Shima Dowla1, May Pendergrass2, Mark Bolding3, Barbara Gower2, Kevin Fontaine4, Ambika Ashraf5, Taraneh Soleymani2, Shannon Morrison6, Amy Goss7. 1. Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, United States; School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States. 2. Department of Nutrition, University of Alabama at Birmingham, Birmingham, AL, United States. 3. Division of Advanced Medical Imaging Research, Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, United States. 4. Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, United States. 5. Division of Pediatric Endocrinology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, United States. 6. School of Nursing, University of Alabama at Birmingham, Birmingham, AL, United States. 7. Department of Nutrition, University of Alabama at Birmingham, Birmingham, AL, United States. Electronic address: amymiski@uab.edu.
Abstract
BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is the most common liver disorder among children in the developed world and can progress to cirrhosis, hepatocellular carcinoma, and liver failure. No evidence-based dietary guidelines exist on the most effective diet prescription to treat NAFLD. OBJECTIVE: To compare the effect of a carbohydrate (CHO)-restricted diet vs fat-restricted diet, the current standard of care, on changes in hepatic fat infiltration, body composition, and metabolic health over an 8-week period among overweight and obese children diagnosed with NAFLD. METHODS: In this two-arm, parallel design randomized controlled trial (RCT), 40 participants aged 9 to 18 years were randomized to a CHO restricted diet (<25:>50:25% daily calories from CHO: fat: protein) or control, fat restricted diet (55,20:25% daily calories from CHO: fat: protein). This family-based diet intervention included: (1) a 2-week supply of groceries to feed a four-person household specific to the assigned diet; and (2) extensive education on diet implementation through biweekly, diet-specific group and individualized counseling sessions with participants and one parent or guardian led by a registered dietitian (RD). The primary outcome measure of this study was hepatic lipid, measured using magnetic resonance spectroscopy (MRS). Secondary outcomes included liver transaminases; markers of inflammation (hsCRP, IL-6, TNF-α); body composition; visceral adipose tissue; and insulin resistance. All testing was conducted at baseline and week 8; hepatic transaminases were also measured at weeks 2 and 4. This RCT is registered with ClinicalTrials.gov (ID: NCT02787668).
RCT Entities:
BACKGROUND:Non-alcoholic fatty liver disease (NAFLD) is the most common liver disorder among children in the developed world and can progress to cirrhosis, hepatocellular carcinoma, and liver failure. No evidence-based dietary guidelines exist on the most effective diet prescription to treat NAFLD. OBJECTIVE: To compare the effect of a carbohydrate (CHO)-restricted diet vs fat-restricted diet, the current standard of care, on changes in hepatic fat infiltration, body composition, and metabolic health over an 8-week period among overweight and obesechildren diagnosed with NAFLD. METHODS: In this two-arm, parallel design randomized controlled trial (RCT), 40 participants aged 9 to 18 years were randomized to a CHO restricted diet (<25:>50:25% daily calories from CHO: fat: protein) or control, fat restricted diet (55,20:25% daily calories from CHO: fat: protein). This family-based diet intervention included: (1) a 2-week supply of groceries to feed a four-person household specific to the assigned diet; and (2) extensive education on diet implementation through biweekly, diet-specific group and individualized counseling sessions with participants and one parent or guardian led by a registered dietitian (RD). The primary outcome measure of this study was hepatic lipid, measured using magnetic resonance spectroscopy (MRS). Secondary outcomes included liver transaminases; markers of inflammation (hsCRP, IL-6, TNF-α); body composition; visceral adipose tissue; and insulin resistance. All testing was conducted at baseline and week 8; hepatic transaminases were also measured at weeks 2 and 4. This RCT is registered with ClinicalTrials.gov (ID: NCT02787668).
Authors: J L Kraschnewski; J Boan; J Esposito; N E Sherwood; E B Lehman; D K Kephart; C N Sciamanna Journal: Int J Obes (Lond) Date: 2010-05-18 Impact factor: 5.095
Authors: Manal F Abdelmalek; Ayako Suzuki; Cynthia Guy; Aynur Unalp-Arida; Ryan Colvin; Richard J Johnson; Anna Mae Diehl Journal: Hepatology Date: 2010-06 Impact factor: 17.425
Authors: Priya Sumithran; Luke A Prendergast; Elizabeth Delbridge; Katrina Purcell; Arthur Shulkes; Adamandia Kriketos; Joseph Proietto Journal: N Engl J Med Date: 2011-10-27 Impact factor: 91.245
Authors: Jeffrey B Schwimmer; Reena Deutsch; Jeffrey B Rauch; Cynthia Behling; Robert Newbury; Joel E Lavine Journal: J Pediatr Date: 2003-10 Impact factor: 4.406
Authors: Mariana Lazo; Ruben Hernaez; Susanne Bonekamp; Ihab R Kamel; Frederick L Brancati; Eliseo Guallar; Jeanne M Clark Journal: BMJ Date: 2011-11-18
Authors: Elena Buzzetti; Audrey Linden; Lawrence Mj Best; Angela M Madden; Danielle Roberts; Thomas J G Chase; Suzanne C Freeman; Nicola J Cooper; Alex J Sutton; Dominic Fritche; Elisabeth Jane Milne; Kathy Wright; Chavdar S Pavlov; Brian R Davidson; Emmanuel Tsochatzis; Kurinchi Selvan Gurusamy Journal: Cochrane Database Syst Rev Date: 2021-06-11
Authors: Meghan Pauley; Chadd Mays; James R Bailes; Michal Laniado Schwartzman; Mark Castle; Marji McCoy; Casey Patick; Deborah Preston; Matthew J R Nudelman; Krista L Denning; Lars Bellner; Joseph Werthammer Journal: Metab Syndr Relat Disord Date: 2021-02-09 Impact factor: 1.894