Effect of ingestion order of the fat component of a solid meal on intragastric fat distribution and gastric emptying assessed by MRI

Abstract

Purpose:To develop an MRI technique to investigate how varying the ingestion order of nonfat and fat components of a solid meal influences three-dimensional intragastric distribution and gastric emptying (GE). Materials and Methods:Eight healthy subjects were studied twice in randomized order. On one occasion (condition F-NF), the fat component (40 g mayonnaise on toast) was served before the nonfat component (270 g pasta, 200 g tomato sauce, 100 mL water); on the other (condition NF-F), the ingestion order was reversed. GE and intragastric distribution of both components were assessed by MRI for 180 minutes.Results: During condition F-NF, GE of fat was significantly faster than during condition NF-F (T 25 [min]: F-NF: 20 Ϯ 9; NF-F: 40 Ϯ 7; P Ͻ 0.05), a larger amount of fat was observed in the antrum during condition F-NF, and more fat layering occurred. No differences were observed in total GE between the two conditions. Conclusion:Meal ingestion order influences GE and intragastric distribution of fat, which can be assessed by MRI techniques, providing new insights into the physiology of gastric processing and intragastric distribution of different meal phases.

Methods for measurement of gastric motility

“…MRI has the potential to become an overall test to measure gastric emptying, volume change, and wall motion as a surrogate of contractile activity without radiation exposure (43,72,73,76,85,86,111). It also has the ability to separately assess the emptying of fat and water from the stomach (73). However, to date MRI has not been validated to the same degree as scintigraphy and gastric emptying breath tests, and there is a paucity of studies in disease states or in response to different perturbations other than the effects of different nutrients or drugs such as erythromycin.…”

Enhancement of intragastric acid stability of a fat emulsion meal delays gastric emptying and increases cholecystokinin release and gallbladder contraction

“…Recently several groups have begun to exploit the developments in MRI to describe this process in more detail and have shown that the oil phase floats above the aqueous phase in the gastric fundus and hence empties last (6). The order of ingestion of different meal components may also influence gastric emptying and the intragastric spatial distribution of fat (29).…”

“…MRI represents a unique tool to carry out such investigations because it is a noninvasive, well-established method to gain insights into the spatial distribution of intraluminal contents and to follow gastric emptying (17,33,44). Furthermore, MRI has high spatial resolution and can by virtue of its unique sensitivity to changes in the proton environment discriminate well between the water and the fat components of a meal (6,7,17,19,27,29,45,46).…”

Mixed Meal Model in Type 1 Diabetes

“…5 and 6 demonstrate an accurate representation of the rate of lipolysis and the gradual increase in NEFA levels due to fatty acid spillover from postprandial CM-TG metabolism, respectively, which our previous conceptual model [9] is neither able to reproduce. Although carbohydrates and dietary fat from a mixed meal are digested as chyme in the same physiological chamber, the biphasic nature of gut transit of mixed meals is represented separately for each macronutrient since the rate of gastric emptying of the fat component is basically slower than that of carbohydrates [24]. Moreover, despite the existence of some evidence, there is no absolute consensus about the relationship between BG levels and gastric emptying due to conflicting results from clinical studies [25], except for an apparent normal gastric emptying at normoglycemia [26].…”