Volume 133, Issue 4, Pages 1124-1131 (October 2007) Free Fatty Acids Have More Potent Effects on Gastric Emptying, Gut Hormones, and Appetite Than Triacylglycerides  Tanya J. Little, Antonietta Russo, James H. Meyer, Michael Horowitz, Douglas R. Smyth, Max Bellon, Judith M. Wishart, Karen L. Jones, Christine Feinle–Bisset  Gastroenterology  Volume 133, Issue 4, Pages 1124-1131 (October 2007) DOI: 10.1053/j.gastro.2007.06.060 Copyright © 2007 AGA Institute Terms and Conditions

Figure 1 Outline of the study protocol. At t = −10 minutes, a baseline blood sample was collected and a VAS questionnaire completed. At t = −5 minutes, a meal containing either (1) 40 g FFA, (2) 40 g TG, both as 600-mL oil-in-water emulsions, stabilized with 4% (wt/vol) powered milk protein and labeled with 15 MBq 123I, or (3) control solution (24 g skim milk powder in 600 mL water, labeled with 15 MBq 99mTc–sulfur colloid) was administered intragastrically. Static images to evaluate gastric emptying and intragastric meal distribution were acquired at t = 0, 10, 20, 30, 45, 60, 90, 120, 150, 180, 210, and 240 minutes. Blood samples for measurement of plasma CCK and PYY levels were collected at t = −10, 0, 10, 20, 30, 45, 60, 90, 120, 180, and 240 minutes and a VAS was administered at t = 0, 10, 20, 30, 45, 60, 75, 90, 120, 150, 180, 210, and 240 minutes. At t = 240 minutes, subjects were presented with a cold, buffet-style meal. At t = 270 minutes, a final blood sample was collected and a VAS was completed. Gastroenterology 2007 133, 1124-1131DOI: (10.1053/j.gastro.2007.06.060) Copyright © 2007 AGA Institute Terms and Conditions

Figure 2 GE (% retention) (A) after intragastric administration of (1) 40 g FFA, (2) 40 g TG, both as 600-mL oil-in-water emulsions, stabilized with 4% (wt/vol) powered milk protein, or (3) control solution (24 g skim milk powder in 600 mL water), and retention of the fat component of TG and FFA in the (B) proximal and (C) distal stomach. Data are means ± SEM (n = 9). *FFA and TG vs control, #FFA vs TG: P < .001. ♢, Control; ■, TG; ○, FFA. Gastroenterology 2007 133, 1124-1131DOI: (10.1053/j.gastro.2007.06.060) Copyright © 2007 AGA Institute Terms and Conditions

Figure 3 Grams of fatty acid emptied after intragastric administration of (1) 40 g FFA or (2) 40 g TG, both as 600-mL oil-in-water emulsions, stabilized with 4% (wt/vol) powered milk protein. Data are means ± SEM (n = 9). #FFA vs TG: P < .05. ■, TG; ○, FFA. Gastroenterology 2007 133, 1124-1131DOI: (10.1053/j.gastro.2007.06.060) Copyright © 2007 AGA Institute Terms and Conditions

Figure 4 Plasma concentrations of (A) CCK and (B) PYY after intragastric administration of (1) 40 g FFA, (2) 40 g TG, both as 600-mL oil-in-water emulsions, stabilized with 4% (wt/vol) powered milk protein, or (3) control solution (24 g skim milk powder in 600 mL water). Data for CCK are changes from baseline values. Data are means ± SEM (n = 9). *FFA vs control, #FFA vs TG, ^control vs TG: P < .05. ♢, Control; ■, TG; ○, FFA. Gastroenterology 2007 133, 1124-1131DOI: (10.1053/j.gastro.2007.06.060) Copyright © 2007 AGA Institute Terms and Conditions

Figure 5 (A) Hunger and (B) fullness after intragastric administration of (1) 40 g FFA, (2) 40 g TG, both as 600-mL oil-in-water emulsions, stabilized with 4% (wt/vol) powered milk protein, or (3) control solution (24 g skim milk powder in 600 mL water). Data are means ± SEM (n = 9). *FFA vs control, #FFA vs TG: P < .05. ♢, Control; ■, TG; ○, FFA. Gastroenterology 2007 133, 1124-1131DOI: (10.1053/j.gastro.2007.06.060) Copyright © 2007 AGA Institute Terms and Conditions