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Original Research Communications |
1 From INSERM Unité 476 (National Institute of Health and Medical Research), Marseille, France; the Unité des Maladies Métaboliques, INRA-CRNH, Clermont-Ferrand, France; the Service de Gastroentérologie, Centre Hospitalier Universitaire Nord, Marseille, France; the Laboratoire Central d'Analyse, Hôpital Ste Marguerite, Marseille, France; and Clintec Technologies, Vellizy, France.
Background: The extent of fat emulsification affects the activity of digestive lipases in vitro and may govern digestion and absorption of dietary fat.
Objective: We investigated the effect of the fat globule size of 2 enteral emulsions on fat digestion and assimilation in humans.
Design: Healthy subjects received intragastrically a coarse (10 µm) and a fine (0.7 µm) lipid emulsion of identical composition in random order. Gastric and duodenal aspirates were collected throughout digestion to measure changes in fat droplet size, gastric and pancreatic lipase activities, and fat digestion. Blood lipids were measured postprandially for fat assimilation.
Results: Despite an increase in droplet size in the stomach (2.75–6.20 µm), the fine emulsion retained droplets of smaller size and its lipolysis was greater than that of the coarse emulsion (36.5% compared with 15.8%; P < 0.05). In the duodenum, lipolysis of the fine emulsion was on the whole higher (73.3% compared with 46.3%). The overall 0–7-h plasma and chylomicron responses given by the areas under the curve were not significantly different between the emulsions, but the triacylglycerol peak was delayed with the fine emulsion (3 h 56 min compared with 2 h 50 min).
Conclusions: Fat emulsions behave differently in the digestive tract depending on their initial physicochemical properties. A lower initial fat droplet size facilitates fat digestion by gastric lipase in the stomach and duodenal lipolysis. Overall fat assimilation in healthy subjects is not affected by differences in initial droplet size because of efficient fat digestion by pancreatic lipase in the small intestine. Nevertheless, these new observations could be of interest in the enteral nutrition of subjects suffering from pancreatic insufficiency.
Key Words: Fat droplet size • fat • lipolysis • digestion • assimilation • gastric lipase • pancreatic lipase • postprandial lipemia • humans • pancreatic insufficiency • emulsion • enteral nutrition
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