Plasma levels of the orexigenic hormone ghrelin are suppressed by meals with an efficacy dependent on their macronutrient composition. We hypothesized that heterogeneity in osmolarity among macronutrient classes contributes to these differences. In three studies, the impact of small intestinal hyperosmolarity was examined in Sprague-Dawley rats. In study 1, isotonic, 2.5ϫ, and 5ϫ hypertonic solutions of several agents with diverse absorption and metabolism properties were infused duodenally at a physiological rate (3 ml/10 min). Jugular vein blood was sampled before and at 30,60,90, 120, 180, 240, and 300 min after infusion. Plasma ghrelin was suppressed dose dependently and most strongly by glucose. Hyperosmolar infusions of lactulose, which transits the small intestine unabsorbed, and 3-O-methylglucose (3-O-MG), which is absorbed like glucose but remains unmetabolized, also suppressed ghrelin. Glucose, but not lactulose or 3-O-MG, infusions increased plasma insulin. In study 2, intestinal infusions of hyperosmolar NaCl suppressed ghrelin, a response that was not attenuated by coinfusion with the neural blocker lidocaine. In study 3, we reconfirmed that the low-osmolar lipid emulsion Intralipid suppresses ghrelin more weakly than isocaloric (but hypertonic) glucose. Importantly, raising Intralipid's osmolarity to that of the glucose solution by nonabsorbable lactulose supplementation enhanced ghrelin suppression to that seen after glucose. Hyperosmolar ghrelin occurred particularly during the initial 3 postinfusion hours. We conclude that small intestinal hyperosmolarity 1) is sufficient to suppress ghrelin, 2) may combine with other postprandial mechanisms to suppress ghrelin, 3) might contribute to altered ghrelin regulation after gastric bypass surgery, and 4) may inform dietary modifications for metabolic health.ghrelin; intestinal osmolarity; 3-O-methylglucose; lactulose; satiation GHRELIN IS THE ONLY KNOWN appetite-stimulating gastrointestinal hormone in humans and other vertebrates. Exogenous administration of this 28-amino-acid peptide increases short-term hunger, food intake, and motivation to eat, as well as body weight (14,16,17,67). Circulating ghrelin levels correlate with energy balance, i.e., they increase with weight loss or during meal anticipation and decrease with weight gain or after food intake. Ghrelin's orexigenic effects lend practical importance to a detailed understanding of its regulation by diet.The mechanisms underlying postmeal ghrelin suppression are incompletely understood, although some factors have been elucidated. First, the magnitude of ghrelin suppression correlates with the total caloric content of ingested food (8). Second, the nutrient sensors that initiate postprandial ghrelin suppression are not located in the stomach, i.e., the site of most ghrelin-producing cells, but more distally in the gastrointestinal tract and/or at postabsorptive sites (69, 91). Third, the magnitude of ghrelin suppression depends on the macronutrient composition of meals; e.g., ingested carbohyd...