohydrate and in reference to their absorption rate, dietary proteins can be classified as 'fast' or 'slow' proteins depending on matrix food structure and technological processes, which can influence amino acids availability and their subsequent metabolic actions. 'Fast' digestive proteins have been shown to stimulate muscle protein synthesis and to improve muscle function in several recent studies involving older patients. These new aspects may be applied for improving health through preservation or restoration of muscle protein mass and function in clinical situations (obesity, rheumatoid arthritis and cancer cachexia). Using fast digestive proteins is of major interest to overcome 'anabolic resistance' of aging for limiting sarcopenia. Fast proteins' action on muscle anabolism may be stimulated by other nutrients like vitamin D or omega 3 fatty acids or by combination with exercise. The beneficial impact of the 'fast' protein concept beyond the amount of dietary protein on muscle preservation is a promising therapeutic perspective to improve mobility and quality of life of older patients affected with chronic disease.

Clinicopathological Findings and Prognosis in Canine Cases Diagnosed As Primary Hypoplasia of the Portal Vein.

Canine primary hypoplasia of the portal vein (PHPV) is a microscopic malformation of the hepatic vasculature. The prevalence, clinical signs, and clinicopathological findings of PHPV in dogs are unclear, because there are few reports concerning PHPV in the veterinary literature. This retrospective study reviewed clinical records and liver biopsy data from 48 dogs with hepatic disease that were examined at a private veterinary hospital in Japan between April 2011 and March 2014 to determine the prevalence of PHPV among dogs that underwent liver biopsy and to determine the clinical and clinicopathological findings of PHPV in dogs. Records for all 48 dogs that underwent liver biopsy were investigated. Collected data included signalment, clinical signs, physical examination findings, complete blood cell count, chemistry results, pre-and postprandial serum total bile acid concentrations, coagulation profiles (prothrombin time, activated partial thromboplastin time, fibrinogen, and antithrombin), and abdominal ultrasonography findings at the first medical examination. The diagnosis of PHPV was made on the basis of histological examination of hepatic biopsy specimens and portography or CT angiography. Among the 48 canine cases, 28 dogs (58.3%) were diagnosed with PHPV, which was the most common diagnosis. The most frequent clinical sign in dogs with PHPV was asymptomatic persistently increased liver enzymes (57.1%). Toy poodles were at a significantly higher risk of PHPV than other breeds among dogs that underwent liver biopsy (P < 0.001). The median survival time of dogs with PHPV was more than 5 years. Plasma fibrinogen concentration below the reference range was an indicator of PHPV in this study. Dogs with PHPV frequently had mild clinical signs and a favorable prognosis.

Effect of homogenised and pasteurised versus native cows' milk on gastrointestinal symptoms, intestinal pressure and postprandial lipid metabolism

Some people experience gastrointestinal symptoms related to cow’s milk consumption even if neither lactose intolerance nor cow’s milk allergy can be diagnosed. To investigate whether milk homogenization could cause gastrointestinal problems, homogenized and pasteurized milk and native milk were served to eleven volunteers who reported such sensitivity in a random order together with an ingestible pressure measuring capsule. Postprandial lipemia did not differ between the two milk types, but significant differences were found in the postprandial plasma fatty acid composition. No significant difference was found in the amount of gastrointestinal symptoms or in the intestinal pressure after the consumption of native and processed milk. However, the obtained results on pressure in the large intestine (P = 0.068) as well as reported symptoms (P = 0.103) suggest that further studies in this area are needed with a bigger subject group and with longer exposure times to differently processed milk types.