Functional dyspepsia is associated with a greater symptomatic response to fat but not carbohydrate, increased fasting and postprandial CCK, and diminished PYY.
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.
Pilichiewicz
Amelia N
AN
University of Adelaide Discipline of Medicine, Royal Adelaide Hospital, Adelaide, Australia.
Feltrin
Kate L
KL
Horowitz
Michael
M
Holtmann
Gerald
G
Wishart
Judith M
JM
Jones
Karen L
KL
Talley
Nicholas J
NJ
Feinle-Bisset
Christine
C
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
D004040:Dietary Carbohydrates; D004041:Dietary Fats; D019894:Peptide YY; D002766:Cholecystokinin