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

Background: Recent reports have suggested that food deprivation may contribute to acetaminophen hepatotoxicity by shunting drug detoxification from the conjugative to the potentially toxic oxidative pathways. Methods: This study 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 start and again after food restriction. Sequential liver tests, as well as serum and urine acetaminophen and its derivatives were measured.Results: In both food-restricted groups there was no evidence of any change in the elimination or in the metabolic pattern of acetaminophen removal. Liver tests remained 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 of caloric restriction on acetaminophen disposition