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Fast-food-based hyper-alimentation can induce rapid and profound elevation of serum alanine aminotransferase in healthy subjects
Linköping University, Department of Medical and Health Sciences, Internal Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Medical and Health Sciences, Radiation Physics. Linköping University, Faculty of Health Sciences.
Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Medical and Health Sciences, Internal Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Radiation Physics.ORCID iD: 0000-0001-8661-2232
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2008 (English)In: Gut, ISSN 0017-5749, E-ISSN 1468-3288, Vol. 57, no 5, 649-654 p.Article in journal (Refereed) Published
Abstract [en]

 Objective: To study the effect of fast-food-based hyperalimentation on liver enzymes and hepatic triglyceride content (HTGC).

Design: Prospective interventional study with parallel control group.

Setting: University Hospital of Linko¨ping, Sweden.

Participants: 12 healthy men and six healthy women with a mean (SD) age of 26 (6.6) years and a matched control group.

Intervention: Subjects in the intervention group aimed for a body weight increase of 5–15% by eating at least two fast-food-based meals a day with the goal to double the regular caloric intake in combination with adoption of a sedentary lifestyle for 4 weeks.

Main outcome measures: Weekly changes of serum aminotransferases and HTGC measured by proton nuclear magnetic resonance spectroscopy at baseline and after the intervention.

Results: Subjects in the intervention group increased from 67.6 (9.1) kg to 74.0 (11) kg in weight (p,0.001). Serum ALT increased from 22.1 (11.4) U/l at study start to an individual mean maximum level of 97 (103) U/l (range 19.4–447 U/l). Eleven of the 18 subjectspersistently showed ALT above reference limits (women .19 U/l, men .30 U/l) during the intervention. Sugar (mono- and disaccharides) intake during week 3 correlated with the maximal ALT/baseline ALT ratio(r=0.62, p=0.006). HTGC increased from 1.1 (1.9)% to 2.8 (4.8)%, although this was not related to the increase in ALT levels. ALT levels were unchanged in controls.

Conclusion: Hyper-alimentation per se can induce profound ALT elevations in less than 4 weeks. Our study clearly shows that in the evaluation of subjects with elevated ALT the medical history should include not only questions about alcohol intake but also explore whetherrecent excessive food intake has occurred.

Place, publisher, year, edition, pages
2008. Vol. 57, no 5, 649-654 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-60150DOI: 10.1136/gut.2007.131797ISI: 000254918200018OAI: oai:DiVA.org:liu-60150DiVA: diva2:355351
Available from: 2010-10-06 Created: 2010-10-06 Last updated: 2017-12-12
In thesis
1. Hyper-alimentation - effects on health and well-being.
Open this publication in new window or tab >>Hyper-alimentation - effects on health and well-being.
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The general aim of this thesis was to prospectively examine the effects on health and well-being when healthy normal weight individuals increase their energy intake, mainly from fast food and simultaneously adopt a sedentary lifestyle.

This thesis is based upon a prospective experimental study design where 18 healthy normal weight individuals, 12 men and 6 women, aged 26 (6.6) years, increased their energy intake with in average 70 % during four weeks. Simultaneously their physical activity was limited to a maximum of 5000 steps per day. An age and gender matched control group (n=18), was recruited and asked not to change their eatingand physical activity habits for four weeks. Long-term follow-up measurements were performed after 6 and 12 months and 2.5 years after the intervention.

During the intervention body weight increased with 6.4 (2.8) kg and measurements of body composition showed an increase of both fat mass and fat free mass after the intervention. Lower physical and mental health scores on SF-36 as well as depressive symptoms were found compared to baseline. They were temporary and when followed up 6 and 12 months after the intervention, physical and mental health had returned to baseline values, despite a somewhat increased body weight. The main essence of adopting an obesity provoking behaviour was lack of energy emerging from five structures: influenced self-confidence, commitment to oneself and others, managing eating, feelings of tiredness and physical impact. Laboratory measurements showed an increase of ALT above reference limits in 14 of the 18 participants during the intervention and HTGC increased, although this was not related to the increase in ALT levels. Twelve months after the intervention an increase of body weight with 1.5 (2.4) kg was found compared to baseline (p=0.018), fat free mass was unchanged compared to baseline while fat mass had increased, + 1.4 (1.9) kg (p=0.01). Two and a half years after the intervention an increase of body weight with 3.1 (4.0) kg was found compared to baseline (p=0.01), while there was no change in controls compared to baseline, + 0.1 (2.5) kg (p=0.88).

Hyper-alimentation and limited physical activity during a short-term period of 4 weeks is sufficient to temporarily induce worsened HRQoL, cause depressive symptoms and lack of energy in healthy normal weight individuals. There were also temporary but clear effects on biochemical markers, suggesting that hyperalimentation per se can induce profound ALT elevations in less than 4 weeks. During the intervention both fat mass and fat-free mass increased while after 12 months there was only an increase of fat mass which was greater than expected from epidemiological studies. The marked difference between the increase in body weight in the intervention- and control group at 2.5 years also raises the question whether there is a long-term effect of increasing fat mass after a short period of hyperalimentation.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2010. 86 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1200
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-60171 (URN)978-91-7393-331-5 (ISBN)
Public defence
2010-10-01, Berzeliussalen, Hälsouniversitetet,, Campus US, Linköpings universitet, Linköping, 09:00 (Swedish)
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Available from: 2010-10-11 Created: 2010-10-07 Last updated: 2010-10-11Bibliographically approved

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Kechagias, StergiosErnersson, ÅsaDahlqvist Leinhard, OlofLundberg, PeterLindström, TorbjörnNyström, FredrikLänne, Toste

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Kechagias, StergiosErnersson, ÅsaDahlqvist Leinhard, OlofLundberg, PeterLindström, TorbjörnNyström, FredrikLänne, Toste
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Internal MedicineFaculty of Health SciencesDepartment of Endocrinology and Gastroenterology UHLNursing ScienceCenter for Medical Image Science and Visualization (CMIV)Radiation PhysicsDepartment of Radiation PhysicsDivision of Cardiovascular MedicineDepartment of Cardiology in Linköping
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