The effects of food restriction in man on hepatic metabolism of acetaminophen

Background: Recent reports have suggested that food deprivation may contrib ute to acetaminophen hepatotoxicity by shunting drug detoxification from th e conjugative to the potentially toxic oxidative pathways. Methods:This stu dy assessed this concept in a prospective study of food restriction of 500 calories/day over 5 days and also of 1000 calories/day over 13 days. Obese, otherwise normal, individuals received 2 g acetaminophen orally at the sta rt and again after food restriction. Sequential liver tests, as well as ser um and urine acetaminophen and its derivatives were measured. Results: In b oth food-restricted groups there was no evidence of any change in the elimi nation or in the metabolic pattern of acetaminophen removal. Liver tests re mained normal. The average weight loss was about 6 pounds. Conclusions: Our data, with this brief, but major degree of food restriction, and this load of acetaminophen (half-maximal daily dose), do not demonstrate an effect o f caloric restriction on acetaminophen disposition. (C) 2001 Harcourt Publi shers Ltd.