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Clinical Studies and Practice

Ileal brake activation: macronutrient-specific effects on eating behavior?

International Journal of Obesity volume 39, pages 235–243 (2015)Cite this article

Subjects

Abstract

Background:

Activation of the ileal brake, by infusing lipid directly into the distal part of the small intestine, alters gastrointestinal (GI) motility and inhibits food intake. The ileal brake effect on eating behavior of the other macronutrients is currently unknown.

Objective:

The objective of this study was to investigate the effects of ileal infusion of sucrose and casein on food intake, release of GI peptides, gastric emptying rate and small-bowel transit time with safflower oil as positive control.

Design:

This randomized, single-blind, crossover study was performed in 13 healthy subjects (6 male; mean age 26.4±2.9 years; mean body mass index 22.8±0.4 kg m−2) who were intubated with a naso–ileal catheter. Thirty minutes after the intake of a standardized breakfast, participants received an ileal infusion, containing control ((C) saline), safflower oil ((HL) 51.7 kcal), low-dose casein ((LP) 17.2 kcal) or high-dose casein ((HP) 51.7 kcal), low-dose sucrose ((LC) 17.2 kcal) and high-dose sucrose ((HC) 51.7 kcal), over a period of 90 min. Food intake was determined during an ad libitum meal. Visual analogue score questionnaires for hunger and satiety and blood samples were collected at regular intervals.

Results:

Ileal infusion of lipid, protein and carbohydrate resulted in a significant reduction in food intake compared with control (HL: 464.3±90.7 kcal, P<0.001; HP: 458.0±78.6 kcal, P<0.005; HC: 399.0±57.0 kcal, P<0.0001 vs control: 586.7±70.2 kcal, P<0.001, respectively). A reduction in energy intake was still apparent when the caloric amount of infused nutrients was added to the amount eaten during the ad libitum meal.

Secretion of cholecystokinin and peptide YY but not of glucagon-like peptide-1 (7–36) was increased during ileal perfusion of fat, carbohydrates and protein. During ileal perfusion of all macronutrients, a delay in gastric emptying and intestinal transit was observed, but differences were not significant compared with control.

Conclusion:

Apart from lipids, also sucrose and casein reduce food intake on ileal infusion, thereby activating the ileal brake. In addition to food intake, also satiety and GI peptide secretion were affected.

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Acknowledgements

The research was funded by TI Food and Nutrition, a public-private partnership on pre-competitive research in food and nutrition. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.

Author Contributions

FJT, HFH and AAMM designed the research; MvA and FJT conducted the research; MvA and DR analyzed data and performed the statistical analyses; DR performed the hormone analyses; MvA, FJT, HFH and AAMM contributed to interpretation of the results; MvA, FJT and AAMM wrote the manuscript; and AAMM had primary responsibility for the final content of the manuscript.

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Authors and Affiliations

  1. Top Institute of Food and Nutrition, Wageningen, The Netherlands

    M van Avesaat, F J Troost, D Ripken, H F Hendriks & A A M Masclee

  2. Division of Gastroenterology and Hepatology, Department of Internal Medicine, NUTRIM, Maastricht University Medical Center, Maastricht, The Netherlands

    M van Avesaat, F J Troost & A A M Masclee

  3. The Netherlands Organisation for Applied Scientific Research, TNO, Zeist, The Netherlands,

    D Ripken & H F Hendriks

  4. Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands

    D Ripken

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Correspondence to M van Avesaat.

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van Avesaat, M., Troost, F., Ripken, D. et al. Ileal brake activation: macronutrient-specific effects on eating behavior?. Int J Obes 39, 235–243 (2015). https://doi.org/10.1038/ijo.2014.112

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  • DOI: https://doi.org/10.1038/ijo.2014.112

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