Gender and microbiota determine hepatic bile acid and metabolic response to a single fast-food meal in healthy adults

Background and Aim High caloric Western type diet is associated with obesity, the metabolic syndrome and its hepatic manifestation nonalcoholic fatty liver disease (NAFLD). Fast foods are quick alternatives to home cooked meals, high in saturated fat, sugar, salt and calories, which is frequently consumed in excess and represents the preferred food type of several eating disorders including bulimia and binge eating. To date it remains unclear how intermittent excess food intake and especially fast food consumption may influence liver metabolism. Aim of this study was to characterize the effects of a single fast food binge on hepatic steatosis, inflammation, bile acid- (BA), glucose and lipid metabolism.

Methods We recruited 25 healthy individuals without significant alcohol consumption during 14 days prior to inclusion and assessed baseline transaminases, fasting bile acids, lipid profile, glucose and cytokine levels. Additionally, transient elastography as well as controlled attenuation parameter (CAP) to assess hepatic steatosis were performed. Later that day, the subjects received a high caloric fast food meal of their choice and were asked to continue eating for a two-hour period or until fully saturated. The next day, we repeated all the studies mentioned above after a 12h fasting period. Additionally, we collected stool samples for microbiota analysis prior to the food excess.

Results Analysis revealed a modest increase of fasting CAP accompanied by a robust increase of fasting serum BA levels the day after the meal. Surprisingly, serum transaminases, cholesterol and bilirubin levels were significantly lower the day after the meal. When differentiating individuals with a relevant deltaBA>1 vs. individuals without deltaBA≤1, we identified several gut microbiota as well as the individuals’ sex to be associated with BA increase and the observed alterations in liver function, metabolism and inflammation.

Conclusion A single excess fast food meal leads to a robust increase of total serum BA and alterations in several parameters of liver injury and metabolism, indicating a potential acute effect on MDR2 and FXR signaling.

Publication History

Article published online:
04 January 2021