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A comparative, randomised MRI study of the physiological and appetitive responses to gelling (alginate) and non-gelling nasogastric tube feeds in healthy men

Aliyu, Abdulsalam I.; Nixon, Aline; Hoad, Caroline; Marciani, Luca; Corsetti, Maura; Aithal, Guruprasad P.; Macdonald, Ian A.; Cordon, Sally M.; Alhussain, Maha H.; Inoue, Hiroaki; Yamada, Masahiko; Taylor, Moira A.

A comparative, randomised MRI study of the physiological and appetitive responses to gelling (alginate) and non-gelling nasogastric tube feeds in healthy men Thumbnail


Abdulsalam I. Aliyu

Aline Nixon

Senior Research Fellow

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Professor of Gastrointestinal Imaging

Clinical Associate Professor

Ian A. Macdonald

Sally M. Cordon

Maha H. Alhussain

Hiroaki Inoue

Masahiko Yamada


AbstractInclusion in nasogastric tube feeds (NGTF) of acid-sensitive, seaweed-derived alginate, expected to form a reversible gel in the stomach, may create a more normal intragastric state and modified gastrointestinal responses. This may ameliorate NGTF-associated risk of diarrhoea, upper gastrointestinal symptoms and appetite suppression. In a randomised, crossover, comparison study, undertaken in twelve healthy males, an alginate-containing feed (F + ALG) or one that was alginate-free (F-ALG) (300 ml) was given over 1 h with a 7–14-d washout period between treatments. Baseline and for 4-h post-feed initiation, MRI measurements were made to establish small bowel water content (SBWC), gastric contents volume (GCV) and appearance, and superior mesenteric artery blood flux. Blood glucose and gut peptides were measured. Subjective appetite and upper gastrointestinal symptoms scores were obtained. Ad libitum pasta consumption 3-h post-feeding was measured. F + ALG exhibited a gastric appearance consistent with gelling surrounded by a freely mobile water halo. Significant main effects of feed were seen for SBWC (P = 0·03) and peptide YY (PYY) (P = 0·004) which were attributed to generally higher values for SBWC with F + ALG (max difference between adjusted means 72 ml at 210 min) and generally lower values for PYY with F + ALG. GCV showed a faster reduction with F + ALG, less between-participant variation and a feed-by-time interaction (P = 0·04). Feed-by-time interactions were also seen with glucagon-like-peptide 1 (GLP-1) (P = 0·02) and glucose-dependent insulinotropic polypeptide (GIP) (P = 0·002), both showing a blunted response with F + ALG. Apparent intragastric gelling with F + ALG and subsequent differences in gastrointestinal and endocrine responses have been demonstrated between an alginate-containing and alginate-free feed.

Journal Article Type Article
Acceptance Date Jan 25, 2023
Online Publication Date Feb 7, 2023
Publication Date Oct 28, 2023
Deposit Date Feb 3, 2023
Publicly Available Date Aug 8, 2023
Journal British Journal of Nutrition
Print ISSN 0007-1145
Electronic ISSN 1475-2662
Publisher Cambridge University Press (CUP)
Peer Reviewed Peer Reviewed
Volume 130
Issue 8
Pages 1316-1328
Keywords Nutrition and Dietetics, Medicine (miscellaneous)
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