The effect of L-rhamnose on intestinal transit time, short chain fatty acids and appetite regulation: a pilot human study using combined 13CO2 / H2 breath tests

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Title: The effect of L-rhamnose on intestinal transit time, short chain fatty acids and appetite regulation: a pilot human study using combined 13CO2 / H2 breath tests
Authors: Byrne, C
Preston, T
Brignardello, J
Garcia-Perez, I
Holmes, E
Frost, G
Morrison, D
Item Type: Journal Article
Abstract: Background: The appetite-regulating effects of non-digestible carbohydrates (NDC) have in part previously been attributed to their effects on intestinal transit rates as well as microbial production of short chain fatty acids (SCFA). Increased colonic production of the SCFA propionate has been shown to reduce energy intake and stimulate gut hormone secretion acutely in humans. Objective: We investigated the effect of the propiogenic NDC, L-rhamnose, on gastrointestinal transit times using a combined 13CO2/H2 breath test. We hypothesised that L-rhamnose would increase plasma propionate leading to a reduction in appetite, independent of changes in gastrointestinal transit times. Design: We used a dual 13C-octanoic acid/lactose 13C-ureide breath test combined with breath H2 to measure intestinal transit times following the consumption of 25g/d L-rhamnose, compared with inulin and cellulose, in 10 healthy humans in a randomised cross-over design pilot study. Gastric emptying (GE) and oro-caecal transit times (OCTT) were derived from the breath 13C data and compared with breath H2. Plasma SCFA and peptide YY (PYY) were also measured alongside subjective measures of appetite. Results: L-rhamnose significantly slowed GE rates (by 19.5min) but there was no difference in OCTT between treatments. However, breath H2 indicated fermentation of L-rhamnose before it reached the caecum. OCTT was highly correlated with breath H2 for inulin but not for L-rhamnose or cellulose. L-rhamnose consumption significantly increased plasma propionate and PYY but did not significantly reduce subjective appetite measures. Conclusions: The NDCs tested had a minimal effect on intestinal transit time. Our data suggest that L-rhamnose is partially fermented in the small intestine and that breath H2 reflects the site of gastrointestinal fermentation and is only a reliable marker of OCTT for certain NDCs (e.g. inulin). Future studies should focus on investigating the appetite-suppressing potential of L-rhamnose and verifying the findings in a larger cohort. Clinical trial registry no.ISRCTN9022576.
Issue Date: 1-Oct-2018
Date of Acceptance: 17-Jul-2018
DOI: https://dx.doi.ogr/10.1088/1752-7163/aad3f1
ISSN: 1752-7155
Publisher: IOP Publishing
Journal / Book Title: Journal of Breath Research
Volume: 12
Issue: 4
Copyright Statement: © 2018 IOP Publishing Ltd. Original content from this work may be used under the terms of the Creative Commons Attribution 3.0 licence ( Any further distribution of this work must maintain attribution to the author(s) and the title of the work, journal citation and DOI.
Keywords: Science & Technology
Life Sciences & Biomedicine
Biochemical Research Methods
Respiratory System
Biochemistry & Molecular Biology
dietary fibre
short chain fatty acids
gastric emptying
oro-caecal transit time
C-13 breath test
peptide YY
Publication Status: Published
Article Number: 046006
Online Publication Date: 2018-08-06
Appears in Collections:Division of Surgery
Department of Medicine
Faculty of Medicine

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