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Frontiers in Endocrinology 2023Since statins have had such tremendous therapeutic success over the last three decades, the field of atherosclerosis has become somewhat LDL-centric, dismissing the... (Review)
Review
Since statins have had such tremendous therapeutic success over the last three decades, the field of atherosclerosis has become somewhat LDL-centric, dismissing the relevance of triglycerides (TG), particularly chylomicrons, in atherogenesis. Nonetheless, 50% of patients who take statins are at risk of developing atherosclerotic cardiovascular disease (ASCVD) and are unable to achieve their goal LDL-C levels. This residual risk is mediated, in part by triglyceride rich lipoproteins (TRL) and their remnants. Following his seminal investigation on the subject, Zilversmit proposed that atherosclerosis is a postprandial event in 1979 (1-4). In essence, the concept suggests that remnant cholesterol-rich chylomicron (CM) and very-low density lipoprotein (VLDL) particles play a role in atherogenesis. Given the foregoing, this narrative review addresses the most recent improvements in our understanding of postprandial dyslipidemia. The primary metabolic pathways of chylomicrons are discussed, emphasizing the critical physiological role of lipoprotein lipase and apoCIII, the importance of these particles' fluxes in the postprandial period, their catabolic rate, the complexities of testing postprandial metabolism, and the role of angiopoietin-like proteins in the partition of CM during the fed cycle. The narrative is rounded out by the dysregulation of postprandial lipid metabolism in insulin resistance states and consequent CVD risk, the clinical evaluation of postprandial dyslipidemia, current research limits, and potential future study directions.
Topics: Humans; Chylomicrons; Lipoproteins, VLDL; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Postprandial Period; Atherosclerosis; Dyslipidemias
PubMed: 38303975
DOI: 10.3389/fendo.2023.1322869 -
The American Journal of Clinical... Sep 2021
Postprandial metabolism and inflammation-a comprehensive model to advance Precision Nutrition? Lessons learned from the Personalised REsponses to DIetary Composition Trial (PREDICT study).
Topics: Diet; Humans; Inflammation; Nutritional Status; Postprandial Period
PubMed: 34143866
DOI: 10.1093/ajcn/nqab200 -
Nutrients Mar 2023Functional dyspepsia is a gastrointestinal disorder characterized by postprandial fullness, early satiation, epigastric pain, and epigastric burning. The pathophysiology... (Review)
Review
Functional dyspepsia is a gastrointestinal disorder characterized by postprandial fullness, early satiation, epigastric pain, and epigastric burning. The pathophysiology of the disease is not fully elucidated and there is no permanent cure, although some therapies (drugs or herbal remedies) try to reduce the symptoms. Diet plays a critical role in either the reduction or the exacerbation of functional dyspepsia symptoms; therefore dietary management is considered to be of high importance. Several foods have been suggested to be associated with worsening functional dyspepsia, such as fatty and spicy foods, soft drinks, and others, and other foods are thought to alleviate symptoms, such as apples, rice, bread, olive oil, yogurt, and others. Although an association between functional dyspepsia and irregular eating habits (abnormal meal frequency, skipping meals, late-night snacking, dining out, etc.) has been established, not many dietary patterns have been reported as potential factors that influence the severity of functional dyspepsia. A higher adherence to Western diets and a lower adherence to FODMAPs diets and healthy patterns, such as the Mediterranean diet, can contribute to the worsening of symptoms. More research is needed on the role of specific foods, dietary patterns, or specific eating habits in the management of functional dyspepsia.
Topics: Humans; Dyspepsia; Abdominal Pain; Diet; Feeding Behavior; Gastrointestinal Diseases; Postprandial Period
PubMed: 36986274
DOI: 10.3390/nu15061544 -
The Journal of Nutrition Sep 2019Excess lipid availability has been associated with the development of anabolic resistance. As such, obesity may be accompanied by impairments in muscle protein...
BACKGROUND
Excess lipid availability has been associated with the development of anabolic resistance. As such, obesity may be accompanied by impairments in muscle protein metabolism.
OBJECTIVE
We hypothesized that basal and postprandial muscle protein synthesis rates are lower in obese than in lean men.
METHODS
Twelve obese men [mean ± SEM age: 48 ± 2 y; BMI (in kg/m2): 37.0 ± 1.5; body fat: 32 ± 2%] and 12 age-matched lean controls (age: 43 ± 3 y; BMI: 23.4 ± 0.4; body fat: 21 ± 1%) received primed continuous L-[ring-2H5]-phenylalanine and L-[ring-3,5-2H2]-tyrosine infusions and ingested 25 g intrinsically L-[1-13C]-phenylalanine labeled whey protein. Repeated blood and muscle samples were obtained to assess protein digestion and amino acid absorption kinetics, and basal and postprandial myofibrillar protein synthesis rates.
RESULTS
Exogenous phenylalanine appearance rates increased after protein ingestion in both groups (P < 0.001), with a total of 53 ± 1% and 53 ± 2% of dietary protein-derived phenylalanine appearing in the circulation over the 5-h postprandial period in lean and obese men, respectively (P = 0.82). After protein ingestion, whole-body protein synthesis and oxidation rates increased to a greater extent in lean men than in the obese (P-interaction < 0.05), resulting in a higher whole-body protein net balance in the lean than in the obese (7.1 ± 0.2 and 4.6 ± 0.4 µmol phenylalanine · h-1 · kg-1, respectively; P-interaction < 0.001). Myofibrillar protein synthesis rates increased from 0.030 ± 0.002 and 0.028 ± 0.003%/h in the postabsorptive period to 0.034 ± 0.002 and 0.035 ± 0.003%.h-1 in the 5-h postprandial period (P = 0.03) in lean and obese men, respectively, with no differences between groups (P-interaction = 0.58).
CONCLUSIONS
Basal, postabsorptive myofibrillar protein synthesis rates do not differ between lean and obese middle-aged men. Postprandial protein handling, including protein digestion and amino acid absorption, and the postprandial muscle protein synthetic response after the ingestion of 25 g whey protein are not impaired in obese men. This trial was registered at www.trialregister.nl as NTR4060.
Topics: Adult; Amino Acids; Exercise; Fatty Acids, Nonesterified; Humans; Male; Middle Aged; Muscle Proteins; Myofibrils; Obesity; Phenylalanine; Postprandial Period; Thinness
PubMed: 31174213
DOI: 10.1093/jn/nxz104 -
Clinical Nutrition ESPEN Dec 2021With the rise of global cardiometabolic diseases, it is important to investigate risk factors such as obesity. Metabolic flexibility, the ability to maintain metabolic...
BACKGROUND & AIMS
With the rise of global cardiometabolic diseases, it is important to investigate risk factors such as obesity. Metabolic flexibility, the ability to maintain metabolic homeostasis following an acute challenge, can reflect cardiometabolic health. We investigated the association between body composition and the metabolic flexibility following meal consumption in an adult population.
METHODS
In this study of 1027 participants (mean age 44.0 y ± SD 4.2 y), we administered a mixed-macronutrient meal challenge. Fasting and 2-h postprandial plasma were assayed for lipids, glycemic, and inflammation biomarkers. We characterized metabolic flexibility through meal-induced biomarker responses (%Δ, the difference between postprandial and fasting concentrations, divided by fasting concentration). We then compared the responses by sex-specific tertiles of body mass index (BMI) and percent body fat.
RESULTS
With every unit (kg/m) increase in BMI, %Δ (95% confidence interval) increased by 0.17% (0.09, 0.26%) for total cholesterol, 0.31% (0.07, 0.54%) for triglycerides, and 0.11% (0.01, 0.20%) for apoA-I, whereas insulin elevation was reduced (-6.30%; -8.41, -4.20%), and the reduction in leptin was attenuated (0.64%; 0.25, 1.05%). With each unit (percent) increase in body fat, we observed similar changes in the %Δ of total cholesterol and leptin but not in triglycerides, apoA-I, or insulin. Glucose response increased by 0.29% (0.06, 0.51%) as body fat increases by one unit.
CONCLUSION
Metabolic flexibility, as assessed by biomarker responses to an acute physiological meal challenge, differed by body composition. These findings may help elucidate the pathways through which obesity contributes to cardiometabolic diseases.
Topics: Adult; Blood Glucose; Body Composition; Body Mass Index; Female; Humans; Male; Obesity; Postprandial Period
PubMed: 34857223
DOI: 10.1016/j.clnesp.2021.09.730 -
Asia Pacific Journal of Clinical... Jun 2017The prevalence of obesity in Indonesia has increasing. We have assessed the relationship between plasma acylated ghrelin hormone and self-reported appetite ratings...
BACKGROUND AND OBJECTIVES
The prevalence of obesity in Indonesia has increasing. We have assessed the relationship between plasma acylated ghrelin hormone and self-reported appetite ratings (hunger and desire to eat) in obese and normal weight men.
METHODS AND STUDY DESIGN
Thirty-two men participated in an experimental study, where acylated ghrelin and self-reported appetite ratings were compared between a test group of 16 obese men and a control group of 16 men with normal body mass indices. The participants were administered isocaloric mixed meals, and measurements were taken at 0 (before eating), 30, 60, and 120 minutes postprandial. Data were analysed using an independent t test, the Mann-Whitney U test, the Pearson correlation, the Spearman rank-order correlation, trapezoidal rule analysis for the area under the curve, and receiver operating curve analysis to determine the optimal cut-off values, sensitivity, and specificity.
RESULTS
Acylated ghrelin concentrations were higher in the test group than in the control group at all time points (p<0.01). There were no significant differences in the appetite ratings between the two groups at any time (p>0.05). There was no correlation between the acylated ghrelin concentration and appetite rating. According to the receiver operating curve analysis (sensitivity: 88%; specificity: 100%), the cut-offs for optimal acylated ghrelin immediately before eating and 30 minutes after eating, averaged 2332 pg/mL and 2710 pg/mL, respectively.
CONCLUSIONS
The effect on obesity will depend on associated changes in deacylated ghrelin. Acylated ghrelin increases in obese individuals pre- and 30, 60, 90 and 120 minutes post prandial.
Topics: Acylation; Gene Expression Regulation; Ghrelin; Humans; Male; Obesity; Postprandial Period
PubMed: 28625043
DOI: 10.6133/apjcn.062017.s5 -
Nutrients Oct 2022Postprandial insulinaemia, triglyceridaemia and measures of inflammation are thought to be more closely associated with cardiovascular risk than fasting measures.... (Clinical Trial)
Clinical Trial
Postprandial insulinaemia, triglyceridaemia and measures of inflammation are thought to be more closely associated with cardiovascular risk than fasting measures. Although hypertension is associated with altered fasting metabolism, it is unknown as to what extent postprandial lipaemic and inflammatory metabolic responses differ between hypertensive and normotensive individuals. Linear models adjusting for age, sex, body mass index (BMI), visceral fat mass (VFM) and multiple testing (false discovery rate), were used to investigate whether hypertensive cases and normotensive controls had different fasting and postprandial (in response to two standardised test meal challenges) lipaemic, glycaemic, insulinaemic, and inflammatory (glycoprotein acetylation (GlycA)) responses in 989 participants from the ZOE PREDICT-1 nutritional intervention study. Compared to normotensive controls, hypertensive individuals had significantly higher fasting and postprandial insulin, triglycerides, and markers of inflammation after adjusting for age, sex, and BMI (effect size: Beta (Standard Error) ranging from 0.17 (0.08), = 0.04 for peak insulin to 0.29 (0.08), = 4.4 × 10 for peak GlycA). No difference was seen for postprandial glucose. When further adjusting for VFM effects were attenuated. Causal mediation analysis suggests that 36% of the variance in postprandial insulin response and 33.8% of variance in postprandial triglyceride response were mediated by VFM. Hypertensive individuals have different postprandial insulinaemic and lipaemic responses compared to normotensive controls and this is partially mediated by visceral fat mass. Consequently, reducing VFM should be a key focus of health interventions in hypertension. The ClinicalTrials.gov registration identifier is NCT03479866.
Topics: Humans; Blood Glucose; Hypertension; Inflammation; Insulin; Intra-Abdominal Fat; Postprandial Period; Triglycerides
PubMed: 36364763
DOI: 10.3390/nu14214499 -
Nutrients Oct 2023Dietary fiber plays a potential role in regulating energy intake and stabilizing postprandial blood glucose levels. Soluble dietary fiber has become an important entry... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Dietary fiber plays a potential role in regulating energy intake and stabilizing postprandial blood glucose levels. Soluble dietary fiber has become an important entry point for nutritional research on the regulation of satiety.
METHODS
this was a double-blind, randomized cross-over trial enrolling 12 healthy subjects to compare the effects of RPG (R+PolyGly) dietary fiber products (bread, powder, and capsule) and pectin administered with a standard meal on satiety, blood glucose, and serum insulin level.
RESULTS
Adding 3.8% RPG dietary fiber to bread significantly increased the volume, water content, hardness, and chewiness of bread compared to 3.8% pectin bread and white bread and significantly improved the sensory quality of bread. RPG bread had better appetite suppression effects at some time points than the other two groups and the best postprandial blood glucose lowering effects among the three groups. Administration of RPG capsules containing 5.6 g of RPG dietary fiber with meals improved satiety and reduced hunger compared to 6 g of RPG powder and 6 g of pectin, which had the greatest effect on suppressing appetite and reducing prospective food consumption. The peak level of serum glucagon-like peptide-1 (GLP-1) in the RPG capsule group (578.17 ± 19.93 pg/mL) was significantly higher than that in other groups at 0 min and 30 min after eating. RPG powder had the best effect in reducing postprandial blood glucose and increasing serum insulin levels; the total area under the curve (AUC) of serum insulin with RPG powder was higher than other groups (5960 ± 252.46 μU min/mL).
CONCLUSION
RPG dietary fiber products can improve the sensory properties of food, reduce postprandial blood glucose, and enhance satiety, especially in capsule and powder forms. Further research on the physiological effects of RPG dietary fiber is required to facilitate its use as a functional ingredient in food products.
Topics: Adult; Humans; Blood Glucose; Bread; Cross-Over Studies; Dietary Fiber; Insulin; Pectins; Postprandial Period; Powders
PubMed: 37960222
DOI: 10.3390/nu15214569 -
Nutrients Jan 2024Lentils have potential to improve metabolic health but there are limited randomized clinical trials evaluating their comprehensive impact on metabolism. The aim of this... (Randomized Controlled Trial)
Randomized Controlled Trial
Lentils have potential to improve metabolic health but there are limited randomized clinical trials evaluating their comprehensive impact on metabolism. The aim of this study was to assess the impact of lentil-based vs. meat-based meals on fasting and postprandial measures of glucose and lipid metabolism and inflammation. Thirty-eight adults with an increased waist circumference (male ≥ 40 inches and female ≥ 35 inches) participated in a 12-week dietary intervention that included seven prepared midday meals totaling either 980 g (LEN) or 0 g (CON) of cooked green lentils per week. Linear models were used to assess changes in fasting and postprandial markers from pre- to post-intervention by meal group. Gastrointestinal (GI) symptoms were assessed through a survey randomly delivered once per week during the intervention. We found that regular consumption of lentils lowered fasting LDL (F = 5.53, = 0.02) and total cholesterol levels (F = 8.64, < 0.01) as well as postprandial glucose (β = -0.99, = 0.01), IL-17 (β = -0.68, = 0.04), and IL-1β (β = -0.70, = 0.03) responses. GI symptoms were not different by meal group and all symptoms were reported as "none" or "mild" for the duration of the intervention. Our results suggest that daily lentil consumption may be helpful in lowering cholesterol and postprandial glycemic and inflammatory responses without causing GI stress. This information further informs the development of pulse-based dietary strategies to lower disease risk and to slow or reverse metabolic disease progression in at-risk populations.
Topics: Lens Plant; Glucose; Blood Glucose; Fasting; Cholesterol; Meals; Postprandial Period; Insulin; Cross-Over Studies
PubMed: 38337705
DOI: 10.3390/nu16030419 -
Nutrients Jun 2021In a recent study, we showed that konjac glucomannan (KGM) inhibits rice gruel-induced postprandial increases in plasma glucose and insulin levels. To extend this... (Randomized Controlled Trial)
Randomized Controlled Trial
In a recent study, we showed that konjac glucomannan (KGM) inhibits rice gruel-induced postprandial increases in plasma glucose and insulin levels. To extend this research, we investigated the effects of KGM addition to rice gruel on pre- and postprandial concentrations of circulating lipoprotein lipase (LPL), glycosylphosphatidylinositol-anchored high-density lipoprotein-binding protein 1 (GPIHBP1), hepatic triglyceride lipase (HTGL), free fatty acids (FFA), and triglycerides (TG). A total of 13 Japanese men, without diabetes, dyslipidemia, or gastrointestinal diseases, interchangeably ingested rice gruel containing no KGM (0%G), rice gruel supplemented with 0.4% KGM (0.4%G), and rice gruel supplemented with 0.8% KGM (0.8%G), every Sunday for 3 weeks. Blood samples were obtained at baseline and at 30, 60, and 120 min after ingestion to measure the abovementioned lipid parameters. Lipid parameters showed small, but significant, changes. Significant reductions were found in circulating FFA levels among all participants. Circulating TG levels significantly declined at 30 min and then remained nearly constant in the 0.8%G group but exhibited no significant difference in the 0%G and 0.4%G groups. Although circulating levels of LPL and GPIHBP1 significantly decreased in the 0%G and 0.4%G groups, they increased at 120 min in the 0.8%G group. Participants in the 0%G and 0.4%G groups showed significant decreases in circulating HTGL levels, which was not observed in the 0.8%G group. Our results demonstrate the novel pleiotropic effects of KGM. Supplementation of rice gruel with KGM powder led to TG reduction accompanied by LPL and GPIHBP1 elevation and HTGL stabilization, thereby attenuating TG metabolism.
Topics: Adult; Cross-Over Studies; Dietary Supplements; Double-Blind Method; Edible Grain; Humans; Lipid Metabolism; Lipoprotein Lipase; Male; Mannans; Middle Aged; Oryza; Postprandial Period; Powders; Receptors, Lipoprotein; Triglycerides
PubMed: 34202167
DOI: 10.3390/nu13072191