Dietary habits associated with NAFLD in obese children

Research has identified a number of variables associated with nonalcoholic fatty liver disease (NAFLD) in obese children.

Insulin resistance, as well as increased consumption of carbohydrates and saturated fatty acids, and a low intake of fiber and omega-3 fatty acids, were all positively associated with the pathogenesis of NAFLD.

"NAFLD is rapidly becoming an important public health problem," report Dimitrios Papandreou (Aristotle University of Thessaloniki, Greece) and colleagues in Appetite. "Undiagnosed, this condition may progress silently and results in cirrhosis, portal hypertension, and liver-related death in early adulthood."

In the present study of 82 obese children, the researchers investigated the potential differences in various anthropometric, biochemical, and dietary variables of obese children with and without NAFLD.

The prevalence of NAFLD in this cohort was 42.6%.

To date, the best available data suggest that the prevalence of NAFLD ranges from 2.6% to as high as 80%, although the true prevalence of NAFLD in children is not really known because of a lack of population-based studies and reliable screening tools.

Among children with NAFLD, body mass index (BMI) and waist circumference were significantly higher than in obese children without NAFLD. The BMI in children with NAFLD was 37.2 kg/m² versus 26.6 kg/m² in children without the liver disease.

Total carbohydrate intake was significantly higher in children with NAFLD than in those without, at 288.0 versus 244.5 g.

"CHO [carbohydrate] intake was increased in parallel to hepatic fatty liver, while fiber consumption was lower in the subjects with NAFLD (severe and mild) compared to children without NAFLD," write Papandreou et al.

The intake of saturated fatty acids was significantly higher in children with NAFLD. In addition, the intake of saturated fatty acids was proportionally increased based on the amount of hepatic steatosis, while the consumption of omega-3 fatty acids inversely correlated with NAFLD.

High saturated fatty acid intake might promote steatohepatitis, "directly by modulating hepatic triglyceride accumulation and oxidative activity as well as indirectly by affecting insulin sensitivity and postprandial triglyceride metabolism," they add.

In a regression analysis adjusted for multiple variables, the presence of insulin resistance and omega-3 fatty acid consumption were significant predictors of NAFLD (odds ratio 1.26 and 1.92, respectively).

Appetite 2012; Advance online publication

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