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

M van Avesaat1, F J Troost1, D Ripken2

  • 11] Top Institute of Food and Nutrition, Wageningen, The Netherlands [2] Division of Gastroenterology and Hepatology, Department of Internal Medicine, NUTRIM, Maastricht University Medical Center, Maastricht, The Netherlands.

International Journal of Obesity (2005)
|June 25, 2014
PubMed
Summary

Ileal infusion of sucrose and casein, like lipids, activates the ileal brake, significantly reducing food intake and increasing satiety. This study demonstrates that carbohydrates and proteins also influence eating behavior via the ileal brake mechanism.

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Area of Science:

  • Gastroenterology
  • Nutritional Science
  • Physiology

Background:

  • The ileal brake mechanism, triggered by lipid infusion into the distal small intestine, is known to alter gastrointestinal motility and suppress appetite.
  • The impact of other macronutrients, specifically carbohydrates and proteins, on the ileal brake and subsequent eating behavior remains largely unexplored.

Purpose of the Study:

  • To investigate the effects of ileal infusion of sucrose (carbohydrate) and casein (protein) on food intake, gastrointestinal peptide release, gastric emptying, and small-bowel transit time.
  • To compare these effects with safflower oil (lipid) as a positive control and saline as a negative control.

Main Methods:

  • A randomized, single-blind, crossover study involving 13 healthy participants.
  • Participants received ileal infusions of saline, safflower oil (51.7 kcal), high-dose casein (51.7 kcal), or high-dose sucrose (51.7 kcal) over 90 minutes after a standardized breakfast.
  • Food intake, hunger/satiety scores, and gastrointestinal peptide levels were measured.

Main Results:

  • Ileal infusion of lipid, protein (casein), and carbohydrate (sucrose) significantly reduced ad libitum food intake compared to the control group.
  • A reduction in overall energy intake was observed even after accounting for the infused calories.
  • Secretion of cholecystokinin and peptide YY increased with all macronutrient infusions, while glucagon-like peptide-1 (7-36) secretion did not significantly change.
  • A trend towards delayed gastric emptying and intestinal transit was noted with all macronutrient infusions, though not statistically significant.

Conclusions:

  • Ileal infusion of sucrose and casein effectively activates the ileal brake, leading to reduced food intake, similar to lipids.
  • The ileal brake mechanism is responsive to carbohydrates and proteins, influencing not only food intake but also satiety and gastrointestinal peptide secretion.