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AIM: To assess the role of lactate as a precursor for butyrate biosynthesis in human colonic microflora. METHODS AND RESULTS: Three human faecal microfloras were incubated in vitro with media supplemented with 30 mmol l(-1) unenriched or 13C-enriched lactate. Lactate metabolism and short-chain fatty acid (SCFA) production were quantified. Lactate conversion to butyrate was investigated by gas chromatography-mass spectrometry and the pathways involved were identified by 13C nuclear magnetic resonance spectroscopy. All human faecal microfloras rapidly and completely fermented lactate, yielding approx. 19 mmol l(-1) total SCFAs. However, the SCFA composition varied markedly between microfloras. Butyrate was the main end-product for two microfloras but not for the third (60 and 61%vs 27% of the net concentration of SCFA produced respectively). The latter was typified by its ability to produce propionate as a major product (37%), and valerate (3%). 13C-Labelling showed that butyrate was produced through the acetyl-CoA pathway and that the three microfloras possessed significant differences in their metabolic pathways for lactate consumption. CONCLUSIONS: In contrast to the ruminal microflora, the human intestinal microflora can utilize both d- and l-lactate as precursors for butyrate synthesis. Inter-individual variation is found. SIGNIFICANCE AND IMPACT OF THE STUDY: This study suggests that the butyrogenic capability of colonic prebiotics could be related to lactate availability. These findings will direct the development of selection strategies for the isolation of new butyrate-producing bacteria among the lactate-utilizing bacteria present in the human intestinal microfloras.

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OBJECTIVE: To explore metabolic and cellular modifications induced during childhood obesity, in a novel animal model of obese mini-piglets. DESIGN: A total of 10 four-month old Yucatan mini-pigs were followed from prepuberty to adulthood. Animals were divided into two groups. The first one had been overfed (OF) a western-type diet and the second one had been normally fed a control recommended human-type diet (NF). MEASUREMENTS: Plasma insulin-like growth factor 1 (IGF-1), insulin, leptin, nonesterified fatty acids, triglycerides (TGs) and glucose were determined at sexual maturity and at young adulthood. Quantitative gene expressions of peroxysome-proliferator-activated receptors (PPARs), glucose transporter 4, insulin receptor, IGF-1, leptin and interleukin-6 (IL-6) in skeletal muscle, adipose tissue and liver were also measured at both stages. Adult insulin sensitivity was measured via euglycaemic-hyperinsulinaemic clamps. RESULTS: Increased body weight in adult OF pigs was associated with increased body size and low insulin sensitivity. Sexually mature OF pigs had higher IGF-1 plasma concentrations than their lean littermates (P < 0.05). In the OF group, TGs and glucose were both decreased (P < 0.05). Muscle PPARgamma and alpha in OF pubescent pigs as compared to NF pigs were 11 times higher and 20 times lower, respectively (P < 0.01). CONCLUSION: Obesity and insulin resistance induced by overfeeding mini-pigs during development and puberty were not associated with the cluster of metabolic modifications frequently observed in their adult littermates. Increased IGF-1 concentrations and modifications of skeletal muscle PPAR (alpha and gamma) expressions may help the young obese pig to partially regulate its glycaemia and triglyceridaemia through an increase of fat mass, which maintains its high insulin sensitivity.

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The digestion in the proximal intestine of mixed meals (5,160 kJ) containing either native (NS) or pregelatinized (PS) maize starches (approximately 200 g), and the postprandial glycaemic responses they induced were compared in pigs. For both meals, approximately 25% of the ingested starch was assimilated above the duodenal cannula (positioned 75 cm beyond the pylorus). Larger amounts of starch were collected for NS than for PS during the first 30 min. The glycaemic responses, however, indicated a higher rate of glucose absorption for PS during the first 30 min, which could be explained by the higher susceptibility of PS to hydrolysis, as we observed in vivo. Indeed, malto-oligosaccharides (G1-G3) represented almost 80% of the total alpha-glucans collected at 150 min in the duodenum after the PS meal. At that time, after the NS meal, only 30% of the alpha-glucans were malto-oligosaccharides. Thus, even after a mixed meal, the starch digestion rate can alter the observed postprandial glycaemic response.

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Use of the ECG for diagnosis of ischemic heart disease is more difficult in the setting of ventricular paced rhythms (VPRs). ST-segment/T-wave configuration are changed by the altered intraventricular conduction associated with ventricular pacing. The anticipated, or expected, morphology in patients with VPRs is one of QRS-complex-ST-segment to T-wave discordance. Several strategies are available to the physician to assist in the correct interpretation of the 12-lead ECG in patients with permanent ventricular pacemakers, including: a knowledge of the anticipated ST-segment-T-wave changes of VPRs and consequently the ability to recognize acute, ischemic morphologies; the performance of serial ECGs or ST-segment trend monitoring demonstrating dynamic changes encountered in acutely ischemic patients; a comparison with previous ECGs; and, if appropriate, an analysis of the native, underlying rhythm. The first strategy, an awareness of the anticipated ST-segment morphologies of VPRs, is the most important and not dependent on additional diagnostic testing, past medical records, or additional expertise in pacemaker function. Two cases are reported in which an analysis of the ECG in the setting of VPR assisted the treating physicians in establishing the correct diagnosis of acute myocardial infarction.

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Acacia gums are commonly used food additives. It is currently unclear how extensively these non-digestible polysaccharides are fermented in the human large intestine. However, they have been shown to support bifidobacterial growth in vitro and may represent useful candidate prebiotics. In these investigations, in vitro 24-h batch incubations and chemostat continuous-cultures of human faecal bacteria were conducted using two acacia gums (Fibregum standard and Fibregum AS). Our aim was to study the effects of these gums on bacterial ecology and fermentation in the large bowel. Fructooligosaccharides (Actilight-950P) were also investigated as a reference. Both Acacia gums were extensively fermented by intestinal flora although there were marked differences in fermentation product formation and ecological effects, probably due to their differing botanical origins and/or biochemical characteristics. In particular, fermentation of Fibregum AS led to significantly higher proportions of propionate both in batch and chemostat experiments. Both gums decreased Clostridium sp. levels but only Fibregum-standard induced higher Lactobacillus sp. counts compared to control. These bacterial modifications were highly dependent of the operating pH of the fermentation system with acidic conditions promoting both the prebiotic and the butyrogenic effects of fructooligosaccharides. In these studies, we have demonstrated that, similarly to fructooligosaccharides, Acacia gums can exert putatively beneficial effects on host health through both the improvement of the composition of the large intestine microflora and SCFA formation.

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