Randomized, crossover trial: comparing the effects of standardized egg‐white meal and Vital® on global gastric emptying parameters and intragastric meal distribution in healthy Asian participants

Background and Aim Measurements of gastric emptying and accommodation for alternative test‐meal protocol during gastric emptying scintigraphy (GES), such as high‐calorie nutrient drinks, are not fully established. We aimed to compare the effects of standardized egg‐white meal (EWM) versus high‐calorie nutrient drink (Vital ® ; Abbott Laboratories) on global GES parameters and intragastric meal distribution at immediate scan (IMD 0h ). Methods Of 84 screened participants, 60 asymptomatic healthy Asian population (38 females; 24.0 ± 1.5 years; 23.8 ± 2.6 kg/m 2 ) were recruited in this 2 × 2 (AB/BA) crossover trial. Participants were randomized to a 4‐h GES with 99m Tc‐radiolabeled EWM (~255.8 kcal), followed by a 200 mL Vital ® (300 kcal), or vice versa, separated by a 2‐week washout period. Global meal retention (GMR), power‐exponential model emptying parameters (half‐emptying [T 1/2 ], lag phases [T lag2% , T lag5% , T lag10% ]), and IMD 0h were determined and compared. Results GMRs for both test meals were within the international standard references for solid GES. Compared to EWM, Vital ® exhibited significantly lower GMRs (faster emptying) from 0.5 to 3 h (all P < 0.001) but comparable at 4 h ( P = 0.153). Similar observations were found for the model‐based T 1/2 and the different T lag thresholds (all P < 0.001). Furthermore, IMD 0h was found to be lower with Vital ® , indicating lower gastric accommodation (faster antral filling) immediately post‐ingestion ( P < 0.001). Both test meals showed significant moderate‐to‐strong positive associations at the late‐phase GE (GMR 2–4 h, T 1/2 ) (all P < 0.05). Conclusions Overall, Vital ® is an acceptable alternative test meal to the EWM for GES; however, exercise caution when interpreting early‐phase GE. The normative values for global GES parameters and IMD 0h are also established.