title: Functional dyspepsia is associated with a greater symptomatic response to fat but not carbohydrate, increased fasting and postprandial CCK, and diminished PYY.
abstract: OBJECTIVE
  In patients with functional dyspepsia (FD), symptoms are frequently triggered, or exacerbated, by fatty foods. We hypothesized that in FD patients, a high-fat (high-FAT) meal would induce more symptoms than a high-carbohydrate (high-CHO) meal, associated with an altered secretion of cholecystokinin (CCK), peptide-YY (PYY), and ghrelin and an increased antral size, when compared to healthy subjects (HS).
  
  
  METHODS
  FD symptoms, appetite perceptions, plasma hormones, and antral area were measured in 8 FD patients and 8 HS on three separate days after the ingestion of high-CHO or high-FAT (500 kcal/400 g) meals, or a low-nutrient control (180 kcal/400 g); the energy intake was quantified 60 min later.
  
  
  RESULTS
  Nausea (P < 0.01) and pain (P= 0.05) were greater in FD after the high-FAT, when compared to high-CHO and control meals and in HS. Discomfort was greater after all meals in FD when compared to HS (P < 0.05). Fasting CCK and stimulation of CCK by the high-FAT (P < 0.01) meal were greater in FD, while fasting and postprandial PYY were lower (P < 0.001) in FD than in HS, with no differences in fasting, or postprandial, plasma ghrelin between FD and HS. Fasting antral area was greater in FD (P < 0.05), with no differences postprandially between FD and HS. There were no differences in the energy intake between the two groups.
  
  
  CONCLUSIONS
  In FD patients: (a) a high-FAT meal induces more symptoms than an isocaloric high-CHO meal, and (b) fasting and postprandial plasma CCK concentrations are greater and PYY concentrations are less. Our findings have important implications for the development of diet-based therapies for the treatment of FD.
authors.affiliation: University of Adelaide Discipline of Medicine, Royal Adelaide Hospital, Adelaide, Australia.
authors.forename: Amelia N
authors.initials: AN
authors.lastname: Pilichiewicz
authors.forename: Kate L
authors.initials: KL
authors.lastname: Feltrin
authors.forename: Michael
authors.initials: M
authors.lastname: Horowitz
authors.forename: Gerald
authors.initials: G
authors.lastname: Holtmann
authors.forename: Judith M
authors.initials: JM
authors.lastname: Wishart
authors.forename: Karen L
authors.initials: KL
authors.lastname: Jones
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Talley
authors.forename: Christine
authors.initials: C
authors.lastname: Feinle-Bisset
mesh_terms: D000328:Adult; D002766:Cholecystokinin / Q000378:metabolism*; D004040:Dietary Carbohydrates / Q000494:pharmacology*; D004041:Dietary Fats / Q000627:therapeutic use*; D018450:Disease Progression; D004415:Dyspepsia / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D005215:Fasting / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D019894:Peptide YY / Q000378:metabolism*; D019518:Postprandial Period / Q000502:physiology*; D011379:Prognosis; D011795:Surveys and Questionnaires
chemical_list: D004040:Dietary Carbohydrates; D004041:Dietary Fats; D019894:Peptide YY; D002766:Cholecystokinin