Pilichiewicz, A.Feltrin, K.Horowitz, M.Holtmann, G.Wishart, J.Jones, K.Talley, N.Feinle-Bisset, C.2009-09-152009-09-152008American Journal of Gastroenterology, 2008; 103(10):2613-26230002-92701572-0241http://hdl.handle.net/2440/50906BACKGROUND/OBJECTIVES: 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.en© 2009 The American College of GastroenterologyHumansDisease ProgressionDyspepsiaCholecystokininPeptide YYDietary CarbohydratesDietary FatsPrognosisFastingFollow-Up StudiesPostprandial PeriodAdultMiddle AgedFemaleSurveys and QuestionnairesJournal article002008334310.1111/j.1572-0241.2008.02041.x0002601784000282-s2.0-5314908853941496Horowitz, M. [0000-0002-0942-0306]Jones, K. [0000-0002-1155-5816]Feinle-Bisset, C. [0000-0001-6848-0125]