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Varna Medical Forum

Challenge tests and their application in nutrition research to investigate phenotypic flexibility

Neshe Ferahova Nazifova-Tasinova, Yoana Dimitrova Kiselova-Kaneva, Diana Georgieva Ivanova


From a metabolic point of view, the optimum health is the ability of the organism to maintain and regain homeostasis in ever-changing environmental conditions and to a wide spectrum of stressors. The capacity of the organism to adapt to all the variables, especially to the dietary variations is called `phenotypic flexibility`. Metabolic profiling of biological samples during a challenge response phase should offer a profound view on the flexibility of a phenotype to cope with daily stressors. Stress tests based on supplementation with carbohydrates, lipids, proteins and/or combination aim temporary disturbance of body`s homeostasis. Clinical diagnostics takes advantage of such tests using them to detect metabolic impairment. The degree of disturbance and the rate of recover are indicative for the health status. The normal glucose tolerance is considered as a sign for a good phenotypic flexibility. The oral glucose tolerance test (OGTT) is the most commonly used stress test and has been applied in diabetes diagnosis for decades. Although the fasting triacylglycerol levels are an independent risk factor for certain conditions, some authors suggest measuring the postprandial levels of metabolites with an oral lipid tolerance test (OLTT) for more precise diagnostics. Thus current study explores the possible application and potential of OGTT, OLTT, mixed-meal challenge and combination of them to assess phenotypic flexibility in nutrition research and to evaluate individual`s health status. 


phenotypic flexibility, oral glucose tolerance test, oral lipid tolerance test

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