Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-05T08:28:53.216Z Has data issue: false hasContentIssue false

The hypotensive response to oral fat is comparable but slower compared with carbohydrate in healthy elderly subjects

Published online by Cambridge University Press:  08 March 2007

Renuka Visvanathan*
Affiliation:
Department of Medicine, University of Adelaide, Adelaide, South Australia Aged and Extended Care Service, The Queen Elizabeth Hospital, Woodville South, Adelaide, South Australia
Michael Horowitz
Affiliation:
Department of Medicine, University of Adelaide, Adelaide, South Australia
Ian Chapman
Affiliation:
Department of Medicine, University of Adelaide, Adelaide, South Australia
*
*corresponding author: Dr Renuka Visvanathan, fax 08 82228593, email [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

The objective of the present study was to determine the comparative hypotensive responses to drinks containing predominantly fat and carbohydrate (CHO) in healthy elderly subjects. Using a randomised, cross-over study, the participants, twelve elderly subjects, six of them female (72·2 (sd 5·7) years), were investigated. On three separate days, blood pressure (BP) and heart rate were measured following ingestion of 300ml drinks containing: (1) CHO (75g glucose and 93g Polyjoule (CHO polymer) providing 2732kJ (653kcal)); (2) 88% fat (cream blended with milk providing 2732kJ (653kcal)); (3) water. Systolic BP decreased following the CHO drink (P<0·001) and the high-fat drink (P<0·001) but not water; there was no difference in the magnitude of the decrease between the CHO drink and the drink containing fat (13·4v. 15·6mmHg). However, the onset of the fall was slower after the fat-containing drink (13·0v. 26·5min (P=0·01); area under the curve for 0–30min for CHO drink −6·5v. fat-containing drink 125·4 mmHg×min (P=0·043)). We conclude that ingestion of a high-fat drink results in a comparable fall in BP to a CHO drink although the onset is relatively slower. These observations may have implications for the management of postprandial hypotension.

Type
Research Article
Copyright
Copyright © The Nutrition Society 2006

References

Bannister, R, da Costa, DF, Forster, S & Mathias, CJCardiovascular effects of lipid and protein meals in autonomic failure. J Physiol 1987 377 62.Google Scholar
Erdmann, J, Topsch, R, Lippl, F, Gussmann, P & Schusdziarra, VPostprandial response of plasma ghrelin levels to various test meals in relation to food intake, plasma insulin, and glucose. J Clin Endocrinol Metab 2004 89 30483054.CrossRefGoogle ScholarPubMed
Ewing, DJ & Clarke, BFDiagnosis and management of diabetic autonomic neuropathy, Br Med J (Clin Res Ed) 1982 285 916918.CrossRefGoogle ScholarPubMed
Fagius, J & Berne, CIncrease in muscle nerve sympathetic activity in humans after food intake Clin Sci (Lond) 1994 86, 159167.CrossRefGoogle ScholarPubMed
Gentilcore, D, Bryant, B, Wishart, JM, Morris, HA, Horowitz, M &Jones, KLAcarbose attenuates the hypotensive response to sucrose and slows gastric emptying in the elderly Am J Med 2005 118 1289.CrossRefGoogle ScholarPubMed
Hawley, SK & Channer, KSRelative effects of fat-, carbohydrate- and protein-containing liquid diets on cardiac output in healthy adult subjects Clin Sci (Lond) 1992 83, 483487.CrossRefGoogle ScholarPubMed
Heseltine, D, Dakkak, M, Macdonald, IA, Bloom, SR & Potter, JFEffects of carbohydrate type on postprandial blood pressure, neuroendocrine and gastrointestinal hormone changes in the elderly. Clin Auton Res 1991 1, 219224.CrossRefGoogle ScholarPubMed
Hoeldtke, RD, óDorisio, TM & Boden, GPrevention of postprandial hypotension with somatostatin Ann Intern Med 1985 103, 889890.CrossRefGoogle ScholarPubMed
Hoost, U, Kelbaek, H, Rasmusen, H, Court-Payen, M, Christensen, NJ, Pedersen-Bjergaard, U & Lorenzen, THaemodynamic effects of eating: the role of meal composition. Clin Sci (Lond) 1996 90 269276.CrossRefGoogle ScholarPubMed
Jansen, R & Hoefnagels, WHypotensive and sedative effects of insulin in autonomic failure. Br Med J (Clin Res Ed) 1987 295 671672.CrossRefGoogle ScholarPubMed
Jansen, RW & Lipsitz, LAPostprandial hypotension: epidemiology, pathophysiology, and clinical management. Ann Intern Med 1995 122 286295.CrossRefGoogle ScholarPubMed
Jansen, RW,Peeters, TL, van Lier, HJ & Hoefnagels, WHThe effect of oral glucose, protein, fat and water loading on blood pressure and the gastrointestinal peptides VIP and somatostatin in hypertensive elderly subjects. Eur J Clin Invest 1990 20 192198.CrossRefGoogle ScholarPubMed
Joannides, R, Moore, N, de la Gueronniere, V & Thuillez, CEffect of water on arteries. Lancet 1999 354 516.CrossRefGoogle ScholarPubMed
Jones, KL, MacIntosh, C, Su, YC, Wells, F, Chapman, IM, Tonkin, A & Horowitz, MGuar gum reduces postprandial hypotension in older people. J Am Geriatr Soc 2001 49 162167.CrossRefGoogle ScholarPubMed
Kuipers, HM, Jansen, RW, Peeters, TL & Hoefnagels, WHThe influence of food temperature on postprandial blood pressure reduction and its relation to substance-P in healthy elderly subjects. J Am Geriatr Soc 1991 39 181184.CrossRefGoogle ScholarPubMed
Mathias, CJ, da Costa, DF, McIntosh, CM, Fosbraey, P, Bannister, R, Wood, SM, Bloom, SR & Christensen, NJblood pressure and hormonal effects after glucose and xylose ingestion in chronic autonomic failure. Clin Sci (Lond) 1989 77 8592.CrossRefGoogle ScholarPubMed
óDonovan, D, Feinle, C, Tonkin, A, Horowitz, M & Jones, KLPostprandial hypotension in response to duodenal glucose delivery in healthy older subjects. J Physiol 2002 540 673679.CrossRefGoogle ScholarPubMed
óDonovan, D, Feinle-Bisset, C, Chong, C, Cameron, A, Tonkin, A, Wishart, J, Horowitz, m & Jones, KLIntraduodenal guar attenuates the fall in blood pressure induced by glucose in healthy older adults. J Gerontol 2005 60A 940946.CrossRefGoogle Scholar
Piha, SJCardiovascular autonomic reflex tests: normal responses and age-related reference values. Clin Physiol 1991 11 277290.CrossRefGoogle ScholarPubMed
Potter, JF, Heseltine, D, Hartley, G, Matthews, J, MacDonald, IA & James, OFEffects of meal composition on the postprandial blood pressure, catecholamine and insulin changes in elderly subjects. Clin Sci (Lond) 1989 77 265272.CrossRefGoogle ScholarPubMed
Routledge, HC, Chowdhary, S, Coote, JH & Townend, JNCardiac vagal response to water ingestion in normal human subjects. Clin Sci (Lond) 2002 103 157162.CrossRefGoogle ScholarPubMed
Shannon, JR, Diedrich, A, Biaggioni, I, Tank, J, Robertson, RM, Robertson, D & Jordan, JWater drinking as a treatment for orthostatic syndromes. Am J Med 2002 112 355360.CrossRefGoogle ScholarPubMed
Sidery, MB, Cowley, AJ & MacDonald, IACardiovascular responses to a high-fat and a high-carbohydrate meal in healthy elderly subjects. Clin Sci (Lond) 1993 84 263270.CrossRefGoogle Scholar
Smith, NL, Psaty, BM, Rutan, GH, Lumley, T, Yanez, D, Chaves, PH & Kronmal, RAThe association between time since last meal and blood pressure in older adults: the cardiovascular health study. J Am Geriatr Soc 2003 51 824828.CrossRefGoogle ScholarPubMed
Stevens, MJ, Edmonds, ME, Mathias, CJ & Watkins, PJDisabling postural hypotension complicating diabetic autonomic neuropathy.l Diabet Med 1991 8 870874.CrossRefGoogle ScholarPubMed
Visvanathan, R, Chen, R, Garcia, M, Horowitz, M & Chapman, IThe effects of drinks made from simple sugars on blood pressure in healthy older people. Br J Nutr 2005 93 575579.CrossRefGoogle ScholarPubMed
Visvanathan, R, Chen, R, Horowitz, M & Chapman, IBlood pressure responses in healthy older people to 50 g carbohydrate drinks with differing glycaemic effects. Br J Nutr 2004 92 335340.CrossRefGoogle ScholarPubMed
Vloet, LC, Mehagnoul-Schipper, DJ, Hoefnagels, WH & Jansen, RWThe influence of low-, normal-, and high-carbohydrate meals on blood pressure in elderly patients with postprandial hypotension. lJ Geronto 2001 M56 M744M748.Google Scholar
Waaler, BA & Eriksen, MPost-prandial cardiovascular responses in man after ingestion of carbohydrate, protein or fat. Acta Physiol Scand 1992 146 321327.CrossRefGoogle ScholarPubMed