Dietary and physical activity patterns in children with fatty liver

• Published in: European journal of clinical nutrition 2010-06, Vol.64 (6), p.628-635
• Main Authors: Mager, D.R, Patterson, C, So, S, Rogenstein, C.D, Wykes, L.J, Roberts, E.A
• Format: Article
• Language: English
• Subjects: 692/699/1503/1607/2750; 692/700/1720; 692/700/459/1994; Activity patterns; Adiponectin; Adiponectin - blood; Adolescent; Adult; Alanine; Alanine transaminase; Alanine Transaminase - blood; Antioxidants; Antioxidants - metabolism; Biological and medical sciences; Biomarkers - blood; Body composition; Body mass index; Body size; Body weight; C-reactive protein; Care and treatment; Causes of; Child; child nutrition; Child, Preschool; Children; Children & youth; Chronology; Clinical Nutrition; Demographic aspects; Development and progression; Diagnosis; Diet; Dietary Fats - administration & dosage; Dietary intake; Dietary Sucrose - administration & dosage; Diseases; Energy expenditure; Epidemiology; Erythrocytes; Exercise; Fat-free body mass; Fatty acids; Fatty liver; Fatty Liver - blood; Fatty Liver - etiology; Feeding. Feeding behavior; Female; Food and nutrition; Food intake; Fructose; Fundamental and applied biological sciences. Psychology; Gastroenterology. Liver. Pancreas. Abdomen; Glutathione; Glutathione peroxidase; Health aspects; Homeostasis; Humans; Hyperinsulinemia; Hyperinsulinism - blood; Hyperinsulinism - complications; Hypertriglyceridemia; Hypertriglyceridemia - blood; Hypertriglyceridemia - complications; Incidence; Inflammation; Inflammation Mediators - blood; Insulin; Insulin Resistance; Internal Medicine; Life Style; Liver; Liver diseases; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Medicine; Medicine & Public Health; Metabolic Diseases; Metabolism; Obesity; Obesity - blood; Obesity - complications; Obesity, Abdominal - blood; Obesity, Abdominal - complications; Omega-3 fatty acids; original-article; Other diseases. Semiology; Overweight; Oxidation resistance; Oxidative stress; Peroxidase; Physical activity; Physical fitness; Physiological aspects; Polyunsaturated fatty acids; Public Health; Sick children; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Vitamin E; Waist Circumference; Young Adult
• ISSN: 0954-3007; 1476-5640
• DOI: 10.1038/ejcn.2010.35

Background/Objectives: To examine lifestyle patterns (diet, physical activity, energy expenditure) and metabolic variables (insulin resistance, oxidative stress, inflammation) in children with fatty liver detected by sonography. Subjects/Methods: Body composition (fat-free mass, body mass index-z), waist circumference (WC), dietary intake and energy expenditure were determined in 38 patients (ages 5–19 years) with fatty liver in whom specific causative liver disorders had been excluded. Laboratory investigations included liver biochemistries, C-reactive protein, tumor necrosis factor-α, glutathione peroxidase, vitamin E, and erythrocyte-glutathione. Results: In all, 36 of 38 children were overweight/obese; 37 had WC indicative of abdominal obesity. They displayed fasting hyperinsulinemia (n=15), hypertriglyceridemia (n=14), and hypoadiponectinemia (5.5±1.9 s.d. μg/ml; n=23) and insulin resistance (homeostasis model of insulin resistance (HOMA-IR)>3; n=21). Alanine aminotransferase (ALT) was elevated in 28 (43–556 U/l; median=56). Some inflammatory markers were elevated, whereas antioxidants were decreased. Diet was characterized by high saturated-, low polyunsaturated-fat, high fructose and sucrose intakes. Fructose intake was independently associated with insulin resistance and decreased serum adiponectin, regardless of serum ALT (P