Ileal Transposition in Rats Reduces Energy Intake, Body Weight, and Body Fat Most Efficaciously When Ingesting a High-Protein Diet

Abstract

Purpose Ileal transposition (IT) allows exploration of hindgut effects of bariatric procedures in inducing weight loss and reducing adiposity. Here we investigated the role of dietary macronutrient content on IT effects in rats. Methods Male Lewis rats consuming one of three isocaloric liquid diets enriched with fat (HF), carbohydrates (HC), or protein (HP) underwent IT or sham surgery. Body weight, energy intake, energy efficiency, body composition, and (meal-induced) changes in plasma GIP, GLP-1, PYY, neurotensin, and insulin levels were measured. Results Following IT, HC intake remained highest leading to smallest weight loss among dietary groups. IT in HF rats caused high initial weight loss and profound hypophagia, but the rats caught up later, and finally had the highest body fat content among IT rats. HP diet most efficaciously supported IT-induced reduction in body weight and adiposity, but (as opposed to other diet groups) lean mass was also reduced. Energy efficiency decreased immediately after IT irrespective of diet, but normalized later. Energy intake alone explained variation in post-operative weight change by 80%. GLP-1, neurotensin, and PYY were upregulated by IT, particularly during (0–60 min) and following 17-h post-ingestive intake, with marginal diet effects. Thirty-day post-operative cumulative energy intake was negatively correlated to 17-h post-ingestive PYY levels, explaining 47% of its variation. Conclusion Reduction in energy intake underlies IT-induced weight loss, with highest efficacy of the HP diet. PYY, GLP-1, and neurotensin levels are upregulated by IT, of which PYY may be most specifically related to reduced intake and weight loss after IT.

Reverse Transposition Of The Ileum Is A New Surgical Model For The Study Of The «Hindgut" Hypothesis In Diabetes Mellitus

“…We present a novel experimental surgical procedure to investigate the role of the ileum in diabetes mellitus and the Hindgut hypothesis. As in most similar previous studies, surgical technique proposed by us is based on the movement of the ileum in the proximal direction and its location after the ligament of Treitz and duodenum, but there is not only interposition of the terminal segment of the ileum [12,13,14], but also reverse transposition -antiperistaltic location of almost the entire small intestine.…”

Nutrient-Based Appetite Regulation

“… 25 , 26 Based on this, it is expected that the GBA can effectively sense the intake of protein and inhibit appetite accordingly. Specifically, when protein is consumed, enteroendocrine cells located in the small intestine secrete cholecystokinin (CCK), 27 glucagon-like peptide 1 (GLP-1), 28 , 29 and peptide YY (PYY). 28 - 30 These three are defined as anorexigenic (appetite suppressant) hormones.…”

“…Specifically, when protein is consumed, enteroendocrine cells located in the small intestine secrete cholecystokinin (CCK), 27 glucagon-like peptide 1 (GLP-1), 28 , 29 and peptide YY (PYY). 28 - 30 These three are defined as anorexigenic (appetite suppressant) hormones. When CCK is released, the nearby region of the small intestine that holds the VN afferents receives the signal from CCK when it binds to its CCK type 1 receptors (CCK 1 ).…”

Der Stellenwert neuerer Verfahren in der Adipositaschirurgie (SADI, SASI und Co.)

“…Deshalb liegen für die IT vor allem tierexperimentelle Studien vor [32]. Durch dieses Umsetzen eines bestimmten Anteils des Dünndarms kommt es unter anderem zu einer Veränderung der Nahrungsaufnahme, der Stoffwechselparameter und letztlich auch des Gewichts und der Körperzusammensetzung [33]. Die Wirkung durch früheren Kontakt des Speisebreis mit dem Ileum wird von einigen Autoren als "Ileal Break" bezeichnet [31].…”