TY - JOUR
T1 - Effect of caloric intake and macronutrient composition on intestinal cholesterol absorption and bile acids in patients with obesity
AU - Hashem, Anas Mohamad
AU - Cifuentes, Lizeth
AU - Calderon, Gerardo
AU - Ricardo-Silgado, Maria Laura
AU - Gonzalez-Izundegui, Daniel
AU - Campos, Alejandro
AU - McRae, Alison
AU - Franks, Shawna
AU - Hurtado, Maria Daniela
AU - Burton, Duane
AU - Petterson, Xuan Mai
AU - Lanza, Ian R.
AU - Camilleri, Michael
AU - Acosta, Andres
N1 - Publisher Copyright:
Copyright © 2022 the American Physiological Society.
PY - 2022/9
Y1 - 2022/9
N2 - Obesity is associated with alterations in cholesterol and bile acid (BA) metabolism. However, the interaction among dietary intake, cholesterol absorption, and BA metabolism in patients with obesity remains unclear. We conducted a 4-wk nutritional intervention nonrandomized clinical trial with three different sequential diets for a week in the following order: regular diet (RD); high calorie, high-fat diet (HCHF), washout period on RD; and low-calorie, low-fat diet (LCLF). We provided participants with meal replacements during HCHF and LCLF diets. A total of 16 participants completed the study [n = 8 normal weight (NW); n = 8 with obesity (OB)]. Overall, there was a significant increase in intestinal cholesterol uptake when changing from RD to HCHF and a reduction in intestinal cholesterol uptake from HCHF to LCLF. When analyzing by BMI groups, these findings were similar in patients with NW (RD to HCHF: P < 0.007; HCHF to LCLF: P = 0.02); however, in patients with obesity, the change in intestinal cholesterol uptake was only observed when changing from RD to HCHF (P = 0.006). There was no correlation between cholesterol absorption and fecal bile acids or other markers of BA metabolism in all patients or the subgroups. Dietary caloric content had a significant effect on cholesterol absorption, however, this effect is blunted in patients with obesity. These data are consistent with the impaired effect of a low-fat diet on cholesterol absorption in obesity.
AB - Obesity is associated with alterations in cholesterol and bile acid (BA) metabolism. However, the interaction among dietary intake, cholesterol absorption, and BA metabolism in patients with obesity remains unclear. We conducted a 4-wk nutritional intervention nonrandomized clinical trial with three different sequential diets for a week in the following order: regular diet (RD); high calorie, high-fat diet (HCHF), washout period on RD; and low-calorie, low-fat diet (LCLF). We provided participants with meal replacements during HCHF and LCLF diets. A total of 16 participants completed the study [n = 8 normal weight (NW); n = 8 with obesity (OB)]. Overall, there was a significant increase in intestinal cholesterol uptake when changing from RD to HCHF and a reduction in intestinal cholesterol uptake from HCHF to LCLF. When analyzing by BMI groups, these findings were similar in patients with NW (RD to HCHF: P < 0.007; HCHF to LCLF: P = 0.02); however, in patients with obesity, the change in intestinal cholesterol uptake was only observed when changing from RD to HCHF (P = 0.006). There was no correlation between cholesterol absorption and fecal bile acids or other markers of BA metabolism in all patients or the subgroups. Dietary caloric content had a significant effect on cholesterol absorption, however, this effect is blunted in patients with obesity. These data are consistent with the impaired effect of a low-fat diet on cholesterol absorption in obesity.
KW - bile acids
KW - caloric intake
KW - cholesterol
KW - fat
KW - obesity
UR - http://www.scopus.com/inward/record.url?scp=85136340010&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85136340010&partnerID=8YFLogxK
U2 - 10.1152/ajpgi.00108.2022
DO - 10.1152/ajpgi.00108.2022
M3 - Article
C2 - 35727128
AN - SCOPUS:85136340010
SN - 0193-1857
VL - 323
SP - G157-G164
JO - American Journal of Physiology - Gastrointestinal and Liver Physiology
JF - American Journal of Physiology - Gastrointestinal and Liver Physiology
IS - 3
ER -