Elsevier

Nutrition

Volume 30, Issues 11–12, November–December 2014, Pages 1344-1348
Nutrition

Applied nutritional investigation
Short-term dietary supplementation with fructose accelerates gastric emptying of a fructose but not a glucose solution

https://doi.org/10.1016/j.nut.2014.03.023Get rights and content

Abstract

Objective

Short-term dietary glucose supplementation has been shown to accelerate the gastric emptying rate of both glucose and fructose solutions. The aim of this study was to examine gastric emptying rate responses to monosaccharide ingestion following short-term dietary fructose supplementation.

Methods

The gastric emptying rate of a fructose solution containing 36 g of fructose and an equicaloric glucose solution containing 39.6 g glucose monohydrate were measured in 10 healthy non-smoking men with and without prior fructose supplementation (water control) using a randomized crossover design. Gastric emptying rate was assessed for a period of 1 h using the [13C]breath test with sample collections at baseline and 10-min intervals following drink ingestion. Additionally, appetite ratings of hunger, fullness, and prospective food consumption were recorded at baseline and every 10 min using visual analog scales.

Results

Increased dietary fructose ingestion resulted in significantly accelerated half-emptying time of a fructose solution (mean = 48, SD = 6 versus 58, SD = 14 min control; P = 0.037), whereas the emptying of a glucose solution remained unchanged (mean = 85, SD = 31 versus 78, SD = 27 min control; P = 0.273). Time of maximal emptying rate of fructose was also significantly accelerated following increased dietary fructose intake (mean = 33, SD = 6 versus 38, SD = 9 min control; P = 0.042), while it remained unchanged for glucose (mean = 45, SD = 14 versus 44, SD = 14 min control; P = 0.757). No effects of supplementation were observed for appetite measures.

Conclusion

Three d of supplementation with 120 g/d of fructose resulted in an acceleration of gastric emptying rate of a fructose solution but not a glucose solution.

Introduction

A rate-limiting step in the delivery, and thus absorption, of nutrients and fluid in the small intestine is the rate of gastric emptying. The regulation of gastric emptying is therefore perceived as an important factor in appetite control [1]. Gastric distension induced by an intragastric balloon to simulate the mechanical presence of food in the stomach has been shown to cause both satiation and satiety [2]. Therefore, a prolonged period of gastric distension as a result of delayed emptying may lead to a prolonged satiety period [3]. Slower emptying also delays the appearance of nutrients in the circulation that might contribute to satiety.

Carbohydrates, when ingested orally or directly administered into the stomach or small intestine, result in a reduction in subsequent food intake [4]. However, it has been suggested that the magnitude of this effect varies between different types of carbohydrates or sugars. With the recent rise in levels of obesity and its associated morbidities worldwide, research interests in carbohydrates and satiety have centered on the possible role of fructose in the pathogenesis of obesity and metabolic syndrome [5]. This has been motivated by the widespread use of fructose, either in the form of sucrose or high-fructose corn syrup, as an added ingredient in soft drinks and other sweetened beverages or foods, greatly increasing its dietary consumption [6], [7]. Excessive intake of fructose and overconsumption of sugary beverages is suggested to contribute to the development of metabolic syndrome and obesity through altering feeding patterns and the promotion of weight gain [7]. The gastric emptying rate may play an important modulatory role in these outcomes.

A small compilation of research indicates that gastric emptying in humans may be influenced by patterns of previous dietary nutrient intake. Furthermore, there is evidence to suggest that these adaptive changes are macronutrient-specific [8], [9] and rapid, with adaptations occurring in only a few days [3], [9]. A high-fat diet for 14 d has been shown to accelerate gastric emptying of a high-fat test meal [10] but not a high-carbohydrate meal [8]. More recently, this adaptive response of the gastrointestinal (GI) system to the ingestion of high-fat meals has been reported to occur following only 3 d of high-fat diet [3]. Similarly, short-term dietary supplementation with 400 g/d of glucose for 3 d in healthy individuals has been shown to accelerate gastric emptying of a hyperosmotic glucose solution, but not of a protein solution [9]. The specificity of these effects of a high-glucose diet has not been extended to different monosaccharides, however. The emptying of a hyperosmotic fructose solution was equally accelerated following short-term supplementation with glucose solutions [11]. Whether these effects are replicated in response to short-term dietary supplementation with fructose is unknown. The aim of this study was to investigate the effect of 3 d of dietary fructose supplementation on the rate of gastric emptying of glucose and the rate of gastric emptying of fructose solutions as well as the accompanying subjective feelings of appetite.

Section snippets

Participants

Ten healthy men completed this study (mean age = 27, SD = 6 y; height = 179.9, SD = 9.2 cm; body mass = 81, SD = 11 kg; body mass index = 25, SD = 3 kg/m2; estimated body fat = 21%, SD = 8%). All volunteers were non-smokers, had no history of GI symptoms or disease, were not consuming medication with any known effects on GI function, and had no other relevant medical conditions as assessed by a medical screening questionnaire. Verbal and written explanations of the experimental procedures were

Body mass, hydration status, and drink osmolality

Body mass remained stable over the duration of the study (Table 1). Furthermore, the constancy of preingestion urine osmolality indicated that hydration status before each experimental trial was also consistent (Table 1). Drink osmolalities were 368 (SD = 3), 368 (SD = 3), 370 (SD = 4), and 369 (SD = 3) mOsmol/kg1 (P = 0.490) for FC, FS, GC, and GS, respectively.

Gastric emptying

Gastric emptying T½ for fructose was accelerated after the period of dietary supplementation with fructose compared to when the

Discussion

The results of this study show that a 3-d period of dietary supplementation with 120 g fructose consumed throughout the day results in an acceleration of gastric emptying of a fructose solution but not of a glucose solution. This study thus shows a monosaccharide-specific adaptation to increased fructose in the diet in contrast to the glucose supplementation results previously described [11]. Furthermore, the results of this study demonstrate an adaptation of gastric emptying rate to a much

Conclusion

The results of this study reveal that 3 d of dietary supplementation with 120 g fructose daily accelerates gastric emptying of a fructose solution but not of a glucose solution. The mechanisms and implications of this observed GI adaptation to increased dietary fructose should be further investigated.

Acknowledgments

The authors acknowledge the volunteers who participated in this study. The authors also acknowledge Dave Maskew of Manchester Metropolitan University for his technical support in the laboratory, and the staff at Salford Royal Hospital's Gastrointestinal Physiology department for their cooperation with breath sample analysis. AMWY was supported by a Manchester Metropolitan University Ph.D. studentship.

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    • This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. AMWY contributed to the study design; recruited the participants; performed the data collection, biochemical analysis, data analysis, and interpretation; and wrote the manuscript. GHE contributed to the study design, data collection, and manuscript writing. JM, RJM, and WG contributed to the study design and manuscript writing. All authors read and approved the final manuscript and none of the authors has any conflict of interest to report.

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