L-Rhamnose increases serum propionate after long-term supplementation, but lactulose does not raise serum acetate

Background: Acute ingestion of the unabsorbed sugar L-rhamnose in humans raises serum propionate, whereas acute ingestion of lactulose raises serum acetate. It is not known whether short-chain fatty acid concentrations in urine and feces reflect those in blood. Objective: The objective was to test the effects of oral L-rhamnose and lactulose for 28 d on acetate and propionate concentrations in serum, urine, and feces. Design: Eleven subjects ingested 25 g L-rhamnose, lactulose, or D-glucose (control) for 28 d in a partially randomized crossover design. One fecal sample, hourly blood samples, and all urine samples were collected over 12 h on the last day of each phase. Results: The increase in serum propionate was greater after L-rhamnose than after lactulose (P < 0.05). The effect of lactulose on serum acetate was not significant, but lactulose raised the acetate: propionate ratio compared with D-glucose or L-rhamnose in serum (P < 0.005) and urine (P < 0.02). Flatulence was significantly greater after lactulose and L-rhamnose than after D-glucose (P < 0.0001), an effect that lasted 4 wk with lactulose but only 1 wk with L-rhamnose. Conclusions: This study confirmed that L-rhamnose ingestion over 28 d continues to selectively raise serum propionate in humans. Although serum acetate did not increase significantly after lactulose, the serum acetate:propionate ratio was significantly different after L-rhamnose and lactulose, which suggests that these substrates could be used to examine the role of colonic acetate and propionate production in the effect of dietary fiber on lipid metabolism. Changes in the ratio of urinary acetate to propionate reflected those in serum.