Longitudinal Changes in the Blood Pressure Responses to, and Gastric Emptying of, an Oral Glucose Load in Healthy Older Subjects

Pham, Hung; Phillips, Liza K.; Trahair, Laurence G.; Hatzinikolas, Seva; Horowitz, Michael; Jones, Karen L.

doi:10.1093/gerona/glz014

Cited by 13 publications

(15 citation statements)

References 25 publications

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“…In this study, the mixed macronutrient drink containing 504 kcal emptied linearly and predictably much slower than the macronutrient drink containing 280 kcal. We, and others, have reported that the gastric emptying of solid and liquid food is slightly slower in healthy older adults than younger adults, within the expected range of gastric emptying rates (1-4 kcal/min [30][31][32]). In the current study, there was a trend for slower gastric emptying in older than younger men study after P 280 , potentially caused by the greater increase from baseline of GLP-1 concentrations in the older men, which is known to slow gastric emptying by inhibiting gastrointestinal motility and gastric acid secretion [33].…”

Section: Discussionsupporting

confidence: 62%

Effects of Age on Acute Appetite-Related Responses to Whey-Protein Drinks, Including Energy Intake, Gastric Emptying, Blood Glucose, and Plasma Gut Hormone Concentrations—A Randomized Controlled Trial

et al. 2020

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Protein-rich supplements are used commonly to increase energy intake in undernourished older people. This study aimed to establish age effects on energy intake, appetite, gastric emptying, blood glucose, and gut hormones in response to protein-rich drinks. In a randomized double-blind, order, 13 older men (age: 75 ± 2 yrs, body mass index (BMI): 26 ± 1 kg/m2) and 13 younger (23 ± 1 yrs, 24 ± 1 kg/m2) men consumed (i) a control drink (~2 kcal) or drinks (450 mL) containing protein/fat/carbohydrate: (ii) 70 g/0 g/0 g (280 kcal/‘P280′), (iii) 14 g/12.4 g/28 g (280 kcal/‘M280′), (iv) 70 g/12.4 g/28 g (504 kcal/‘M504′), on four separate days. Appetite (visual analog scales), gastric emptying (3D ultrasonography), blood glucose, plasma insulin, ghrelin, cholecystokinin (CCK), glucagon-like peptide-1 (GLP-1) concentrations (0–180 min), and ad-libitum energy intake (180–210 min) were determined. Older men, compared to younger men, had higher fasting glucose and CCK concentrations and lower fasting GLP-1 concentrations (all p < 0.05). Energy intake by P280 compared to control was less suppressed in older men (increase: 49 ± 42 kcal) than it was in younger men (suppression: 100 ± 54 kcal, p = 0.038). After the caloric drinks, the suppression of hunger and the desire to eat, and the stimulation of fullness was less (p < 0.05), and the stimulation of plasma GLP-1 was higher (p < 0.05) in older men compared to younger men. Gastric emptying, glucose, insulin, ghrelin, and CCK responses were similar between age groups. In conclusion, ageing reduces the responses of caloric drinks on hunger, the desire to eat, fullness, and energy intake, and protein-rich nutrition supplements may be an effective strategy to increase energy intake in undernourished older people.

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Section: Discussionsupporting

confidence: 62%

Effects of Age on Acute Appetite-Related Responses to Whey-Protein Drinks, Including Energy Intake, Gastric Emptying, Blood Glucose, and Plasma Gut Hormone Concentrations—A Randomized Controlled Trial

et al. 2020

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“…PPH currently lacks an effective treatment and occurs in 25%–40% of patients with T2D [11,13] and ~15% of the ‘healthy’ elderly [13,14]. We have shown that the fall in BP after a meal is greater when the rate of gastric emptying is faster in both healthy older subjects [14,15] and patients with T2D [16], while slowing gastric emptying with guar gum attenuates the fall [17,18]. Moreover, exogenous administration of GLP-1 [19] and the ‘short-acting’ GLP-1 receptor agonist, lixisenatide [20], both slow gastric emptying, and markedly attenuate the magnitude of the postprandial fall in BP.…”

Section: Introductionmentioning

confidence: 99%

The Effects of a Whey Protein and Guar Gum-Containing Preload on Gastric Emptying, Glycaemia, Small Intestinal Absorption and Blood Pressure in Healthy Older Subjects

et al. 2019

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A whey protein/guar gum preload reduces postprandial glycaemia in type 2 diabetes through slowing gastric emptying. However, gastric emptying has previously been assessed using a stable isotope breath test technique, which cannot discriminate between slowing of gastric emptying and small intestinal absorption. This preload also may be useful in the management of postprandial hypotension. We evaluated the effects of a whey protein/guar preload on gastric emptying, glucose absorption, glycaemic/insulinaemic and blood pressure (BP) responses to an oral glucose load. Eighteen healthy older participants underwent measurements of gastric emptying (scintigraphy), plasma glucose and insulin, glucose absorption, superior mesenteric artery (SMA) flow, BP and heart rate (HR) after ingesting a 50 g glucose drink, with or without the preload. The preload reduced plasma glucose (p = 0.02) and serum 3-O-methylglucose (3-OMG) (p = 0.003), and increased plasma insulin (p = 0.03). There was no difference in gastric emptying or BP between the two days. The reduction in plasma glucose on the preload day was related to the reduction in glucose absorption (r = 0.71, p = 0.002). In conclusion, the glucose-lowering effect of the preload may relate to delayed small intestinal glucose absorption and insulin stimulation, rather than slowing of gastric emptying.

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“…The majority of studies investigating PPH have utilised an oral [11,12,13,16,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73], and/or ID glucose [14,18,74,75,76,77,78,79,80,81,82,83,84,85,86,87,88] load that induces a substantial fall in BP. There have been a total of 58 studies related to effects of glucose on postprandial BP in a range of cohorts including health [11,12,14,16,18,39,40,41...…”

Section: Nutritive Sweetenersmentioning

confidence: 99%

“…Intensive care unit (ICU) survivors are more predisposed to PPH; a marked and prolonged decrease in SBP and diastolic BP (DBP) was observed in 35 older patients discharged from the ICU [44], 10 of whom experienced PPH [44]. In healthy older participants [11,12,46] and patients with T2DM [11,64], the fall in BP following glucose ingestion has been shown to be related to the rate of gastric emptying of glucose, i.e., faster gastric emptying is associated with a greater fall in BP. In contrast, in healthy young participants, there is little fall, and in some cases an increase in, SBP following oral glucose [53,89].…”

Section: Nutritive Sweetenersmentioning

confidence: 99%

“…In patients with PPH, these compensatory responses are inadequate [5]. The postprandial fall in BP is greater when gastric emptying is more rapid [11,12,13], whereas gastric distension attenuates the fall in BP in both healthy young and older participants [11,12,13]. The macronutrient composition of the meal is also an important determinant of postprandial BP, with carbohydrate inducing an earlier fall in BP compared with protein and fat [14] (Figure 1).…”

Section: Introductionmentioning

confidence: 99%

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Acute Effects of Nutritive and Non-Nutritive Sweeteners on Postprandial Blood Pressure

2019

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Postprandial hypotension (PPH) is under-recognised, but common, particularly in the elderly, and is of clear clinical importance due to both the independent association between PPH and an increase in mortality and lack of effective management for this condition. Following health concerns surrounding excessive consumption of sugar, there has been a trend in the use of low- or non-nutritive sweeteners as an alternative. Due to the lack of literature in this area, we conducted a systematic search to identify studies relevant to the effects of different types of sweeteners on postprandial blood pressure (BP). The BP response to ingestion of sweeteners is generally unaffected in healthy young subjects, however in elderly subjects, glucose induces the greatest decrease in postprandial BP, while the response to sucrose is less pronounced. The limited studies investigating other nutritive and non-nutritive sweeteners have demonstrated minimal or no effect on postprandial BP. Dietary modification by replacing high nutritive sweeteners (glucose, fructose, and sucrose) with low nutritive (d-xylose, xylitol, erythritol, maltose, maltodextrin, and tagatose) and non-nutritive sweeteners may be a simple and effective management strategy for PPH.

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Longitudinal Changes in the Blood Pressure Responses to, and Gastric Emptying of, an Oral Glucose Load in Healthy Older Subjects

Cited by 13 publications

References 25 publications

Effects of Age on Acute Appetite-Related Responses to Whey-Protein Drinks, Including Energy Intake, Gastric Emptying, Blood Glucose, and Plasma Gut Hormone Concentrations—A Randomized Controlled Trial

Effects of Age on Acute Appetite-Related Responses to Whey-Protein Drinks, Including Energy Intake, Gastric Emptying, Blood Glucose, and Plasma Gut Hormone Concentrations—A Randomized Controlled Trial

The Effects of a Whey Protein and Guar Gum-Containing Preload on Gastric Emptying, Glycaemia, Small Intestinal Absorption and Blood Pressure in Healthy Older Subjects

Acute Effects of Nutritive and Non-Nutritive Sweeteners on Postprandial Blood Pressure

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