Mechanisms of intestinal fat absorption.

Even though most of the major controversies regarding intestinal fat absorption have been resolved over the past three decades, our concepts of fat digestion and absorption continue to be modified, and new concepts have emerged. The purpose of this review is to summarize advances in our understanding of fat digestion and absorption since the topic was last reviewed by Johnston in 1968. The discussion will emphasize 1) the role of colipase and its interactions with lipase, bile salt micelle, and triglyceride substrate; 2) the importance of the unstirred water layer in fat absorption; 3) micellar formation and dissociation; 4) the role of fatty acid binding protein; 5) factors influencing the reesterification mechanisms in the intestine; and 6) intestinal contribution to lipoprotein and apoprotein production. The importance of these new concepts and the remaining gaps in our understanding of these complex digestive and absorptive processes are discussed.