The effect of a regular oral diet supplying 167 kJ/kg per d (40 kcal/kg per d) on nutritional state, liver function and serum lipid profile was assessed in thirty severely malnourished alcoholic cirrhotic in-patients. Their diet was monitored by a trained dietitian and they were vigorously encouraged to eat all meals served. One month after their entry into the study, protein and energy intakes were significantly higher (P 0·001) in keeping with an improvement of their nutritional status as evaluated by means of height-creatinine index, muscular mid-arm circumference, tricipital skinfold thickness (P 0·01 for all) and fat mass (P 0·001). Assessment of liver function tests showed that levels of aspartate amino-transferase (EC 2.6.1.1), y-glutamyl transferase (EC 2.3.2.2) and bilirubin decreased (P <0·05, P > 0·02 and P > 0·05 respectively) while prothrombin time values increased (P < 0·05). Similarly, serum albumin increased modestly while transthyretin did not change. Orosomucoid and C-reactive protein decreased (P < 0·001 and P < 0·01 respectively), indicating an improvement of the inflammatory state. Apolipoprotein Al and high-density-lipoprotein (HDL)-cholesterol correlated with several tests of liver function and improved significantly during the study period (P < 0·001 and P < 0·02 respectively). Moreover, changes in cholesterol and HDL-cholesterol correlated with those in transthyretin (P < 0·02 and P < 0·05 respectively). The changes in ApoAl and HDL-cholesterol were greater in patients whose fat mass increased significantly. Our findings show that adequate oral nutrition resulted in a better nutritional status in cirrhotics after 1 month of hospitalization. The serum lipid variables appeared to be more useful indicators of functional liver improvement than the classic liver function tests which rather indicate liver damage.

Twelve groups of eight rats and two control groups of sixteen rats were given semisynthetic diets with 40% energy as fat for a period of 76 d. All diets contained a minimum of 3% energy as linoleic acid and comparable basal levels of D-α- and D-γ-tocopherol. The diets varied in fat composition and in the content of DL-α-tocopheryl acetate. The diets high in polyunsaturated fatty acids (PUFA) were either rich in fish oil (FO; groups 1–4; 10% energy as fish oil PUFA), linseed oil (LN; groups 1–4; 10% energy as α-linolenic acid) or sunflower seed oil (SF; groups 1–4; 10 + 3% energy as linoleic acid). The control groups were given a diet high in monounsaturated fatty acids (MUFA; CO 1; 10 + 13% energy as oleic acid) or a diet with an ‘average’ linoleic acid content (CO 2; 8.5% energy as linoleic acid). Of each high PUFA diet three groups were supplemented with graded levels of DL-α-tocopheryl acetate. Steatitis, a sensitive histopathological indicator of vitamin E deficiency in animals fed on diets rich in fatty acids with three or more double bonds, was observed only in the adipose tissue of the FO groups, even in the group with the highest DL-α-tocopheryl acetate supplementation. Liver and serum α- tocopherol levels were found to be positively correlated and liver and serum γ-tocopherol levels negatively correlated with dietary DL-α-tocopheryl acetate. The groups on the FO diets had significantly reduced liver and serum tocopherol levels in comparison with the groups on the other high-PUFA diets. With the supplementation scheme used for the FO groups the liver α-tocopherol levels of both control groups were reached but the serum control levels were not.

Untreated wheat straw (UWS) or ammoniated wheat straw without (AWS) or with (AWSP) a supplement of potato protein of a low rumen degradability was fed to three steers according to a 3 × 3 Latin square design. All rations were supplemented with sugar-beet pulp and minerals. Voluntary organic matter intake (OMI, g/kg0.75 per d) was 67.8, 76.0 and 80.1 for whole rations (51.1, 59.7 and 59.2 for straw) for UWS, AWS and AWSP respectively, which was significantly higher for AWS and AWSP than for UWS. Organic matter digestibility (OMD, g/kg) was 561, 596 and 625 for the respective rations UWS, AWS and AWSP, also significantly higher for AWS and AWSP than for UWS. The increased voluntary intake and digestion of ammoniated wheat-straw-based rations were associated with a significantly higher potentially degradable fraction (D) of neutral detergent fibre (NDF) in offered straw (556 and 661 g/kg for untreated and ammoniated wheat straw respectively) and in the rumen pool (469, 555 and 554 g/kg for UWS, AWS and AWSP respectively). Isolated small rumen particles (retained on sieves with a pore size < 1.25 and > 0.041 mm) had a significantly lower D of NDF (average 588 g/kg) than isolated large rumen particles (average 663 g/kg). Fractional rates of degradation of NDF did not differ significantly either between untreated and ammonia-treated wheat straw offered (2.9 and 2.6%/h respectively) or between rumen pools (1.8, 1.7 and 2.1 %/h for UWS, AWS and AWSP respectively). Rations based on ammoniated wheat straw had a significantly higher rumen NH3-N concentration than UWS. Although the rumen pool size of total contents differed significantly between treatments, those of dry and organic matter and of cell wall constituents were not significantly different. The proportion of rumen dry matter passing through a sieve with a pore size of 1.25 mm averaged 0.684 over rations (not significantly different between rations). Daily rumination (96 min) and eating (52 min) times/kg NDF ingested did not differ between rations. The rate of comminution of large particles estimated from the disappearance of indigestible NDF in large rumen particles from the rumen of animals without access to feed was 4.1, 6.3 and 7.1 %/h for UWS, AWS and AWSP respectively. These values were not significantly different. The fractional rate of passage estimated from the faecal excretion of Cr-NDF was 5.4, 6.1 and 6.3%/h for UWS, AWS and AWSP respectively (significantly higher for AWS and AWSP than for UWS) but the turnover rate of indigestible NDF did not differ between treatments.