Nutrition assessment and MASH severity in children using the Healthy Eating Index
Year: 2023
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Pediatric metabolic-associated fatty liver disease (MAFLD) is a global health problem, with lifestyle modification as its major therapeutic strategy. Rigorous characterization of dietary content on MAFLD in children is lacking. We hypothesized an objectively measured healthier diet would positively modulate MAFLD. METHODS: Diet was assessed using the Nutrition Data System for Research in children enrolled from 10 tertiary clinical centers to determine the Healthy Eating Index (HEI, 0-100) and individual food components. RESULTS: In all, 119 children were included (13.3 ± 2.7 y), 80 (67%) male, 67 (18%) White, and 90 (76%) Hispanic, with an average body mass index Z-score of 2.2 ± 0.5. Diet was classified as low HEI < 47.94 (n = 39), mid HEI ≥ 47.94 and < 58.89 (n = 41), or high HEI ≥ 58.89 (n=39). Children with high HEI (healthier diet) had lower body weight (p = 0.005) and more favorable lipids. Mean serum triglycerides for low, mid, and high HEI were 163, 148, and 120 mg/dL, respectively; p = 0.04 mid versus high, p = 0.01 low versus high. Mean HDL was 38, 41 and 43 mg/dL; p = 0.02 low vs high. Less severe steatosis was noted with added sugar ≤ 10% of calories (p = 0.03). Higher lobular inflammation is associated with a higher percentage of calories from fat (OR (95% CI) = 0.95 (0.91-1.00), p = 0.04). CONCLUSIONS: In children with MAFLD, high HEI is associated with lower body weight and more favorable lipids, while added sugar and fat intake has individual histologic features. Differential consumption of major dietary components may modify both metabolic risk factors and histologic liver injury, highlighting the importance of objective diet assessments in children with MAFLD.
Source: Hepatology Communications
Institutions: Saint Louis University, Johns Hopkins University, University of California San Diego, Rady Children's Hospital-San Diego, University of California, San Francisco, Cleveland Clinic, Riley Hospital for Children, Indiana University Indianapolis, Indiana University School of Medicine, Cincinnati Children's Hospital Medical Center, Baylor College of Medicine, Texas Children's Hospital, Emory University, Children's Healthcare of Atlanta
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,700
Awards: Continuation of the Nonalcoholic Steatohepatitis Clinical Research Network, San Diego Clinical and Translational Research Institute, Institute of Translational Health Sciences, Northwestern University Clinical and Translational Science Institute (NUCATS), Multidisciplinary Clinical and Translational Science (MCTS) Program (UL1), Clinical and Translational Science Institute, Atlanta Clinical and Translational Science Institute (ACTSI) Renewal, Washington University Institute of Clinical and Translational Sciences, Role of intestinal microbiota in driving injury mechanisms in short bowel syndrome, Institute for Clinical and Translational Research, Indiana Clinical and Translational Science Institute (UL1), Clinical and Translational Science Award, Biomarker Discovery for Nonalcoholic Fatty Liver Disease in Children, Cincinnati Center for Clinical and Translational Sciences and Training, Nonalcoholic Steatohepatitis Clinical Research Network (NASH CRN), Nonalcoholic Steatohepatitis Clinical Research Network (NASH CRN), Data Coordinating Center for the Nonalcoholic Steatohepatitis Clinical Research Network (NASH CRN) Continuation, Clinical Research Network in Nonalcoholic Steatohepatitis, Prevention of Pediatric NAFLD in Hispanic Children, Collaborative Clinical Research in Nonalcoholic Steatohepatitis, Role of bile acid receptors FXR and TGR5 in preventing injury in short bowel syndrome, Continuation of the Nonalcoholic Steatohepatitis Clinical Research Network (NASH CRN) Clinical Center-Cleveland site, Clinical Research on Nonalcoholic Fatty Liver Disease, The Saint Louis University Component of the NASH Clinical Research Network, Nonalcoholic Steatohepatitis Clinical Research Network (NASH CRN)
OpenAlex ID: W4389434245