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

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• 作者：Jonathan A. Africa ; Kimberly P. Newton…
• 刊名：Digestive Diseases and Sciences
• 出版年：2016
• 出版时间：May 2016
• 年：2016
• 卷：61
• 期：5
• 页码：1375-1386
• 全文大小：427 KB
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Gastroenterology
  Hepatology
  Oncology
  Transplant Surgery
  Biochemistry
  
• 出版者：Springer Netherlands
• ISSN：1573-2568
• 卷排序：61

文摘

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.KeywordsNonalcoholic steatohepatitisObesityHypertensionDyslipidemiaInsulin resistancePhysical activityDietary supplementsProbiotics