Loading...
Intermittent versus continuous enteral nutrition attenuates increases in insulin and leptin during short-term bed rest
Gonzalez, Javier T. Dirks, Marlou L. Holwerda, Andrew M. Kouw, Imre W. K. van Loon, Luc J. C.
Gonzalez, Javier T.
Dirks, Marlou L.
Holwerda, Andrew M.
Kouw, Imre W. K.
van Loon, Luc J. C.
Abstract
Purpose
To compare endocrine responses to intermittent vs continuous enteral nutrition provision during short-term bed rest.
Methods
Twenty healthy men underwent 7 days of bed rest, during which they were randomized to receive enteral nutrition (47%E as carbohydrate, 34%E as fat, 16%E as protein and 3%E as fibre) in a continuous (CONTINUOUS; n = 10; 24 h day−1 at a constant rate) or intermittent (INTERMITTENT; n = 10; as 4 meals per day separated by 5 h) pattern. Daily plasma samples were taken every morning to assess metabolite/hormone concentrations.
Results
During bed rest, plasma leptin concentrations were elevated to a lesser extent with INTERMITTENT vs CONTINUOUS (iAUC: 0.42 ± 0.38 vs 0.95 ± 0.48 nmol L−1, respectively; P = 0.014) as were insulin concentrations (interaction effect, P < 0.001) which reached a peak of 369 ± 225 pmol L−1 in CONTINUOUS, compared to 94 ± 38 pmol L−1 in INTERMITTENT (P = 0.001). Changes in glucose infusion rate were positively correlated with changes in fasting plasma GLP-1 concentrations (r = 0.44, P = 0.049).
Conclusion
Intermittent enteral nutrition attenuates the progressive rise in plasma leptin and insulinemia seen with continuous feeding during bed rest, suggesting that continuous feeding increases insulin requirements to maintain euglycemia. This raises the possibility that hepatic insulin sensitivity is impaired to a greater extent with continuous versus intermittent feeding during bed rest. To attenuate endocrine and metabolic changes with enteral feeding, an intermittent feeding strategy may, therefore, be preferable to continuous provision of nutrition.
This trial was registered on clinicaltrials.gov as NCT02521025.
Keywords
glucagon, glucagon-like peptide-1, glucose, insulin, insulin sensitivity, metabolism
Date
2020
Type
Journal article
Journal
European Journal of Applied Physiology
Book
Volume
120
Issue
Page Range
2083-2094
Article Number
ACU Department
Centre for Exercise and Nutrition
Faculty of Health Sciences
Faculty of Health Sciences
Collections
Relation URI
Source URL
Event URL
Open Access Status
License
CC BY 4.0
File Access
Open