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Activation of gastrointestinal ileal brake response with dietary slowly digestible carbohydrates, with no observed effect on subjective appetite, in an acute randomized, double-blind, crossover trial

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Abstract

Purpose

To test the hypothesis that oral ingestion of slowly digestible carbohydrates (SDCs) that reach the ileum triggers the ileal brake as indicated by delayed gastric emptying, reduced glycemic response, and decreased subjective appetite.

Methods

The study was a five-arm, randomized, double-blind, crossover trial with a 1-week washout period between treatments (n = 20; 9 females, 11 males). Five treatments consisted of three SDC ingredients [raw corn starch, isomaltooligosaccharide (IMO), sucromalt], and an IMO/sucromalt combination, shown in vitro to have slow and extended digestion profiles, and a rapidly digestible carbohydrate control (maltodextrin). Carbohydrates (26 g) were incorporated into yogurt [300 g total; carbohydrate (~ 77 g), fat (~ 0.2 g), and protein (~ 9 g)] with closely matched energy content (346 kcal) and viscosity (~ 30,000 cP). Outcomes were measured in a 4 h postprandial period.

Results

Mean gastric half-emptying times were moderately though significantly increased for the raw corn starch and IMO treatments (P < 0.05), but they could be sub-divided into larger effect responder (n = 11) and non-responder groups (n = 9). Longer time for glycemic response to return to baseline was associated with increased gastric half-emptying time in an exploratory subset of data removing gastric half-emptying times > 3.5 h (P = 0.02). No significant differences in appetite ratings were observed.

Conclusion

SDCs caused slower gastric emptying rate through activation of the ileal brake, as closely matched semi-solid yogurts were used and only rate of carbohydrate digestion differed. Extending glycemic response through consumption of SDCs was associated with triggering the ileal brake.

Trial registration

ClinicalTrials.gov NCT03630445, August 2018, retrospectively registered.

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Abbreviations

AUC:

Area under the curve

BMI:

Body mass index

CGM:

Continuous glucose monitoring

CPDR:

Cumulative percent dose recovery

DOB:

Delta over baseline

GLP-1:

Glucagon-like peptide-1

IMO:

Isomaltooligosaccharide

PDR:

Percent dose recovery

PYY:

Peptide tyrosine tyrosine

RDC:

Rapidly digestible carbohydrate

SDC:

Slowly digestible carbohydrate

VAS:

Visual analog scale

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Author notes

  1. Tahnia D. Gonzalez is not currently affiliated with General Mills; Tanhia D. Gonzalez contributed to this study while she was affiliated with General Mills.

Authors and Affiliations

  1. Whistler Center for Carbohydrate Research and Department of Food Science, Purdue University, 745 Agriculture Mall Drive, West Lafayette, IN, 47907, USA

    Mohammad Chegeni, Anna M. R. Hayes, Jongbin Lim & Bruce R. Hamaker

  2. General Mills, Inc, 9000 Plymouth Avenue North, Minneapolis, MN, 55427, USA

    Tanhia D. Gonzalez, Michelle M. Manderfeld, Ravi S. Menon, Nort M. Holschuh & Mary E. Hedges

  3. AgriFiber Solutions, 1011 Campus Dr, Mundelein, IL, 60060, USA

    Mohammad Chegeni

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  1. Mohammad Chegeni
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Contributions

MC: conceptualization, formal analysis, investigation, writing—original draft. AMRH: formal analysis, investigation, writing—original draft, writing—review and editing, visualization. TDG: conceptualization, methodology, formal analysis, resources. MMM: methodology, resources, writing—review and editing. JL: investigation. RSM: conceptualization, writing—review and editing. NMH: methodology, formal analysis. MEH: resources. BRH: conceptualization, methodology, resources, writing—original draft, writing—review and editing, project administration, funding acquisition. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Bruce R. Hamaker.

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Conflict of interest

TDG, MMM, RSM, NMH, and MEH were employed at General Mills, Inc. when the study was conducted. MC, AMRH, JL, and BRH report no conflict of interest to the study.

Ethical approval

All procedures were conducted in accordance with the ethical standards of the Purdue University Institutional Review Board (Protocol #1502015807) and the study was registered at ClinicalTrials.gov (NCT03630445).

Consent to participate

Written informed consent was provided by all participants prior to their inclusion in the study.

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The authors affirm that human research participants acknowledged consent for publication of the current study.

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Chegeni, M., Hayes, A.M.R., Gonzalez, T.D. et al. Activation of gastrointestinal ileal brake response with dietary slowly digestible carbohydrates, with no observed effect on subjective appetite, in an acute randomized, double-blind, crossover trial. Eur J Nutr 61, 1965–1980 (2022). https://doi.org/10.1007/s00394-021-02770-2

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