There is no dietary strategy that has yet been specifically advocated for haemophilia. Therefore, we sought to assess the effect of the Dietary Approaches to Stop Hypertension (DASH) diet in adolescents with haemophilia. In this parallel trial, forty male adolescents with haemophilia were dichotomised into the DASH group or control group for 10 weeks. The serum high sensitivity C-reactive protein, IL-6, complete blood count (CBC), serum glutamic oxaloacetic transaminase, serum glutamic pyruvic transaminase, partial thromboplastin time (PTT), waist circumference (WC), percentage of body fat, fat-free mass and liver steatosis were measured at the beginning and end of the study. Serum vitamin C was measured as a biomarker of compliance with the DASH diet. The DASH diet was designed to include high amounts of whole grains, fruits, vegetables and low-fat dairy products, as well as low amounts of saturated fats, cholesterol, refined grains, sweets and red meat. Serum vitamin C in the DASH group was significantly increased compared with the control (P = 0·001). There was a significant reduction in WC (P = 0·005), fat mass (P = 0·006), hepatic fibrosis (P = 0·02) and PTT (P = 0·008) in the DASH group, compared with the control. However, there were no significant differences regarding other selected outcomes between groups. Patients in the DASH group had significantly greater increase in the levels of erythrocyte, Hb and haematocrit, as compared with the control. Adherence to the DASH diet in children with haemophilia yielded significant beneficial effects on body composition, CBC, inflammation and liver function.

Dietary supplements have been increasingly used by gym users and are often consumed without the guidance of a health professional. Moreover, the indiscriminate supplements use can have adverse health effects, such as changes in liver and kidney function. The aim of this study was to verify the association between dietary supplements intake with alterations in the liver and kidney function among gym users. A cross-sectional study was conducted with 594 gym users (mean age 37 (sd 14) years, 55·2 % women) from a city in southern Brazil. A questionnaire was used to evaluate the use of dietary supplements. The markers of the liver (alanine aminotransferase, aspartate aminotransferase (AST), alkaline phosphatase, γ-glutamyltransferase) and renal (creatinine and urea) function were also evaluated on a subsample of the study population. Data were analysed by binary logistic regression, adjusted for sex, age and education. The prevalence of dietary supplement intake was 36·0 %. Individuals who intake dietary supplements showed a higher prevalence to present slight alterations in the AST enzyme and in the urea after adjustments for potential confounders. In conclusion, the use of dietary supplement was associated with slight alterations in AST enzyme and in the urea among gym users. These findings show the importance of using supplements correctly, especially with guidance from professionals trained to avoid possible risks to health.

The fish paste product, fish balls ‘tsumire’, is a traditional type of Japanese food made from minced fish as well as imitation crab, kamaboko and hanpen. Although tsumire is known as a high-protein and low-fat food, there is a lack of scientific evidence on its health benefits. Hence, we aimed to investigate the effects of tsumire intake on organ weight and biomarker levels in Sprague–Dawley rats for 84 d as a preliminary study. Six-week-old male Sprague–Dawley rats were divided into two groups: group I, fed normal diets, and group II, fed normal diets with 5 % dried tsumire. Throughout the administration period, we monitored their body weight and food intake; at the end of this period, we measured their organ weight and analysed their blood biochemistry. No significant differences were observed with respect to body weight, food intake, organ weight and many biochemical parameters between the two groups. It was found that inorganic phosphorus and glucose levels were higher in group II rats than in group I rats. On the other hand, sodium, calcium, amylase and cholinesterase levels were significantly lower in group II than in group I. Interestingly, we found that the levels of aspartate aminotransferase, alanine transaminase, lactate dehydrogenase and leucine aminopeptidase in group II were significantly lower than in group I, and that other liver function parameters of group II tended to be lower than in group I. In conclusion, we consider that the Japanese traditional food, ‘tsumire,’ may be effective as a functional food for human health management worldwide.

A great interindividual variability exists in biological response to drugs. This variability is partly attributable to pharmacodynamic factors (drug - receptor interactions) and partly to pharmacokinetic factors. Drugs can be eliminated from the body by renal clearance, metabolism or both. Although every tissue has some ability to metabolise xenobiotics like drugs, the liver is the principal organ of biotransformation. Major metabolising enzymes are the cytochrome-P450 mono-oxygenases, epoxide hydrolase, glucuronosyl-transferase, acetyl-transferase, sulfo-transferase and xanthine oxidase. Some of these enzymes display in a subset of subjects a ‘normal’ activity and in another subset of subjects a reduced or a greatly increased activity. This altered activity may be genetically determined and is then called genetic polymorphism. Clinically relevant metabolic differences traditionally have been defined by their genotypie expression such as ‘poor’ and ‘extensive’ metaboliser. The recent developments of powerful methods for DNA (or genomic) analysis portends a revolutionary expansion of our understanding of physiology as well as pathology. Pharmacogenetics is the study of genetic variation underlying differential response to drugs. Genotyping may become a useful tool in optimising drug treatment. Another part of the genetic research is directed towards the discovery of genetic alterations leading to diseases. Once identified, these genetic alterations can become targets for drug treatment (e.g. gene therapy). Pharmaco-genomics applies the large-scale systematic approaches of genomics to speed the discovery of drug response markers, whether they act at the level of the drug target, drug metabolism or disease pathway. Table I gives some examples of genetic alterations that are identified together with their effects. Some of these examples will be briefly discussed here.

Exposure of growing rabbits to heat stress during summer adversely affects their performance leading to major production losses. A total number of 48 rabbits, unsexed V-line weaned rabbits, were randomly divided into four experimental groups, temperature ranged from high at 32°C to low at 23°C. Animals of the 2nd, 3rd and 4th group were individually orally given 200, 400 or 800 mg royal jelly (RJ)/kg BW once a week, respectively, to evaluate RJ ability to reduce physiological strain resulted from heat stress. Weekly BW gain increased by 10.4, 11.8 and 10.8%, and feed conversion ratio was significantly improved by 20, 24 and 18% with RJ treatments. Serum total protein, albumin and globulin increased, whereas serum total lipids, cholesterol and triglycerides decreased with RJ treatments. Creatinine was reduced by 21, 30 and 18% and uric acid by 14, 25 and 18% compared with the heat stressed control with the three doses of RJ. Glucose level increased significantly to reach 116, 125, and 120% of heat stressed control. Calcium, phosphorus and alkaline phosphatase increased significantly with RJ treatments indicating the occurrence of active bone deposition. Thyroid hormone levels increased significantly to reach 108, 111, and 112% of heat stressed control rabbits with the three doses of RJ, counteracting the hypothyroid state resulted from heat stress. It can be concluded that RJ administration to heat stressed growing rabbits can reduce physiological strain resulted from heat stress.

There is a paucity of information on the metabolic effects of undernutrition of the ewe carrying multiple fetuses in late pregnancy. In the present study the effects of induction of ketosis from 132 d gestation in ewes carrying twin fetuses were compared with a control group. The ewes were well fed up to 132 d. Ketotic ewes showed a loss of condition score from 3·7 (SE 0·11) at 130 d gestation to 3·0 (SE 0·15) 10 d later after clinical recovery, compared with control twin-pregnant ewes (P < 0·01). The weight loss during the same time period was from 70·6 (SE 2·7) kg at 130 d to 64·2 (SE 2·7) kg at 140 d gestation. As expected, both groups lost weight and condition score in the first 28 d of lactation. Induction of ketosis caused a significant shortening of the gestation period to 142·8 (SE 0·7) d compared with 150 (SE 0·4) d in normal twin-pregnant ewes (P < 0·001). Ewes with induced ketosis recovered clinically and showed a normal feed intake by 3·4 (SE 0·07) d; three required treatment. Induction of ketosis resulted in reduction of hepatic uptake of bromosulphthalein (P < 0·01) and its biliary excretion (P < 0·05), metabolic clearance rate (P < 0·001), fractional clearance (P < 0·001) and 15 and 30 min retention compared with control twin-pregnant ewes. Most values had returned to normal by the first week of lactation. It is thought that in human pregnancy similar changes in bromosulphthalein clearance may be related to reduced binding sites for bromosulphthalein in the liver caused by increased circulating oestrogens. Induction of ketosis resulted in a significant hypoglycaemic (P < 0·01), ketotic (P < 0·001) state compared with well-fed twin-pregnant ewes. These changes could be correlated with the severity of the clinical signs, together with a significant rise in plasma urea (P < 0·001) and NH3 (P < 0·05) concentrations. Again, the return of most of these values to normal by the first week of lactation lends support to the reversibility of hepatic lesions caused by fatty infiltration of the liver. The seventy of this condition in naturally occurring cases suggests that factors other than undernutrition may be contributory, such as the general body condition of the ewe and glucose metabolism by the liver, including the conversion of propionate to glucose.

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.