Journal of Gastrointestinal Surgery

, Volume 18, Issue 2, pp 286–294 | Cite as

High-Fat Diet Enhances Villus Growth During the Adaptation Response to Massive Proximal Small Bowel Resection

  • Pamela M. Choi
  • Raphael C. Sun
  • Jun Guo
  • Christopher R. Erwin
  • Brad W. Warner
2013 SSAT Plenary Presentation


Previous studies have shown that high-fat diet (HFD) enhances adaptation if provided immediately following small bowel resection (SBR). The purpose of this study was to determine if HFD could further enhance villus growth after resection-induced adaptation had already taken place. C57/Bl6 mice underwent a 50 % proximal SBR or sham operation and were then provided a standard rodent liquid diet (LD) ad lib. After a typical period of adaptation (7 days), SBR and sham-operated mice were randomized to receive either LD or HFD (42 % kcal fat) for an additional 7 days. Mice were then harvested, and small intestine was collected for analysis. Adaptation occurred in both SBR groups; however, the SBR/HFD had significantly increased villus height compared to SBR/LD. Reverse transcription–polymerase chain reaction of villus enterocytes showed a marked increase in CD36 expression in the SBR/HFD group compared with SBR/LD mice. While exposure to increased enteral fat alone did not affect villus morphology in sham-operated mice, HFD significantly increased villus growth in the setting of resection-induced adaptation, supporting the clinical utility of enteral fat in augmenting adaptation. Increased expression of CD36 suggests a possible mechanistic role in dietary fat metabolism and villus growth in the setting of short gut syndrome.


Short gut syndrome Small bowel adaptation High-fat diet CD36 


  1. 1.
    Messing B, Crenn P, Beau P, et al. Long-term survival and parenteral nutrition dependence in adult patients with the short bowel syndrome. Gastroenterology 1999; 117:1043–1050PubMedCrossRefGoogle Scholar
  2. 2.
    Squires RH, Duggan C, Teitelbaum DH, et al: Natural history of pediatric intestinal failure: initial report from the Pediatric Intestinal Failure Consortium. J Pediatr 2012; 161:723–728PubMedCentralPubMedCrossRefGoogle Scholar
  3. 3.
    Menge H, Grafe M, Lorenz-Meyer H, et al: The influence of food intake on the development of structural and functional adaptation following ileal resection in the rat. Gut 1975; 16:468–472PubMedCrossRefGoogle Scholar
  4. 4.
    Buts JP, Morin CL,Ling V: Influence of dietary components on intestinal adaptation after small bowel resection in rats. Clin Invest Med 1979; 2:59–66PubMedGoogle Scholar
  5. 5.
    Dodge ME, Bertolo RF,Brunton JA: Enteral feeding induces early intestinal adaptation in a parenterally fed neonatal piglet model of short bowel syndrome. JPEN J Parenter Enteral Nutr 2012; 36:205–212PubMedCrossRefGoogle Scholar
  6. 6.
    Tappenden KA: Mechanisms of enteral nutrient-enhanced intestinal adaptation. Gastroenterology 2006; 130:S93-S99PubMedCrossRefGoogle Scholar
  7. 7.
    Sukhotnik I, Mor-Vaknin N, Drongowski RA, et al: Effect of dietary fat on early morphological intestinal adaptation in a rat with short bowel syndrome. Pediatr Surg Int 2004; 20:419–424PubMedGoogle Scholar
  8. 8.
    Kollman KA, Lien EL,Vanderhoof JA: Dietary lipids influence intestinal adaptation after massive bowel resection. J Pediatr Gastroenterol Nutr 1999; 28:41–45PubMedCrossRefGoogle Scholar
  9. 9.
    Vanderhoof JA, Park JH, Herrington MK, et al: Effects of dietary menhaden oil on mucosal adaptation after small bowel resection in rats. Gastroenterology 1994; 106:94–99PubMedGoogle Scholar
  10. 10.
    Helmrath MA, VanderKolk WE, Can G, et al: Intestinal adaptation following massive small bowel resection in the mouse. J Am Coll Surg 1996; 183:441–449PubMedGoogle Scholar
  11. 11.
    Guo J, Longshore S, Nair R, et al: Retinoblastoma protein (pRb), but not p107 or p130, is required for maintenance of enterocyte quiescence and differentiation in small intestine. J Biol Chem 2009; 284:134–140PubMedCrossRefGoogle Scholar
  12. 12.
    Sukhotnik I, Gork AS, Chen M, et al: Effect of low fat diet on lipid absorption and fatty-acid transport following bowel resection. Pediatr Surg Int 2001; 17:259–264PubMedCrossRefGoogle Scholar
  13. 13.
    Sukhotnik I, Shiloni E, Krausz MM, et al: Low-fat diet impairs postresection intestinal adaptation in a rat model of short bowel syndrome. J Pediatr Surg 2003; 38:1182–1187PubMedCrossRefGoogle Scholar
  14. 14.
    Sukhotnik I, Mor-Vaknin N, Drongowski RA, et al: Effect of dietary fat on fat absorption and concomitant plasma and tissue fat composition in a rat model of short bowel syndrome. Pediatr Surg Int 2004; 20:185–191PubMedCrossRefGoogle Scholar
  15. 15.
    Hernandez Vallejo SJ, Alqub M, Luquet S, et al: Short-term adaptation of postprandial lipoprotein secretion and intestinal gene expression to a high-fat diet. Am J Physiol Gastrointest Liver Physiol 2009; 296:G782-G792PubMedCrossRefGoogle Scholar
  16. 16.
    Abumrad NA,Davidson NO: Role of the gut in lipid homeostasis. Physiol Rev 2012; 92:1061–1085PubMedCentralPubMedCrossRefGoogle Scholar
  17. 17.
    Nassir F, Wilson B, Han X, et al: CD36 is important for fatty acid and cholesterol uptake by the proximal but not distal intestine. J Biol Chem 2007; 282:19493–19501PubMedCrossRefGoogle Scholar
  18. 18.
    Lobo MV, Huerta L, Ruiz-Velasco N, et al: Localization of the lipid receptors CD36 and CLA-1/SR-BI in the human gastrointestinal tract: towards the identification of receptors mediating the intestinal absorption of dietary lipids. J Histochem Cytochem 2001; 49:1253–1260PubMedCrossRefGoogle Scholar
  19. 19.
    Poirier H, Degrace P, Niot I, et al: Localization and regulation of the putative membrane fatty-acid transporter (FAT) in the small intestine. Comparison with fatty acid-binding proteins (FABP). Eur J Biochem 1996; 238:368–373PubMedCrossRefGoogle Scholar
  20. 20.
    Nauli AM, Nassir F, Zheng S, et al: CD36 is important for chylomicron formation and secretion and may mediate cholesterol uptake in the proximal intestine. Gastroenterology 2006; 131:1197–1207PubMedCentralPubMedCrossRefGoogle Scholar
  21. 21.
    Dur S, Krause K, Pluntke N, et al: Gene structure and expression of the mouse APOBEC-1 complementation factor: multiple transcriptional initiation sites and a spliced variant with a premature stop translation codon. Biochim Biophys Acta 2004; 1680:11–23PubMedCrossRefGoogle Scholar
  22. 22.
    Goudriaan JR, Dahlmans VE, Febbraio M, et al: Intestinal lipid absorption is not affected in CD36 deficient mice. Mol Cell Biochem 2002; 239:199–202PubMedCrossRefGoogle Scholar
  23. 23.
    Lynes M, Narisawa S, Millan JL, et al: Interactions between CD36 and global intestinal alkaline phosphatase in mouse small intestine and effects of high-fat diet. Am J Physiol Regul Integr Comp Physiol 2011; 301:R1738-R1747PubMedCrossRefGoogle Scholar
  24. 24.
    Tran TT, Poirier H, Clement L, et al: Luminal lipid regulates CD36 levels and downstream signaling to stimulate chylomicron synthesis. J Biol Chem 2011; 286:25201–25210PubMedCrossRefGoogle Scholar
  25. 25.
    Jeppesen PB, Pertkiewicz M, Messing B, et al: Teduglutide reduces need for parenteral support among patients with short bowel syndrome with intestinal failure. Gastroenterology. 2012 Dec;143(6):1473–1481.Google Scholar
  26. 26.
    O’Keefe SJ, Jeppesen PB, Gilroy R et al (2013) Safety and Efficacy of Teduglutide After 52 Weeks of Treatment in Patients With Short Bowel Intestinal Failure. Clin Gastroenterol Hepatol. doi:10.1016/j.cgh.2012.12.029 Google Scholar
  27. 27.
    Hsieh J, Longuet C, Maida A, et al: Glucagon-like peptide-2 increases intestinal lipid absorption and chylomicron production via CD36. Gastroenterology 2009; 137:997–1005, 1005PubMedCrossRefGoogle Scholar
  28. 28.
    Newberry EP,Davidson NO: Intestinal lipid absorption, GLP-2, and CD36: still more mysteries to moving fat. Gastroenterology 2009; 137:775–778PubMedCentralPubMedCrossRefGoogle Scholar
  29. 29.
    Rowland KJ, Trivedi S, Lee D, et al: Loss of glucagon-like peptide-2-induced proliferation following intestinal epithelial insulin-like growth factor-1-receptor deletion. Gastroenterology 2011; 141:2166–2175PubMedCrossRefGoogle Scholar
  30. 30.
    Martin GR, Wallace LE, Hartmann B, et al: Nutrient-stimulated GLP-2 release and crypt cell proliferation in experimental short bowel syndrome. Am J Physiol Gastrointest Liver Physiol 2005; 288:G431-G438PubMedCrossRefGoogle Scholar

Copyright information

© The Society for Surgery of the Alimentary Tract 2013

Authors and Affiliations

  • Pamela M. Choi
    • 1
    • 2
  • Raphael C. Sun
    • 1
    • 2
  • Jun Guo
    • 1
    • 2
  • Christopher R. Erwin
    • 1
    • 2
  • Brad W. Warner
    • 1
    • 2
  1. 1.Division of Pediatric SurgerySt Louis Children’s HospitalSt. LouisUSA
  2. 2.Department of SurgeryWashington University School of MedicineSt. LouisUSA

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