Gastric emptying, glucose metabolism and gut hormones: evaluation of a common preoperative carbohydrate beverage

Mechteld A R Vermeulen; Milan C Richir; Martijn K Garretsen; Annelies van Schie; Mohammed A Ghatei; Jens Juul Holst; Annemieke C Heijboer; Bernard M J Uitdehaag; Michaela Diamant; E Marelise W Eekhoff; Paul A M van Leeuwen; Gerdien C Ligthart-Melis

doi:10.1016/j.nut.2010.10.001

Gastric emptying, glucose metabolism and gut hormones: evaluation of a common preoperative carbohydrate beverage

Mechteld A R Vermeulen, Milan C Richir, Martijn K Garretsen, Annelies van Schie, Mohammed A Ghatei, Jens Juul Holst, Annemieke C Heijboer, Bernard M J Uitdehaag, Michaela Diamant, E Marelise W Eekhoff, Paul A M van Leeuwen, Gerdien C Ligthart-Melis

13 Citations (Scopus)

Abstract

Objective: To study the gastric-emptying rate and gut hormonal response of two carbohydrate-rich beverages. A specifically designed carbohydrate-rich beverage is currently used to support the surgical patient metabolically. Fruit-based beverages may also promote recovery, due to natural antioxidant and carbohydrate content. However, gastric emptying of fluids is influenced by its nutrient composition; hence, safety of preoperative carbohydrate loading should be confirmed. Because gut hormones link carbohydrate metabolism and gastric emptying, hormonal responses were studied. Methods: In eight volunteers, gastric emptying rates of both 400 mL of a ready-to-use beverage (A: Nutricia preOp; 50.4 g carbohydrates-mainly polysaccharides; 260 mOsm/kg) and 400 mL over-the-counter fruit-based lemonade (B: Roosvicee Original; 48 g carbohydrates-mainly fruit-associated saccharides; 805 mOsm/kg) were determined scintigraphically (using hepatate Tc-99 ^m) according to a crossover design. Plasma glucose, insulin, C-peptide, glucagon-like peptide (GLP-1), peptide YY, total glucagon, and ghrelin were studied. Results: Gastric emptying showed no differences in residual volumes. Earlier onset in emptying for beverage A versus B was observed (trend), with significantly higher glucose, insulin, C-peptide, and glucagon responses at 15-90 min. GLP-1 was inversely related to residual volume. Conclusion: Fruit-based lemonade is a safe alternative for preoperative purposes. It induces a more limited glucose, insulin, and C-peptide response. Later onset in gastric emptying (B versus A: trend), lower glucagon release, and differences in beverage content and osmolarity may have contributed to those differences. Efficient emptying was reflected by early GLP-1 levels.

Original language	English
Journal	Nutrition
Volume	27
Issue number	9
Pages (from-to)	897-903
Number of pages	7
ISSN	0899-9007
DOIs	https://doi.org/10.1016/j.nut.2010.10.001
Publication status	Published - Sept 2011

Keywords

Adult
Beverages
Blood Glucose
C-Peptide
Carbohydrates
Citrus
Cross-Over Studies
Dietary Carbohydrates
Female
Fruit
Gastric Emptying
Gastrointestinal Contents
Gastrointestinal Hormones
Glucagon
Glucagon-Like Peptide 1
Humans
Insulin
Male
Middle Aged
Polysaccharides
Preoperative Care

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Vermeulen, M. A. R., Richir, M. C., Garretsen, M. K., van Schie, A., Ghatei, M. A., Holst, J. J., Heijboer, A. C., Uitdehaag, B. M. J., Diamant, M., Eekhoff, E. M. W., van Leeuwen, P. A. M., & Ligthart-Melis, G. C. (2011). Gastric emptying, glucose metabolism and gut hormones: evaluation of a common preoperative carbohydrate beverage. Nutrition, 27(9), 897-903. https://doi.org/10.1016/j.nut.2010.10.001

Vermeulen, MAR, Richir, MC, Garretsen, MK, van Schie, A, Ghatei, MA, Holst, JJ, Heijboer, AC, Uitdehaag, BMJ, Diamant, M, Eekhoff, EMW, van Leeuwen, PAM & Ligthart-Melis, GC 2011, 'Gastric emptying, glucose metabolism and gut hormones: evaluation of a common preoperative carbohydrate beverage', Nutrition, vol. 27, no. 9, pp. 897-903. https://doi.org/10.1016/j.nut.2010.10.001

@article{4d5483c7bec749b98f495da537286dac,

title = "Gastric emptying, glucose metabolism and gut hormones: evaluation of a common preoperative carbohydrate beverage",

abstract = "Objective: To study the gastric-emptying rate and gut hormonal response of two carbohydrate-rich beverages. A specifically designed carbohydrate-rich beverage is currently used to support the surgical patient metabolically. Fruit-based beverages may also promote recovery, due to natural antioxidant and carbohydrate content. However, gastric emptying of fluids is influenced by its nutrient composition; hence, safety of preoperative carbohydrate loading should be confirmed. Because gut hormones link carbohydrate metabolism and gastric emptying, hormonal responses were studied. Methods: In eight volunteers, gastric emptying rates of both 400 mL of a ready-to-use beverage (A: Nutricia preOp; 50.4 g carbohydrates-mainly polysaccharides; 260 mOsm/kg) and 400 mL over-the-counter fruit-based lemonade (B: Roosvicee Original; 48 g carbohydrates-mainly fruit-associated saccharides; 805 mOsm/kg) were determined scintigraphically (using hepatate Tc-99 m) according to a crossover design. Plasma glucose, insulin, C-peptide, glucagon-like peptide (GLP-1), peptide YY, total glucagon, and ghrelin were studied. Results: Gastric emptying showed no differences in residual volumes. Earlier onset in emptying for beverage A versus B was observed (trend), with significantly higher glucose, insulin, C-peptide, and glucagon responses at 15-90 min. GLP-1 was inversely related to residual volume. Conclusion: Fruit-based lemonade is a safe alternative for preoperative purposes. It induces a more limited glucose, insulin, and C-peptide response. Later onset in gastric emptying (B versus A: trend), lower glucagon release, and differences in beverage content and osmolarity may have contributed to those differences. Efficient emptying was reflected by early GLP-1 levels.",

keywords = "Adult, Beverages, Blood Glucose, C-Peptide, Carbohydrates, Citrus, Cross-Over Studies, Dietary Carbohydrates, Female, Fruit, Gastric Emptying, Gastrointestinal Contents, Gastrointestinal Hormones, Glucagon, Glucagon-Like Peptide 1, Humans, Insulin, Male, Middle Aged, Polysaccharides, Preoperative Care",

author = "Vermeulen, {Mechteld A R} and Richir, {Milan C} and Garretsen, {Martijn K} and {van Schie}, Annelies and Ghatei, {Mohammed A} and Holst, {Jens Juul} and Heijboer, {Annemieke C} and Uitdehaag, {Bernard M J} and Michaela Diamant and Eekhoff, {E Marelise W} and {van Leeuwen}, {Paul A M} and Ligthart-Melis, {Gerdien C}",

year = "2011",

month = sep,

doi = "10.1016/j.nut.2010.10.001",

language = "English",

volume = "27",

pages = "897--903",

journal = "Nutrition",

issn = "0899-9007",

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T1 - Gastric emptying, glucose metabolism and gut hormones

T2 - evaluation of a common preoperative carbohydrate beverage

AU - Vermeulen, Mechteld A R

AU - Richir, Milan C

AU - Garretsen, Martijn K

AU - van Schie, Annelies

AU - Ghatei, Mohammed A

AU - Holst, Jens Juul

AU - Heijboer, Annemieke C

AU - Uitdehaag, Bernard M J

AU - Diamant, Michaela

AU - Eekhoff, E Marelise W

AU - van Leeuwen, Paul A M

AU - Ligthart-Melis, Gerdien C

PY - 2011/9

Y1 - 2011/9

N2 - Objective: To study the gastric-emptying rate and gut hormonal response of two carbohydrate-rich beverages. A specifically designed carbohydrate-rich beverage is currently used to support the surgical patient metabolically. Fruit-based beverages may also promote recovery, due to natural antioxidant and carbohydrate content. However, gastric emptying of fluids is influenced by its nutrient composition; hence, safety of preoperative carbohydrate loading should be confirmed. Because gut hormones link carbohydrate metabolism and gastric emptying, hormonal responses were studied. Methods: In eight volunteers, gastric emptying rates of both 400 mL of a ready-to-use beverage (A: Nutricia preOp; 50.4 g carbohydrates-mainly polysaccharides; 260 mOsm/kg) and 400 mL over-the-counter fruit-based lemonade (B: Roosvicee Original; 48 g carbohydrates-mainly fruit-associated saccharides; 805 mOsm/kg) were determined scintigraphically (using hepatate Tc-99 m) according to a crossover design. Plasma glucose, insulin, C-peptide, glucagon-like peptide (GLP-1), peptide YY, total glucagon, and ghrelin were studied. Results: Gastric emptying showed no differences in residual volumes. Earlier onset in emptying for beverage A versus B was observed (trend), with significantly higher glucose, insulin, C-peptide, and glucagon responses at 15-90 min. GLP-1 was inversely related to residual volume. Conclusion: Fruit-based lemonade is a safe alternative for preoperative purposes. It induces a more limited glucose, insulin, and C-peptide response. Later onset in gastric emptying (B versus A: trend), lower glucagon release, and differences in beverage content and osmolarity may have contributed to those differences. Efficient emptying was reflected by early GLP-1 levels.

AB - Objective: To study the gastric-emptying rate and gut hormonal response of two carbohydrate-rich beverages. A specifically designed carbohydrate-rich beverage is currently used to support the surgical patient metabolically. Fruit-based beverages may also promote recovery, due to natural antioxidant and carbohydrate content. However, gastric emptying of fluids is influenced by its nutrient composition; hence, safety of preoperative carbohydrate loading should be confirmed. Because gut hormones link carbohydrate metabolism and gastric emptying, hormonal responses were studied. Methods: In eight volunteers, gastric emptying rates of both 400 mL of a ready-to-use beverage (A: Nutricia preOp; 50.4 g carbohydrates-mainly polysaccharides; 260 mOsm/kg) and 400 mL over-the-counter fruit-based lemonade (B: Roosvicee Original; 48 g carbohydrates-mainly fruit-associated saccharides; 805 mOsm/kg) were determined scintigraphically (using hepatate Tc-99 m) according to a crossover design. Plasma glucose, insulin, C-peptide, glucagon-like peptide (GLP-1), peptide YY, total glucagon, and ghrelin were studied. Results: Gastric emptying showed no differences in residual volumes. Earlier onset in emptying for beverage A versus B was observed (trend), with significantly higher glucose, insulin, C-peptide, and glucagon responses at 15-90 min. GLP-1 was inversely related to residual volume. Conclusion: Fruit-based lemonade is a safe alternative for preoperative purposes. It induces a more limited glucose, insulin, and C-peptide response. Later onset in gastric emptying (B versus A: trend), lower glucagon release, and differences in beverage content and osmolarity may have contributed to those differences. Efficient emptying was reflected by early GLP-1 levels.

KW - Adult

KW - Beverages

KW - Blood Glucose

KW - C-Peptide

KW - Carbohydrates

KW - Citrus

KW - Cross-Over Studies

KW - Dietary Carbohydrates

KW - Female

KW - Fruit

KW - Gastric Emptying

KW - Gastrointestinal Contents

KW - Gastrointestinal Hormones

KW - Glucagon

KW - Glucagon-Like Peptide 1

KW - Humans

KW - Insulin

KW - Male

KW - Middle Aged

KW - Polysaccharides

KW - Preoperative Care

U2 - 10.1016/j.nut.2010.10.001

DO - 10.1016/j.nut.2010.10.001

M3 - Journal article

C2 - 21255977

SN - 0899-9007

VL - 27

SP - 897

EP - 903

JO - Nutrition

JF - Nutrition

IS - 9

ER -

Gastric emptying, glucose metabolism and gut hormones: evaluation of a common preoperative carbohydrate beverage

Abstract

Keywords

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