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Summary. The present study examined the acute effects of coingestion of fat (37.5 g) on the post-prandial metabolic responses to 75 g of carbohydrate which was either slowly absorbed (lentils) or rapidly absorbed (potatoes). Co-ingestion of fat resulted in a significant flattening of the post-prandial glucose curves, the effect being more pronounced for the rapidly absorbed potatoes. This was probably due to delayed gastric emptying. However, the post-prandial insulin responses to either carbohydrate were not significantly reduced by fat, suggesting that the insulin response to a given glucose concentration was potentiated in the presence of fat. The gastric inhibitory polypeptide (GIP) responses to both carbohydrates were greatly increased in the presence of fat. To investigate further the possible roles of GIP in the entero-insular axis, a 5-g bolus of glucose was injected intravenously i h after lentils_ fat. This was sufficient to raise the glucose levels above the threshold reported for GIP to potentiate insulin secretion. However, despite the large differences in circulating GIP levels, the insulin response to glucose was not affected by the presence of fat. These results suggest that (1) the rate of absorption of carbohydrate is a major determinant of post-prandial metabolic responses even in the presence of fat, (2) fat-stimulated GIP secretion does not potentiate glucose-induced insulin secretion, and (3) the potentiation of the insulin response to glucose when carbohydrate is co-ingested with fat is consistent with the well-documented insulin resistance associated with high fat diets.Key words: Insulin, gastric inhibitory polypeptide, insulin sensitivity, glucose tolerance, diabetes, diet, fat, rate of carbohydrate digestion.Several studies have demonstrated the beneficial effects of high-carbohydrate, high-fibre diets in the treatment of Type 2 (non-insulin-dependent) diabetes [1,2]. The mechanism by which this dietary regimen improves long-term diabetic control remains unclear: is it due to the high complex carbohydrate, high fibre, type of fibre or low fat contents of such diets? Most previous studies have concentrated on the acute responses to complex carbohydrate and fibre components of the diet [3][4][5], and have highlighted the importance of rate of intestinal digestion and absorption in determining the metabolic responses to different carbohydrates. It has been suggested that these acute metabolic changes form the basis of long-term benefits associated with high-carbohydrate, high-fibre diets.However, as these diets are also low in fat, and insulin sensitivity has been demonstrated to be inversely related to the fat content of the diet [6,7], it is possible that * Present address: University of Melbourne, Department of Medicine, Repatriation General Hospital, Heidelberg West, Victoria, 3081, Australia the improved metabolic control is due (at least in part) to the low fat content. Thus, the aim of the present study was to examine the acute interaction of two components of the high-carbohydrate...

Findings contribute to the TBI literature in showing that it is: (a) the more subjective and not objectively measured nature of participation that is associated with SQOL and (b) positive and negative aspects of quality of life show different relationships with social participation variables. Implications for Rehabilitation A high proportion of individuals with traumatic brain injury (TBI) experiences reduced involvement in social participation (involvement in social and leisure activities and within a social network) and low subjective quality of life (SQOL). This study suggests that, by simply increasing the variety and frequency of social and leisure activities, there may be no positive influences on SQOL. Instead, this study suggests that, to increase SQOL, it is important to increase opportunities for individuals to participate with others and also to enhance their subjective experience of social and leisure activities. The large variance obtained of scores for social participation and SQOL provide a reminder to clinicians to maintain an individualized approach when working with individuals with TBI.

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This is the largest series of small bowel MRI in a paediatric population. MRI reports were at least equivalent to BaFT. MRI had higher sensitivity and, particularly, specificity in detecting terminal ileal pathology. These findings suggest that MRI should become the criterion standard investigation in children with IBD in centres with appropriate expertise, with zero radiation exposure being highly advantageous.