Intensive Lifestyle Management Improves Steatosis and Fibrosis in Pediatric Nonalcoholic Fatty Liver Disease

Precision medicine in nonalcoholic fatty liver disease

“…However, some ant‐fibrotic drug agent NASH trials have yielded disappointing results 45 . Therefore, new hope comes from intensive lifestyle treatment leading to BMI reduction, 46–50 lanifibranor, obeticholic acid, pioglitazone and vitamin E, 40 or drug combination therapies 51 …”

“…43,44 However, some ant-fibrotic drug agent NASH trials have yielded disappointing results. 45 Therefore, new hope comes from intensive lifestyle treatment leading to BMI reduction, [46][47][48][49][50] lanifibranor, obeticholic acid, pioglitazone and vitamin E, 40 or drug combination therapies. 51 Clearly, research and development of new and accurate serum biomarkers and imaging techniques capable of evaluating the dynamics of hepatic fibrogenesis in NASH will improve diagnosis, classification and follow-up of patients with progressive disease.…”

Risk stratification of adolescents for the screening of non‐alcoholic fatty liver disease

“…These higher rates of mortality were associated with increased cause‐specific mortality rates from either cancer, cardiometabolic disease, or liver disease as compared to matched controls. Finally, paediatric studies demonstrate improvement in hepatic steatosis, fibrosis, ALT, and enhanced insulin sensitivity in adolescents who undergo a rigorous lifestyle program of weight loss, and/or exercise 6–8 …”

“…fibrosis, ALT, and enhanced insulin sensitivity in adolescents who undergo a rigorous lifestyle program of weight loss, and/or exercise. [6][7][8] Thus, a new picture has emerged regarding NAFL and NAFLD in adolescence. The disease is significantly more common than previous estimates, the health consequences of these disorders are potentially more severe than previously appreciated, and clinical remission with appropriate lifestyle changes is possible.…”

Nonalcoholic Fatty Liver Disease in Children: Where Are We?

“…There is currently no approved pharmacotherapy for pediatric NAFLD, so present management focuses on lifestyle and dietary changes such as the Mediterranean diet 19 and low-sugar diet, 20 and increasing physical activity as the primary intervention with improvement of biomarkers of NAFLD after weight loss; however, data on improvement in liver fibrosis are limited. Within this context, the study by Lefere et al 21 published in this issue of Clinical Gastroenterology and Hepatology represents a significant advance. Lefere et al 21 performed a prospective study of 204 children and adolescents with severe obesity.…”