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Africa JA, Newton KP, Schwimmer JB. Lifestyle Interventions Including Nutrition, Exercise, and Supplements for Nonalcoholic Fatty Liver Disease in Children. Dig Dis Sci. 2016;61(5):1375-86doi: 10.1007/s10620-016-4126-1.
Africa, J. A., Newton, K. P., & Schwimmer, J. B. (2016). Lifestyle Interventions Including Nutrition, Exercise, and Supplements for Nonalcoholic Fatty Liver Disease in Children. Digestive diseases and sciences, 61(5), 1375-86. https://doi.org/10.1007/s10620-016-4126-1
Africa, Jonathan A, et al. "Lifestyle Interventions Including Nutrition, Exercise, and Supplements for Nonalcoholic Fatty Liver Disease in Children." Digestive diseases and sciences vol. 61,5 (2016): 1375-86. doi: https://doi.org/10.1007/s10620-016-4126-1
Africa JA, Newton KP, Schwimmer JB. Lifestyle Interventions Including Nutrition, Exercise, and Supplements for Nonalcoholic Fatty Liver Disease in Children. Dig Dis Sci. 2016 May;61(5):1375-86. doi: 10.1007/s10620-016-4126-1. Epub 2016 Apr 04. PMID: 27041377; PMCID: PMC4848041.
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Dig Dis Sci. 2016 May;61(5):1375-86. doi: 10.1007/s10620-016-4126-1. Epub 2016 Apr 04.

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

Digestive diseases and sciences

Jonathan A Africa, Kimberly P Newton, Jeffrey B Schwimmer

Affiliations

  1. Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California, San Diego School of Medicine, La Jolla, CA, USA.
  2. Department of Gastroenterology, Rady Children's Hospital San Diego, San Diego, CA, USA.
  3. Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California, San Diego School of Medicine, La Jolla, CA, USA. [email protected].
  4. Department of Gastroenterology, Rady Children's Hospital San Diego, San Diego, CA, USA. [email protected].
  5. Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California, San Diego, 3020 Children's Way, MC 5030, San Diego, CA, 92123, USA. [email protected].

PMID: 27041377 PMCID: PMC4848041 DOI: 10.1007/s10620-016-4126-1

Abstract

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.

Keywords: Dietary supplements; Dyslipidemia; Hypertension; Insulin resistance; Nonalcoholic steatohepatitis; Obesity; Physical activity; Probiotics

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