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Glycemic response, satiety, gastric secretions and emptying after bread consumption with water, tea or lemon juice: a randomized crossover intervention using MRI.
Freitas, D, Boué, F, Benallaoua, M, Airinei, G, Benamouzig, R, Lutton, E, Jourdain, L, Dubuisson, RM, Maître, X, Darrasse, L, et al
European journal of nutrition. 2022;(3):1621-1636
Abstract
PURPOSE Numerous studies, including our previous work with lemon juice, have reported that low-pH meals reduce the glycemic response to starchy foods. However, the underlying mechanism is not yet understood. Tea, for its polyphenol content, has also been investigated. The main objective of this research was to concurrently study gastric emptying, appetite perceptions and glycemic responses to bread consumed with water, tea, or lemon juice. METHODS In this randomized, crossover intervention, ten participants consumed equal portions of bread (100 g) with 250 mL of water, water-diluted lemon juice, or black tea at breakfast. Gastric volumes, blood glucose concentrations and appetite perceptions were alternately assessed over 180 min using magnetic resonance imaging, the finger-prick method and visual analogue scales, respectively. RESULTS Compared to water, lemon juice led to a 1.5 fold increase of the volume of gastric contents, 30 min after the meal (454.0 ± 18.6 vs. 298.4 ± 19.5 mL, [Formula: see text] ± SEM P < 0.00001). Gastric emptying was also 1.5 times faster (P < 0.01). Conversely, lemon juice elicited a lower glycemic response than water (blood glucose concentrations at t = 55 min were 35% lower, P = 0.039). Tea had no effect. Changes in appetite perceptions and gastric volumes correlated well, but with no significant differences between the meals. CONCLUSIONS Lemon juice lowered the glycemic response and increased both gastric secretions and emptying rate. The results are compatible with the hypothesis that the reduction of the glycemic response is mainly due to the interruption of starch hydrolysis via the acid-inhibition of salivary α-amylase. TRIAL REGISTRATION NUMBER NCT03265392, August 29, 2017.
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Quantity and source of dietary protein influence metabolite production by gut microbiota and rectal mucosa gene expression: a randomized, parallel, double-blind trial in overweight humans.
Beaumont, M, Portune, KJ, Steuer, N, Lan, A, Cerrudo, V, Audebert, M, Dumont, F, Mancano, G, Khodorova, N, Andriamihaja, M, et al
The American journal of clinical nutrition. 2017;(4):1005-1019
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Abstract
Background: Although high-protein diets (HPDs) are frequently consumed for body-weight control, little is known about the consequences for gut microbiota composition and metabolic activity and for large intestine mucosal homeostasis. Moreover, the effects of HPDs according to the source of protein need to be considered in this context.Objective: The objective of this study was to evaluate the effects of the quantity and source of dietary protein on microbiota composition, bacterial metabolite production, and consequences for the large intestinal mucosa in humans.Design: A randomized, double-blind, parallel-design trial was conducted in 38 overweight individuals who received a 3-wk isocaloric supplementation with casein, soy protein, or maltodextrin as a control. Fecal and rectal biopsy-associated microbiota composition was analyzed by 16S ribosomal DNA sequencing. Fecal, urinary, and plasma metabolomes were assessed by 1H-nuclear magnetic resonance. Mucosal transcriptome in rectal biopsies was determined with the use of microarrays.Results: HPDs did not alter the microbiota composition, but induced a shift in bacterial metabolism toward amino acid degradation with different metabolite profiles according to the protein source. Correlation analysis identified new potential bacterial taxa involved in amino acid degradation. Fecal water cytotoxicity was not modified by HPDs, but was associated with a specific microbiota and bacterial metabolite profile. Casein and soy protein HPDs did not induce inflammation, but differentially modified the expression of genes playing key roles in homeostatic processes in rectal mucosa, such as cell cycle or cell death.Conclusions: This human intervention study shows that the quantity and source of dietary proteins act as regulators of gut microbiota metabolite production and host gene expression in the rectal mucosa, raising new questions on the impact of HPDs on the large intestine mucosa homeostasis. This trial was registered at clinicaltrials.gov as NCT02351297.
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Randomized clinical trial: efficacy of a food supplement, TRANSITECH, on healthy individuals with mild intermittent constipation.
Alexandre, V, Bertin, C, Boubaya, M, Airinei, G, Bouchoucha, M, Benamouzig, R
European journal of gastroenterology & hepatology. 2016;(9):1087-93
Abstract
BACKGROUND Constipation is a common disorder in the general population and can be observed in healthy individuals. A natural product leading to an increase in bowel movements and decrease in colonic transit time (CTT), without bloating, could be useful for the patient's care. OBJECTIVES To investigate the effects of TRANSITECH, a food supplement composed of plants and lactic ferments, on bowel movements, CTT and bloating. METHODS A total of 100 healthy participants, presenting two to five stools per week, were selected and followed over a 6-day baseline period. They were randomly assigned to receive daily two tablets of TRANSITECH or placebo during 10 days. They were then followed up over 28 days after intervention. Participants daily recorded in a home questionnaire the characteristics of stools (frequency and consistency), and the importance of bloating during the preintervention period (from D-6 to D0), the intervention period (from D0 to D10) and the postintervention period (from D10 to D38). Their CTTs were also evaluated by following the propagation of radiopaque markers at D0 and D10. RESULTS At D10, the food supplement group showed, compared with the placebo group, higher daily stool emission (0.95±0.50, 0.70±0.20, P<0.001), softer stool consistency (2.5±0.6 vs. 3.0±0.8, P<0.001) and lower CTT (33.8±28.2 vs. 56.4±36.2 h, P=0.01). The active group also showed a sustained increase in daily stool emissions observed at D38 compared with D0 (P=0.03). CONCLUSION TRANSITECH is an efficient natural solution for the treatment of constipation. It increases the number of bowel movements, decreases the oroanal and segmental CTT, is well tolerated, and presents sustained effects after treatment completion.
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Body mass index association with functional gastrointestinal disorders: differences between genders. Results from a study in a tertiary center.
Bouchoucha, M, Fysekidis, M, Julia, C, Airinei, G, Catheline, JM, Cohen, R, Benamouzig, R
Journal of gastroenterology. 2016;(4):337-45
Abstract
BACKGROUND Obesity is considered as a risk factor for many functional gastrointestinal disorders. The aim of the study was to evaluate if functional digestive disorders are associated with specific body mass index groups and gender. METHODS A total of 1074 patients (50.3 ± 16.5 years, 67 % females) filled out a standard Rome III questionnaire (79 % acceptance rate). The patients were assigned to five groups according to their body mass index: underweight (6 %), normal (49 %), overweight (28 %), obese (12 %), and morbidly obese (5 %). Data analysis was performed using multinomial logistic regression; subjects with the normal weight were the reference group. RESULTS Patients presented specific demographic and clinical characteristics according to the weight groups. Underweight patients were younger (p < 0.001), and presented a female predominance (p = 0.006), dysphagia (p = 0.013) and soiling (p = 0.021). Overweight patients were older (p = 0.001), and reported more frequently globus (p = 0.001), regurgitation (p = 0.004), postprandial distress syndrome (p = 0.009). Obese patients reported more frequently regurgitation (p < 0.001). Morbid obese patients reported dyspepsia (p = 0.046). In patients, the odds of regurgitation increased with body mass index from underweight to obesity, but not when compared to morbid obesity. The probability of globus and regurgitation increased with body mass index and presented a steeper increase in females. CONCLUSIONS In patients with functional gastrointestinal disorders, globus and regurgitation are associated with body mass index, mainly in female patients.
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Casein Compared with Whey Proteins Affects the Organization of Dietary Fat during Digestion and Attenuates the Postprandial Triglyceride Response to a Mixed High-Fat Meal in Healthy, Overweight Men.
Mariotti, F, Valette, M, Lopez, C, Fouillet, H, Famelart, MH, Mathé, V, Airinei, G, Benamouzig, R, Gaudichon, C, Tomé, D, et al
The Journal of nutrition. 2015;(12):2657-64
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Abstract
BACKGROUND Postprandial lipemia is a risk factor for cardiovascular disease. The potential impacts of the type/nature of dietary protein on postprandial lipemia and associated dysregulations have been insufficiently investigated. OBJECTIVE We investigated the postprandial effect of including in a high-fat meal some milk protein fractions that markedly differ in their physicochemical properties and composition [either casein (CAS), whey protein (WHE), or α-lactalbumin-enriched whey protein (LAC)]. METHODS The protein fractions were incorporated as 15% energy in a high-fat meal in a 3-period, crossover postprandial study of 10 healthy overweight men with an elevated waist circumference (>94 cm). We measured postprandial changes in plasma lipids, amino acids, glucose, and oxidative stress markers, vascular function (using pulse contour analysis), and low-grade inflammation (using plasma markers). We also characterized in vitro the meal structures, including the size of the fat globule, and possible changes during digestion. RESULTS The type of protein did not affect postprandial plasma glucose, amino acids, insulin, or nonesterified fatty acids, but, compared with WHE and LAC, which did not differ, CAS markedly reduced postprandial triglycerides (TGs), achieving a 22 ± 10% reduction in the 6-h area under the curve (P < 0.05). Similar trends were shown for plasma chylomicrons [apolipoprotein (apo)B-48; P < 0.05]. However, there were no significant differences between the meals regarding postprandial oxidative stress (plasma hydroperoxides and malondialdehyde), endothelial dysfunction (salbutamol-induced changes in pulse contour analysis), or low-grade inflammation. In vitro studies showed that when the pH of the meal decreased to stomach pH values, the reduction in the solubility of casein resulted in a phase separation between fat and protein, whereas the proteins in the other meals remained suspended with fat globules. CONCLUSION In healthy overweight men, casein has specific physical interactions with fat that affect postprandial TGs, leading to the formation of fewer chylomicrons or an increase in chylomicron clearance. This trial was registered at clinicaltrials.gov as NCT00931151.
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The satiating effects of eggs or cottage cheese are similar in healthy subjects despite differences in postprandial kinetics.
Marsset-Baglieri, A, Fromentin, G, Nau, F, Airinei, G, Piedcoq, J, Rémond, D, Barbillon, P, Benamouzig, R, Tomé, D, Gaudichon, C
Appetite. 2015;:136-43
Abstract
Studies have reported a better satiating effect of eggs when compared with common cereal-based breakfasts, an effect that can be attributed to their macronutrient composition. Our aim was to compare the satiating power of an omelette and cottage cheese, both being common food snacks with similar nutrient compositions (containing proteins and lipids) but in different food forms. Thirty healthy volunteers participated in a randomized crossover trial. On each test day, the subjects consumed one of the two snacks, both providing 1346 kJ, 26 g protein, 21 g lipids, and 8 g lactose. The elapsed time between the snack and lunch request, their food intake at lunch, and their satiety scores were recorded. In a subgroup of 10 volunteers, blood was sampled to measure plasma metabolites and hormones. The two preloads were similar in terms of the time between the snack and a request for the buffet (167 ± 8 min), energy intake at the buffet (3988 ± 180 kJ) and appetite ratings. Plasma amino acid and urea concentrations indicated a marked delay in kinetic delivery after the eggs compared with the cottage cheese. In contrast, glucose, triglycerides and cholesterol displayed similar profiles after the snack. GIP and insulin secretions increased significantly after the cottage cheese, while glucagon and GLP-1 secretions were delayed with the omelette. We conclude that despite important differences in protein kinetics and their subsequent effects on hormone secretion, eggs and cottage cheese had a similar satiating power. This strongly suggests that with dose of proteins that is compatible to supplement strategies, i.e. 20-30 g, a modulation of protein kinetics is ineffective in increasing satiety.
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Milk protein fractions moderately extend the duration of satiety compared with carbohydrates independently of their digestive kinetics in overweight subjects.
Marsset-Baglieri, A, Fromentin, G, Airinei, G, Pedersen, C, Léonil, J, Piedcoq, J, Rémond, D, Benamouzig, R, Tomé, D, Gaudichon, C
The British journal of nutrition. 2014;(4):557-64
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Abstract
Digestive kinetics are believed to modulate satiety through the modulation of nutrient delivery. We hypothesised that the duration of satiety could be extended by modulating the kinetics of dietary amino acid delivery in overweight subjects, using snacks containing casein and whey protein. In the present study, eighty-two subjects underwent a first satiety test where they received a control snack containing 60 g maltodextrin. For the next 5 d, the subjects consumed a liquid protein snack containing 30 g carbohydrates and 30 g proteins (casein, whey protein or an equal mix of the two; n 26-28 per group). The subjects then underwent a second satiety test after ingesting the protein snack. The time period elapsing between the snack and request for lunch, food intake at lunch and satiety scores were recorded. A subgroup of twenty-four subjects underwent a digestive and metabolic investigation after ingesting their protein snack. Gastric emptying times were 2·5, 4 and 6 h for whey protein, mix and casein, respectively, displaying different kinetics of appearance of dietary N in plasma but without affecting pancreatic and gastrointestinal hormones. Compared with the control snack, proteins extended the duration of satiety (+17 min, P= 0·02), with no difference between the protein groups. The satiating effect of proteins was greater in subjects who ate their lunch early after the snack (below the median value, i.e. 2 h) at the control test (+32 min, P= 0·001). Energy intake at lunch was not modulated by proteins. The satiating effect of proteins is efficient in overweight subjects, especially when the duration of satiety is short, but independently of their digestive and plasma amino acid kinetics.
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Sequential release of milk protein-derived bioactive peptides in the jejunum in healthy humans.
Boutrou, R, Gaudichon, C, Dupont, D, Jardin, J, Airinei, G, Marsset-Baglieri, A, Benamouzig, R, Tomé, D, Leonil, J
The American journal of clinical nutrition. 2013;(6):1314-23
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BACKGROUND The digestive hydrolysis of dietary proteins leads to the release of peptides in the intestinal tract, where they may exert a variety of functions, but their characterization and quantification are difficult. OBJECTIVES We aimed to characterize and determine kinetics of the formation of peptides present in the jejunum of humans who ingested casein or whey proteins by using mass spectrometry and to look for and quantify bioactive peptides. DESIGN Subjects were equipped with a double-lumen nasogastric tube that migrated to the proximal jejunum. A sample collection was performed for 6 h after the ingestion of 30 g (15)N-labeled casein (n = 7) or whey proteins (WPs; n = 6). Nitrogen flow rates were measured, and peptides were identified by using mass spectrometry. RESULTS After casein ingestion, medium-size peptides (750-1050 kDa) were released during 6 h, whereas larger peptides (1050-1800 kDa) were released from WPs in the first 3 h. A total of 356 and 146 peptides were detected and sequenced in the jejunum after casein and WP ingestion, respectively. β-casein was the most important precursor of peptides, including bioactive peptides with various activities. The amounts of β-casomorphins (β-casein 57-, 58-, 59-, and 60-66) and β-casein 108-113 released on the postprandial window were sufficient to elicit the biological action of these peptides (ie, opioid and antihypertensive, respectively). CONCLUSIONS Clear evidence is shown of the presence of bioactive peptides in the jejunum of healthy humans who ingested casein. Our findings raise the question about the physiologic conditions under which these peptides can express their bioactivity in humans. This trial was registered at clinicaltrials.gov as NCT00862329.
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Monosodium glutamate raises antral distension and plasma amino acid after a standard meal in humans.
Boutry, C, Matsumoto, H, Airinei, G, Benamouzig, R, Tomé, D, Blachier, F, Bos, C
American journal of physiology. Gastrointestinal and liver physiology. 2011;(1):G137-45
Abstract
The consumption of monosodium glutamate (MSG) is advocated to elicit physiological and metabolic effects, yet these effects have been poorly investigated directly in humans and in particular in the postprandial phase. Thirteen healthy adults were supplemented for 6 days with a nutritional dose of MSG (2 g) or sodium chloride (NaCl) as control, following a crossover design. On the 7th day, they underwent a complete postprandial examination for the 6 h following the ingestion of the same liquid standard meal (700 kcal, 20% of energy as [(15)N]protein, 50% as carbohydrate, and 30% as fat) supplemented with MSG or NaCl. Real-ultrasound measures of antral area indicated a significant increased distension for the 2 h following the meal supplemented with MSG vs. NaCl. This early postprandial phase was also associated with significantly increased levels of circulating leucine, isoleucine, valine, lysine, cysteine, alanine, tyrosine, and tryptophan after MSG compared with NaCl. No changes to the postprandial glucose, insulin, glucagon-like peptide (GLP)-1, and ghrelin were noted between MSG- and NaCl-supplemented meals. Subjective assessments of hunger and fullness were neither affected by MSG supplementation. Finally, the postprandial fate of dietary N was identical between dietary conditions. Our findings indicate that nutritional dose of MSG promoted greater postprandial elevations of several indispensable amino acids in plasma and induced gastric distension. Further work to elucidate the possible sparing effect of MSG on indispensable amino acid first-pass uptake in humans is warranted. This trial was registered at clinicaltrials.gov as NCT00862017.
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Postprandial protein metabolism but not a fecal test reveals protein malabsorption in patients with pancreatic exocrine insufficiency.
Airinei, G, Gaudichon, C, Bos, C, Bon, C, Kapel, N, Bejou, B, Raynaud, JJ, Luengo, C, Aparicio, T, Levy, P, et al
Clinical nutrition (Edinburgh, Scotland). 2011;(6):831-7
Abstract
BACKGROUND & AIMS Pancreatic exocrine insufficiency (PEI) impairs fat absorption, but few data are available on protein absorption. We investigated this question in patients with chronic pancreatitis, both in the absence and presence of enzyme therapy, using a stable isotope sensitive method. METHODS Eleven patients with sustained PEI and regular enzyme substitution were investigated at hospital, after a washout period without enzyme substitution, and later after reintroduction of substitution. The digestibility and postprandial metabolism of dietary protein were characterized after the ingestion of a semi-synthetic single meal containing 20 g (15)N-labeled casein. RESULTS At baseline, 20 ± 8% of dietary nitrogen was transferred to the metabolic pools vs. 24.5 ± 7% under enzyme treatment (P = 0.04). After treatment, the transfer of dietary nitrogen tended to increase in plasma amino acids, and increased significantly in plasma proteins and the deamination pool. In contrast, the fecal excretion of dietary nitrogen did not demonstrate any treatment effect. In patients not receiving insulin for diabetes, the treatment stimulated insulin secretion. CONCLUSIONS Protein malabsorption was mostly undetectable using standard fecal tests. The study of the postprandial fate of dietary protein revealed a moderate increase of its transfer to metabolic pools after enzyme substitution.