Lifestyle changes improve liver health in children with NAFLD

An intensive lifestyle management program for children and adolescents with non-alcoholic fatty liver disease (NAFLD) significantly reduced liver fibrosis and fat accumulation, according to study results published in Clinical Gastroenterology and Hepatology .

Resulting from fatty accumulation in the liver, NAFLD and its most severe form, non-alcoholic steatohepatitis (NASH), are responsible for an increasing proportion of advanced liver disease worldwide. As a result of inflammation, NAFLD can lead to fibrosis, cirrhosis, and even liver cancer. In the absence of effective approved medical therapies, management depends on lifestyle changes, such as weight loss and exercise. But research on lifestyle interventions for children with fatty liver disease has been limited.

Sander Lefere, MD, PhD, of the Ghent University Liver Research Center in Belgium, and colleagues studied the impact of lifestyle management on children and adolescents with severe obesity. The intensive lifestyle intervention, conducted in a multidisciplinary residential setting, included calorie reduction, exercise, healthy living counseling and psychosocial support. Liver imaging was performed at baseline and at six and 12 months into the study to determine the presence of hepatic fat and fibrosis. The results of the study have already been presented at the AASLD liver meeting.

A total of 204 participants with a median age of 14 years were included in the study. Using ultrasound, NAFLD was identified in 71% of participants; 20% of them had a severe case. More than two-thirds had a high controlled attenuation parameter (CAP) score indicating hepatic steatosis. The CAP score measures the intensity of sound waves as they pass through fatty tissue compared to normal liver tissue. A third had moderate fibrosis (stage F2) and 10% had a FibroScan value indicating more severe liver scarring.

After six months of the program, 167 participants experienced a median weight loss of 16%. Fibrosis improved in 75% of participants, and fibrosis resolution was predicted by the degree of scarring and liver fat at baseline. A total of 79 participants reached the one-year milestone, and the improvement continued. All participants who had fibrosis at baseline experienced fibrosis regression of at least one stage.

“NAFLD and associated fibrosis are highly prevalent in children and adolescents with severe obesity,” the researchers wrote. “An intensive multidisciplinary lifestyle management program that results in significant weight loss not only improves fatty liver disease, but fibrosis as well.”

Click here to read the study abstract in Clinical Gastroenterology and Hepatology.

Click here for more information on fatty liver disease.

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