Intensive lifestyle treatment for non-alcoholic fatty liver disease in children with severe obesity: inpatient versus ambulatory treatment

Koot, Bart; Baan-Slootweg, Olga H van der; Vinke, S.; Bohte, Anneloes E.; Tamminga-Smeulders, C L J; Jansen, Petér L. M.; Stoker, Jaap; Benninga, Marc A.

doi:10.1038/ijo.2015.175

Cited by 28 publications

(41 citation statements)

References 38 publications

(39 reference statements)

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“…There was significantly greater rate of achieving the outcome in relation to the intensity of the intervention (inpatient 43%, ambulatory 33%, usual care 22%). A similar trend was seen for normalization of ALT (inpatient 41%, ambulatory 33%, usual care 6%) [24]. …”

Section: Combination Of Nutrition and Exercisesupporting

confidence: 71%

Lifestyle Interventions Including Nutrition, Exercise, and Supplements for Nonalcoholic Fatty Liver Disease in Children

2016

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Nonalcoholic fatty liver disease (NAFLD) is the most common cause of liver disease among children. Lifestyle interventions, such as diet and exercise, are frequently recommended. Children with NAFLD have a distinct physiology that is different from obesity alone and has the potential to influence lifestyle treatments. Studies of diet alone in the treatment of pediatric NAFLD have focused on sugar and carbohydrate, but did not indicate any one dietary approach that was superior to another. For children who are obese and have NAFLD, weight loss may have a beneficial effect regardless of the diet used. Exercise is widely believed to improve NAFLD because a sedentary lifestyle, poor aerobic fitness, and low muscle mass are all risk factors for NAFLD. However, there have been no randomized controlled trials of exercise as a treatment for children with NAFLD. Studies of the combination of diet and exercise suggest a potential for improvement in serum alanine aminotransferase activity and/or magnetic resonance imaging liver fat fraction with intervention. There is also enthusiasm for the use of dietary supplements, however, studies in children have shown inconsistent effects of vitamin E, fish oil, and probiotics. This review presents the available data from studies of lifestyle intervention and dietary supplements published to date, and highlights challenges that must be addressed in order to advance the evidence base for the treatment of pediatric NAFLD.

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Section: Combination Of Nutrition and Exercisesupporting

confidence: 71%

Lifestyle Interventions Including Nutrition, Exercise, and Supplements for Nonalcoholic Fatty Liver Disease in Children

2016

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“…The AASLD practice guidelines indicate that weight loss of least 3–5% appears necessary for improving steatosis, but a greater loss (up to 10%) may be needed to alleviate necroinflammation23. A recent study showed that intensive inpatient and ambulatory treatments are more effective than usual care24. According to Vilar-Gomez et al 25,.…”

Section: Discussionmentioning

confidence: 99%

Long-term lifestyle interventions in middle-aged and elderly men with nonalcoholic fatty liver disease: a randomized controlled trial

Dong

Zhang

Huang

et al. 2016

Sci Rep

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Nonalcoholic fatty liver disease (NAFLD), a metabolic disorder related to insulin resistance and metabolic syndrome, has become a public health concern. Currently, the principal therapeutic modalities targeting NAFLD are lifestyle interventions. However, the efficacy of long-term lifestyle interventions in managing NAFLD remains largely unexplored. This study aimed to evaluate the efficacy of long-term lifestyle interventions in middle-aged and elderly men with NAFLD. All 280 eligible patients were randomized to the control or test group. Patients in the test group received counseling on diet and exercise from 2 physicians every 3 months via a phone call. Patients in the control group received only counseling in annual checkups without regular intervention. After the 2-year periodic intervention, body weight, abdominal circumference, ALT, TCH, LDL-C and HDL-C decreased in the test group. Specifically, the fatty liver index (FLI) and NAFLD-fibrosis score (NAFLD-FS) reduced markedly in the test group. However, in the control group, there was only a significant decrease in LDL-C, HDL-C and NAFLD-FS (P < 0.001). The liver steatosis grade of the test group decreased significantly, while it increased in the control group. In NAFLD, long-term lifestyle interventions exert an anti-obesity effect and attenuate liver dysfunction and steatosis.

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“…Antioxidant therapy did not improve liver histology, but children in both groups who had already reduced their weight through designated lifestyle changes showed significant improvement in steatosis, inflammation, ballooning, and the NAS. In one study consisting of 51 children with severe obesity (BMI z‐score >3.5) and NAFLD, intensive lifestyle modification (either in an inpatient or ambulatory setting) offered sustained biochemical benefits in comparison to usual care …”

Section: Aspects Of Nafld Specific To Children and Adolescentsmentioning

confidence: 99%

The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases

et al. 2017

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PreambleThis guidance provides a data-supported approach to the diagnostic, therapeutic, and preventive aspects of nonalcoholic fatty liver disease (NAFLD) care. A "Guidance" document is different from a "Guideline." Guidelines are developed by a multidisciplinary panel of experts and rate the quality (level) of the evidence and the strength of each recommendation using the Grading Abbreviations: AASLD, American Association for the Study of Liver Diseases; ACG, American College of Gastroenterology; AIH, autoimmune hepatitis; ALT, alanine aminotransferase; APRI, AST to platelet ratio index; AST, aspartate aminotransferase; AUROC, area under the receiver operating

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Intensive lifestyle treatment for non-alcoholic fatty liver disease in children with severe obesity: inpatient versus ambulatory treatment

Cited by 28 publications

References 38 publications

Lifestyle Interventions Including Nutrition, Exercise, and Supplements for Nonalcoholic Fatty Liver Disease in Children

Lifestyle Interventions Including Nutrition, Exercise, and Supplements for Nonalcoholic Fatty Liver Disease in Children

Long-term lifestyle interventions in middle-aged and elderly men with nonalcoholic fatty liver disease: a randomized controlled trial

The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases

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