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Liquid-mixed meal better stimulates insulin response among weight-loss patients
A liquid-mixed meal test resulted in a stronger insulin and incretin response and was better tolerated than other meal tests among adults who underwent medical or surgical weight loss, according to research in Obesity Science & Practice.
Clare Jung Lee, MD, an assistant professor of medicine in the division of endocrinology, diabetes and metabolism at Johns Hopkins University, and colleagues analyzed data from six adults (four women; five white; one with prediabetes) who underwent surgical or medical weight loss within the past 12 months. Two patients underwent Roux-en-Y gastric bypass; two patients underwent sleeve gastrectomy; two patients underwent medical weight loss. After an overnight fast, each participant completed three meal-tolerance tests during three visits, each separated by at least 4 days. Meals included one liquid-mixed meal (Ensure Plus), one solid-mixed meal (one large egg, 1.5 oz American cheese, 6 oz nonfat yogurt and 4 oz applesauce) and one high-fat meal test (Häagen-Dazs vanilla bean ice cream). Participants were encouraged to finish meals within 30 minutes. Researchers obtained blood samples at baseline and 30, 60, 120, 180 and 240 minutes after the start of each meal, and measured the tolerability of each test (palatability rating and total amounts consumed), as well as fasting and meal-stimulated glucagon-like peptide, glucose-dependent insulinotropic polypeptide, insulin and glucose.
Among the three meal tests, the liquid-mixed meal was the best tolerated and the most consumed, and it offered the least variability in macronutrient consumption when compared with the other two meal options.
For the four participants who underwent bariatric surgery, the liquid-mixed meal resulted in the best insulin response and stimulated greater differences in incretin changes and glycemic variability between patients who underwent Roux-en-Y gastric bypass and those who underwent sleeve gastronomy. Medical weight-loss participants also experienced a higher prandial insulin response with the liquid-mixed meal vs. the solid-mixed or high-fat meals, whereas prandial incretin response was similar for all three meal test options.
“Our findings suggest that [a] liquid-mixed meal, when compared with the other test meals, stimulates the strongest prandial insulin response in both the surgical weight-loss and medical weight-loss groups,” the researchers wrote. “Furthermore, we found that the liquid-mixed meal elicited the strongest prandial incretin response in both surgical weight-loss groups.” – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.