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Clinical Studies and Practice

Small intestinal protein infusion in humans: evidence for a location-specific gradient in intestinal feedback on food intake and GI peptide release

International Journal of Obesity volume 41, pages 217–224 (2017)Cite this article

Subjects

Abstract

BACKGROUND:

Protein infusion in the small intestine results in intestinal brake activation: a negative feedback mechanism that may be mediated by the release of gastrointestinal peptides resulting in a reduction in food intake. It has been proposed that duodenum, jejunum and ileum may respond differently to infused proteins.

OBJECTIVE:

To investigate differences in ad libitum food intake, feelings of hunger and satiety and the systemic levels of cholecystokinin (CCK), glucagon-like peptide-1 (GLP-1), peptide YY (PYY), glucose and insulin after intraduodenal, intrajejunal and intraileal protein infusion.

METHODS:

Fourteen subjects (four male, mean age: 23±2.1 years, mean body mass index: 21.6±1.8 kg m−2) were intubated with a naso-ileal catheter in this double-blind, randomized, placebo-controlled crossover study. Test days (four in total, executed on consecutive days) started with the ingestion of a standardized breakfast, followed by the infusion of 15 g of protein in the duodenum, jejunum or ileum over a period of 60 min. Food intake was measured by offering an ad libitum meal and Visual Analogue Scale (VAS) scores were used to assess feelings of hunger and satiety. Blood samples were drawn at regular intervals for CCK, GLP-1, PYY, glucose and insulin analyses.

RESULTS:

Intraileal protein infusion decreased ad libitum food intake compared with both intraduodenal and placebo infusion (ileum: 628.5±63 kcal vs duodenum: 733.6±50 kcal, P<0.01 and placebo: 712.2±53 kcal, P<0.05). GLP-1 concentrations were increased after ileal infusion compared with jejunal and placebo infusion, whereas CCK concentrations were only increased after intraileal protein infusion compared with placebo. None of the treatments affected VAS scores for hunger and satiety nor plasma concentrations of PYY and glucose.

CONCLUSIONS:

Protein infusion into the ileum decreases food intake during the next meal compared with intraduodenal infusion, whereas it increases systemic levels of GLP-1 compared with protein infusion into the jejunum and placebo respectively.

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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. All funders had an input in the study design, whereas study conduct, data collection and analysis, as well as manuscript writing were the sole responsibility of the academic partners. Registered at clinicaltrials.gov: NCT02500069. Names for PubMed indexing: van Avesaat, Ripken, Hendriks, Masclee, Troost.

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Authors and Affiliations

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

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

  2. Division of Gastroenterology-Hepatology, Department of Internal Medicine, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center, Maastricht, The Netherlands

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

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

    D Ripken

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

    D Ripken

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  1. M van Avesaat
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  5. F J Troost
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Correspondence to M van Avesaat.

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van Avesaat, M., Ripken, D., Hendriks, H. et al. Small intestinal protein infusion in humans: evidence for a location-specific gradient in intestinal feedback on food intake and GI peptide release. Int J Obes 41, 217–224 (2017). https://doi.org/10.1038/ijo.2016.196

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