***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE The goal of this study was to determine the effect of artificial sweeteners on glucose , insulin , and glucagon-like peptide (GLP)-1 in humans . RESEARCH DESIGN AND METHODS For this study , 22 healthy volunteers ( mean age 18.5 ± 4.2 years ) underwent two 75-g oral glucose tolerance tests with frequent measurements of glucose , insulin , and GLP-1 for 180 min . Subjects drank 240 ml of diet soda or carbonated water , in r and omized order , 10 min prior to the glucose load . RESULTS Glucose excursions were similar after ingestion of carbonated water and diet soda  . Serum insulin levels tended to be higher after diet soda , without statistical significance . GLP-1 peak and area under the curve ( AUC ) were significantly higher with diet soda ( AUC 24.0 ± 15.2 pmol/l per 180 min ) versus carbonated water ( AUC 16.2 ± 9.0 pmol/l per 180 min ; P = 0.003 ) . CONCLUSIONS Artificial sweeteners synergize with glucose to enhance GLP-1 release in humans . This increase in GLP-1 secretion may be mediated via stimulation of sweet-taste receptors on L-cells by artificial sweetener BACKGROUND & AIMS A diet low in fermentable oligosaccharides , disaccharides , monosaccharides , and polyols ( FODMAPs ) often is used to manage functional gastrointestinal symptoms in patients with irritable bowel syndrome ( IBS ) , yet there is limited evidence of its efficacy , compared with a normal Western diet . We investigated the effects of a diet low in FODMAPs compared with an Australian diet , in a r and omized , controlled , single-blind , cross-over trial of patients with IBS . METHODS In a study of 30 patients with IBS and 8 healthy individuals ( controls , matched for demographics and diet ) , we collected  dietary data  from subjects for 1 habitual week . Participants then r and omly were assigned to groups that received 21 days of either a diet low in FODMAPs or a typical Australian diet , followed by a washout period of at least 21 days , before crossing over to the alternate diet .  Daily symptoms were rated using a 0- to 100-mm visual analogue scale . Almost all food was provided during the interventional diet periods , with a goal of less than 0.5 g intake of FODMAPs per meal for the low-FODMAP diet . All stools were collected from days 17 - 21 and assessed for frequency , weight , water content , and King 's Stool Chart rating . RESULTS Subjects with IBS had lower overall gastrointestinal symptom scores ( 22.8 ; 95 % confidence interval , 16.7 - 28.8 mm ) while on a diet low in FODMAPs , compared with the Australian diet ( 44.9 ; 95 % confidence interval , 36.6 - 53.1 mm ; P < .001 ) and the subjects ' habitual diet . Bloating , pain , and passage of wind also were reduced while IBS patients were on the low-FODMAP diet . Symptoms were minimal and unaltered by either diet among controls . Patients of all IBS subtypes had greater satisfaction with stool consistency while on the low-FODMAP diet , but diarrhea-predominant IBS was the only subtype with altered fecal frequency and King 's Stool Chart scores . CONCLUSIONS In a controlled , cross-over study of patients with IBS , a diet low in FODMAPs effectively reduced functional gastrointestinal symptoms . This high- quality evidence supports its use as a first-line therapy . CLINICAL TRIAL NUMBER ACTRN12612001185853 Background / Objective : The sweet-taste receptor ( T1r2+T1r3 ) is expressed by enteroendocrine L-cells throughout the gastrointestinal tract . Application of sucralose ( a non-calorific , non-metabolisable sweetener ) to L-cells in vitro stimulates glucagon-like peptide (GLP)-1 secretion , an effect that is inhibited with co-administration of a T1r2+T1r3 inhibitor . We conducted a r and omised , single-blinded , crossover study in eight healthy subjects to investigate whether oral ingestion of sucralose could stimulate L-cell-derived GLP-1 and peptide YY ( PYY ) release in vivo . Methods : Fasted subjects were studied on 4 study days in r and om order . Subjects consumed 50 ml of either water , sucralose ( 0.083 % w/v ) , a non-sweet , glucose-polymer matched for sweetness with sucralose addition ( 50 % w/v maltodextrin+0.083 % sucralose ) or a modified sham-feeding protocol ( MSF = oral stimulation ) of sucralose ( 0.083 % w/v ) . Appetite ratings and plasma GLP-1 , PYY , insulin and glucose were measured at regular time points for 120 min . At 120 min , energy intake at a buffet meal was measured . Results : Sucralose ingestion did not increase plasma GLP-1 or PYY . MSF of sucralose did not elicit a cephalic phase response for insulin or GLP-1 .  Maltodextrin ingestion significantly increased insulin and glucose compared with water ( P<0.001 ) . Appetite ratings and energy intake were similar for all groups . Conclusions : At this dose , oral ingestion of sucralose does not increase plasma GLP-1 or PYY concentrations and hence , does not reduce appetite in healthy subjects . Oral stimulation with sucralose had no effect on GLP-1 , insulin or appetite BACKGROUND Glucose-dependent insulinotropic polypeptide ( GIP ) and glucagon-like peptide-1 ( GLP-1 ) are major incretins with important effects on glucoregulatory functions . The aim of this study was to investigate effects of GIP and GLP-1 on gastric emptying and appetite after a mixed meal , and effects on insulin secretion and glucose disposal in humans . METHODS R and omized crossover single-blind study in 17 healthy volunteers receiving GIP ( 2 or 5 pmol kg(-1 ) min(-1 ) , n = 8) , GLP-1 ( 0.75 pmol kg(-1 ) min(-1 ) , n = 9 ) or NaCl for 180 min with a radionuclide-labeled omelette and fruit punch ( 370 kcal ) . Outcome measures were gastric emptying rate , insulinogenic index , hunger , satiety , desire to eat , and prospect i ve food consumption . Blood was analyzed for GIP , GLP-1 , glucagon , C-peptide , peptide YY ( PYY ) and ghrelin . KEY RESULTS Glucose-dependent insulinotropic polypeptide 2 and 5 pmol kg(-1 ) min(-1 ) decreased gastric half-emptying time from 128.5 ± 34.0 min in controls to 93.3 ± 6.3 and 85.2 ± 11.0 min ( P < 0.05 ) . Glucose-dependent insulinotropic polypeptide 5 pmol kg(-1 ) min(-1 ) decreased postpr and ial glucose ( P < 0.001 ) and insulin ( P < 0.05 ) with increased insulinogenic index . Glucose-dependent insulinotropic polypeptide had no effects on hunger , desire to eat , satiety or prospect i ve consumption . Glucagon-like peptide-1 0.75 pmol kg(-1 ) min(-1 ) increased half-emptying time from 76.6 ± 7.6 min to 329.4 ± 71.6 ( P < 0.01 ) . Glucagon-like peptide-1 decreased plasma glucose and insulin ( both P < 0.05 - 0.001 ) , and increased insulinogenic index markedly . Hunger , desire to eat and prospect i ve consumption were decreased ( P < 0.05 ) , and satiety borderline increased ( P < 0.06 ) . CONCLUSION & INFERENCES The incretin effect of GIP and GLP-1 differs as GLP-1 exerts a strong glucoregulatory incretin through inhibition of gastric emptying , which GIP does not . Thus , GLP-1 as incretin mimetic may offer unique benefits in terms of weight loss in treatment of type 2 diabetes Objectives To study the intensity and variation of pain and its temporal relation to eating and defaecation . Furthermore , what irritable bowel ( IBS ) patients mean by constipation and diarrhoea and how bowel symptoms vary . Design Prospect i ve daily symptom recording over 6 weeks . Setting The primary catchment area of University Hospital of Linkoping . Participants Eighty consecutive patients fulfilling the Rome criteria ; 63 finished the study . Results Fifty-nine of 63 patients recorded an average of 29 pain periods and 24 days with pain during the 6 weeks . Over-all pain burden decreased slightly over the study period . At inclusion 38 ( 64 % ) patients cl aim ed that pain was relieved by defaecation . However , on average , only 10 % of each patient 's recorded pain periods were relieved by defaecation . At inclusion 29 ( 49 % ) patients cl aim ed postpr and ial worsening of pain . On average , 50 % of each patient 's recorded pain periods worsened postpr and ially . The patients defined constipation as hard stools and diarrhoea as loose stools and urgency . Stool frequency did not differ . Bowel symptoms varied within , but not between , fortnightly periods . Conclusions Postpr and ial worsening of pain should be included as a criterion in the clinical definition of IBS while the criterion ' pain relieved by defaecation ' should be re-evaluated . IBS patients can probably be divided into subgroups based on stool consistency , not frequency . Daily records are superior to structured clinical interviews or question naires for a detailed study of symptoms in IBS 
    Output:
    
The effect on motility is mainly indirect via increased incretin secretion , though the clinical relevance of this finding is unknown as the downstream effect on motility was not studied .