The droplet size of intraduodenal fat emulsions influences antropyloroduodenal motility, hormone release, and appetite in healthy males

Background: The presence of fat in the small intestine modulates gastrointestinal motility, stimulates plasma cholecystokinin and peptide YY release, and suppresses appetite and energy intake. These effects are dependent on the lipolysis of fat. Objective: Our aim was to evaluate the hypothesis that increasing the droplet size of a fat emulsion would attenuate these effects. Design: Ten healthy, lean males were studied on 4 separate occasions in single-blind randomized order. Antropyloroduodenal pressures, plasma triglycerides, cholecystokinin, peptide YY, and appetite were measured during 120-min intraduodenal infusions of fat emulsions comprising 3 different droplet sizes: 1) 0.26 mu m (LE-0.26), 2) 30 mu m (LE-30), and 3) 170 mu m (LE-170) in addition to saline (control). Energy intake at a buffet lunch was quantified immediately after the infusions. Results: Increasing the droplet size of the lipid emulsion was associated with diminished suppression of antral (r = 0.75, P < 0.01) and duodenal (r = 0.80, P < 0.01) pressure waves and with stimulation of isolated (r = 20.72, P < 0.01) and basal (r = 20.83, P < 0.01) pyloric pressures. Increasing the droplet size was also associated with attenuation of the stimulation of plasma triglycerides (r = 20.73, P < 0.001), cholecystokinin (r = 20.73, P < 0.001), and peptide YY (r = 20.83, P < 0.001) as well as with reductions in the suppression of hunger (r = 0.75, P < 0.01) and energy intake (r = 0.66, P < 0.001). Conclusions: The acute effects of intraduodenal fat emulsions on gastrointestinal function and appetite are dependent on fat droplet size. These observations have implications for the design of functional foods to maximize effects on those gut functions that are involved in the suppression of appetite. Am J Clin Nutr 2009; 89: 1729-36.