Non-alcoholic fatty liver disease (NAFLD) includes a range of disorders from simple steatosis to non-alcoholic steatohepatitis. There is no proven drug treatment for NAFLD, and diet modification is considered part of the main line of treatment for this disease. The aim of this study was to investigate the efficacy of garlic supplementation in NAFLD patients. The effect of garlic powder supplementation on hepatic steatosis, liver enzymes and lipid profile was investigated in NAFLD patients. Ninety NAFLD patients were randomly assigned to take either a garlic powder supplement or a placebo for 12 weeks. The treatment group received four tablets of garlic daily (each tablet contained 400 mg garlic powder). The control group received four tablets of placebo (each placebo contained 400 mg starch). At the end of the study, hepatic steatosis was significantly reduced in the treatment group compared with the control group (P = 0·001). In addition, a significant decrease was seen in the serum concentration of alanine transaminase (P < 0·001), aspartate transaminase (P = 0·002), γ-glutamyltransferase (P = 0·003) as well as total cholesterol (P = 0·009), TAG (P < 0·001), HDL-cholesterol (P < 0·001) and LDL-cholesterol (P = 0·01) in the treatment group compared with the control group. No significant difference was seen between the two groups in serum concentration of alkaline phosphatase. Overall, garlic powder supplementation improved hepatic features and lipid profile among NAFLD patients.

Non-alcoholic fatty liver disease (NAFLD) is a considerable challenge to public health across the globe. Whole grain is highly recommended as an inseparable part of a healthy diet and has been proposed as an effective way to manage NAFLD. The objective in the present study was to evaluate the effects of whole-grain consumption on hepatic steatosis and liver enzymes as primary outcomes in patients with NAFLD. Over the 12 weeks of this open-label, randomised controlled clinical trial, 112 patients (mean age 43 (sd 8·7) years; BMI 32·2 (sd 4·3) kg/m2) were randomly assigned to two groups to receive dietary advice, either to obtain at least half of their cereal servings each day from whole-grain foods or from usual cereals. By the end of the study, the grades of NAFLD showed a significant decrease in the intervention group (P < 0·001). In addition, a significant reduction in serum concentration of alanine aminotransferase (P < 0·001), aspartate aminotransferase (P < 0·001), γ-glutamyltransferase (P = 0·009), systolic blood pressure (P = 0·004) and diastolic blood pressure (P = 0·008) was observed in the intervention group compared with the control group. After adjusting, however, no significant differences were found between the two groups in terms of lipid profile, glycaemic status and anthropometric measurements. Overall, our study demonstrated that consumption of whole grains for 12 weeks had beneficial effects on hepatic steatosis and liver enzymes concentrations in patients with NAFLD.

Bij de mens bestaat een grate interindividuele variabiliteit in de capaciteit om geneesmiddelen oxidatief te metaboliseren. Een van de factoren die daaraan bijdraagt, is het voorkomen van een genetisch bepaalde oxidatieve capaciteit van verschillende isozymen welke deel uitmaken van het cytochroom P450. Voor het oxidatief metabolisme van geneesmiddelen zijn de P450 isozymen CYP2D6 (het enzym dat de meeste antidepressiva, antipsychotica, enkele anti-arrhythmica en codeïne oxideert), de CYP2C familie, de CYP3A familie en de CYP1A familie van belong. Van de isozymen CYP2D6 en CYP2C19 is ondubbelzinnig aangetoond dat er genetisch bepaalde verschillen in metabole capaciteit bestaan. Een frequentieverdeling van de metabole capaciteit in een populatie toont dan een bimodaal beeld met een onderverdeling in trage en snelle metaboliseerders met consequenties voor de individueel benodigde dosering. De capaciteit van de P450 isozymen is in het algemeen beperkt en de qffiniteil van substraat voor de isozymen is groot. Er bestaat derhalve een grate kans op interacties. Deze interacties zijn competitivef van aard waarbij het ook voorkomt dat interacties plaatsvinden met isozymen waarvoor de betreffende substantie geen substraat vormt.

Worldwide, farm animals are kept on litter or foraging substrate that becomes increasingly soiled throughout the production cycle. For animals like laying hens, this means that it is likely they would scratch, forage and consume portions of excreta found in the litter or foraging substrate. However, no study has investigated the relative preference of laying hens for foraging and consumption of feed mixed with different percentages of excreta. A total of 48 White Leghorn laying hens of two strains, a commercial strain (Lohmann LSL-Lite (LSL), n=24) and UCD-003 strain (susceptible to liver damage, n=24), were individually housed and given access to feed mixed with increasing percentages of hen excreta (0%, 33%, 66% and 100% excreta diets) and corn as a luxury food reward (four corn kernels per diet daily). The amount of substrate and number of corn kernels consumed from each diet was recorded for a period of 3 weeks. Both LSL and UCD-003 hens preferred to consume and forage in diets with 0% excreta, followed by 33% and finally diets containing 66% and 100% excreta. Despite the presence of excreta-free diets, birds consumed on average 61.3 g per day of the diets containing excreta. Neither physical health, measured by plasma enzyme activity levels, nor cognitive differences, assessed by recalling a visual discrimination task, was associated with relative feeding or foraging preference. In conclusion, this study demonstrated a clear preference for feeding and foraging on substrate without excreta in laying hens. However, considering the amount of excreta diets consumed, further studies are needed to understand the causes and consequences of excreta consumption on physiological and psychological functioning, and how this information can be used to allow adjustments in the management of foraging substrates in farmed birds.

This study examined the association of chocolate consumption with insulin resistance and serum liver enzymes in a national sample of adults in Luxembourg. A random sample of 1153 individuals, aged 18–69 years, was recruited to participate in the cross-sectional Observation of Cardiovascular Risk Factors in Luxembourg study. Chocolate consumption (g/d) was obtained from a semi-quantitative FFQ. Blood glucose and insulin levels were used for the homoeostasis model assessment of insulin resistance (HOMA-IR). Hepatic biomarkers such as serum γ-glutamyl-transpeptidase (γ-GT), serum aspartate transaminase and serum alanine transaminase (ALT) (mg/l) were assessed using standard laboratory assays. Chocolate consumers (81·8 %) were more likely to be younger, physically active, affluent people with higher education levels and fewer chronic co-morbidities. After excluding subjects taking antidiabetic medications, higher chocolate consumption was associated with lower HOMA-IR (β=−0·16, P=0·004), serum insulin levels (β=−0·16, P=0·003) and γ-GT (β=−0·12, P=0·009) and ALT (β=−0·09, P=0·004), after adjustment for age, sex, education, lifestyle and dietary confounding factors, including intakes of fruits and vegetables, alcohol, polyphenol-rich coffee and tea. This study reports an independent inverse relationship between daily chocolate consumption and levels of insulin, HOMA-IR and liver enzymes in adults, suggesting that chocolate consumption may improve liver enzymes and protect against insulin resistance, a well-established risk factor for cardiometabolic disorders. Further observational prospective research and well-designed randomised-controlled studies are needed to confirm this cross-sectional relationship and to comprehend the role and mechanisms that different types of chocolate may play in insulin resistance and cardiometabolic disorders.

In man a great interindividual variability exists in the oxidative capacity to metabolize drugs. A major factor contributing to this phenomenon is the genetically determined hydroxyla-tion-capacity of the cytochrome P450 enzyme system. The cytochrome P450 system comprises of several isozymes. For several isozymes (CYP2D6, CYP2C) a genetically based hydroxylation capacity has been demonstrated. A frequency distribution of the clearance shows a bimodal distribution with poor and extensive metabolizers. Applying standard dosing schemes of the drugs that are predominantly metabolised by these isozymes, a considerable number of patients will be intoxicated because of poor metabolism. In general, cytochrome P450 capacity is limited and substrate-affinity is high. Henceforth cytochrome P450 isozymes are likely targets for pharmacokinetic interactions.

Phyto-oestrogens are a family of plant-derived xeno-oestrogens that appear to have beneficial effects on human health. To date, no data are available about phyto-oestrogen consumption affecting liver health in a population. The present study aimed to explore the relationship of urinary phyto-oestrogen metabolites with serum liver enzymes in US adults. A nationally representative sample of US adults in the National Health and Nutrition Examination Survey (NHANES) 2003–10 was analysed. The cross-sectional study sample consisted of 6438 adults with data on urinary phyto-oestrogen levels, serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and γ-glutamyl transaminase (GGT) concentrations and data on other potential confounders. Multivariate logistic regression and linear regression were applied to assess associations between urinary phyto-oestrogen levels and ALT, AST, ALP and GGT concentrations. We found a remarkable association between urinary enterolactone and GGT in both adult males (OR 0·37, 95 % CI 0·22, 0·61; P= 0·003) and females (OR 0·37, 95 % CI 0·26, 0·54; P= 0·009). Moreover, elevated enterolactone levels were inversely associated with ALT and AST levels in adult males. However, no association was present between levels of urinary daidzein, O-desmethylangolensin, equol, enterodiol or genistein with liver enzyme levels in this population. The present study results provide epidemiological evidence that urinary enterolactone levels are associated with liver GGT levels in humans. This suggests a potential protective effect of enterolactone on human liver function. However, the underlying mechanisms still need further investigation.