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We read with great interest the recent article by Kechegias et al on the hepatic effects of fast-food hyper-alimentation and exercise restriction (Gut 2008;57:649–54). The metabolic effects of fast-food consumption are a major public health issue, and have recently resulted in demands for the energy and nutrient content labelling of fast-food menus.1 Fast-food consumers significantly underestimate the energy and fat content of fast-foodstuffs, and their consumptive behaviours alter when they are informed of the foodstuffs’ true content.2
We would first like to commend them on performing such a valuable study. We agree with their conclusion that a dietary, as well as an alcohol history is an imperative component of the evaluation of patients with an idiopathically elevated alanine aminotransferase (ALT). Our …
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