Minor digestive symptoms and their impact in the general population: a cluster analysis approach.

BACKGROUND: The classification and treatment of patients who do not meet the criteria for a functional gastrointestinal (GI) disorder has not been well established. This study aimed to record the prevalence of minor digestive symptoms (MDSs) in the general population attempting to divide them into symptom clusters as well as trying to assess their impact and the way sufferers cope with them. METHODS: Following face-to-face interviews, a web-based, self-administered questionnaire was designed to capture a range of GI sensations using 34 questions and 12 images depicting abdominal symptoms. A randomly selected sample of 1515 women and 409 men representing the general population in France was studied. Cluster analysis was used to identify groups of respondents with naturally co-occurring symptoms. Data were also collected on other factors such as exacerbating and relieving strategies. RESULTS: MDSs were reported at least every 2 months in 66.5% of women and 47.7% of men. A total of 11 symptom clusters were identified: constipation-like, flatulence, abdominal pressure, abdominal swelling, acid reflux, diarrhoea-like, intestinal heaviness, intestinal pain, gurgling, burning and gastric pain. Despite being minor, these problems had a major impact on vitality and self-image as well as emotional, social and physical well-being. Respondents considered lifestyle, food and disordered function as the main factors responsible for MDSs. Physical measures and dietary modification were the most frequent strategies adopted to obtain relief. CONCLUSIONS: MDSs are common and improved methods of recognition are needed so that better management strategies can be developed for individuals with these symptoms. The definition of symptom clusters may offer one way of achieving this goal.

A very high 70%-protein diet does not induce conditioned taste aversion in rats.

This study was designed to assess the effects of transition and adaptation to a very high protein diet on behavioral food responses, energy intake, body weight gain, and body composition in rats. For this purpose, adult male Wistar rats were fed either a diet with 70% of energy as protein (P70 group) or a diet with 14% of energy as protein (P14 group) for 16 d. These two groups were compared with a P14 pair-fed (P14-pf) group. A behavioral satiety sequence was also examined. The P70 group ate 21% less than the P14 rats (P < 0.001) and gained less body weight (P < 0.01). The P70 group gained more carcass weight than either P14 or P14-pf rats (P < 0.05). Behavior and food intake data were affected in P70 rats on d 1 of eating the very high protein diet and then returned to baseline values as early as d 2 of consuming the P70 diet. Rats that adapted to the very high protein diet did not acquire a conditioned taste aversion but rather exhibited satiety and a normal behavioral satiety sequence.

Preabsorptive factors are not the main determinants of intake depression induced by a high-protein diet in the rat.

The factors involved in the depression of food intake produced by a high-protein diet are still poorly understood. The aim of this study was to assess the role of several preingestive or preabsorptive factors likely to influence food intake when rats were fed ad libitum. Food intake was measured after modifying the composition of the high-protein diet, i.e., the type of proteins, or carbohydrates. Moreover, correlations between high-protein diet intake and the quantity of fluid ingested or stomach volume were studied. By varying the carbohydrate composition (sucrose/cornstarch) and the protein source (soy or gluten or total milk protein) of high-protein diets, we modified the orosensory properties of these diets. However, no differences in food intake were observed between these groups of rats during the transition phase or after adaptation, except during the first day of soy- or gluten-based diets when the depression of food intake was intensified. The depression of high-protein diet intake was neither the consequence of any delay necessary to increase the fluid intake induced by eating a high-protein diet nor due to a marked increase in stomach volume, which might explain enhanced satiety and decreased food intake through the activation of vagal afferent fibers. Our experiments do not indicate a preponderant role for oropharyngeal or preabsorptive factors in the depression of food intake induced by a high-protein diet.

Total subdiaphragmatic vagotomy does not suppress high protein diet-induced food intake depression in rats.

This study was undertaken to determine whether the subdiaphragmatic vagus nerve is involved in the depression of food intake induced by the ingestion of a high protein diet (P50) in rats. After total subdiaphragmatic vagotomy (Vago group) or sham surgery (Sham group), rats consumed the control diet for a 2-wk recovery period and then both groups consumed the high protein diet for 16 d. Daily food intake, meal pattern analysis and behavioral satiety sequence were measured. Total subdiaphragmatic vagotomy did not modify the daily intake of the control diet or suppress the dramatic depression in food intake produced by acute transition to a high protein diet. However, the daily intake of a high protein diet was slightly reduced under acute conditions or even after adaptation (P < 0.005). Analysis of meal parameters and the behavioral satiety sequence after adaptation indicated no major metabolic distress. In conclusion, these results suggest that the subdiaphragmatic vagus nerve does not constitute an obligatory pathway for the transfer of information to the brain, resulting in a depression of high protein diet intake. In contrast, a defect in this visceral regulating system could reinforce the metabolic-associated food intake depression signal.