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Dietitian-led lifestyle modification programme for obese Chinese adolescents with non-alcoholic fatty liver disease: a randomized controlled study

Published on Sep 1, 2018in International Journal of Obesity 4.51
· DOI :10.1038/s41366-018-0010-8
Dorothy F.Y. Chan12
Estimated H-index: 12
(CUHK: The Chinese University of Hong Kong),
H. K. So1
Estimated H-index: 1
(HKU: University of Hong Kong)
+ 7 AuthorsE. A. S. Nelson20
Estimated H-index: 20
(CUHK: The Chinese University of Hong Kong)
The prevalence of non-alcoholic fatty liver disease (NAFLD) in children is increasing. This study evaluated the efficacy of a dietitian-led lifestyle modification programme (D-LMP) to reduce NAFLD in obese adolescents. Subjects with intra-hepatic triglyceride content (IHTC) equal to or greater than 5% diagnosed by proton-magnetic resonance spectroscopy (1H-MRS) were enroled and randomly assigned to either the D-LMP intervention or conventional paediatrician-led consultation (P-CON) group. Subjects in the P-CON group received usual care consisting of a consultation by a paediatrician with the child and parents every 16 weeks. Intention-to-treat analysis was used for data analysis. Fifty-two subjects were recruited, with 26 in each group. After the initiation phase (at week-16), there was a greater difference in the change in the IHTC and BMI z-score in the D-LMP group (P = 0.029 and <0.001, respectively) and there was a decrease in dietary intake of fat content (P = 0.019). After 52 weeks of the maintenance phase, both groups had reductions of IHTC to 2–3% and there was no intergroup difference in the rate of reduction. During the maintenance phase, parents’ involvement was minimal in the D-LMP group, with only three parents accompanying their children to attend the dietitian sessions. In contrast, over 90% of the parents in the P-CON group regularly accompanied their children to attend the consultations suggesting the possibility that regular parental and paediatrician involvement may contribute to increasing awareness on fatty liver complications. Multivariate analysis showed that only reduction in body fat remained as an independent factor associated with remission of NAFLD at the end of both study phases. A dietitian-led lifestyle modification intervention reduced IHTC, BMI z-score and body fat in obese Chinese adolescents with NAFLD. To sustain the effect of this intervention, regular parental and paediatrician involvement may be important.
  • References (26)
  • Citations (1)
Published on Nov 1, 2016in Hepatology 14.97
Zobair M. Younossi76
Estimated H-index: 76
Deirdre Blissett1
Estimated H-index: 1
+ 6 AuthorsRachel Beckerman1
Estimated H-index: 1
Nonalcoholic fatty liver disease (NAFLD) is a major cause of chronic liver disease. There is uncertainty around the economic burden of NAFLD. We constructed a steady-state prevalence model to quantify this burden in the United States and Europe. Five models were constructed to estimate the burden of NAFLD in the United States and four European countries. Models were built using a series of interlinked Markov chains, each representing age increments of the NAFLD and the general populations. Incid...
Published on Sep 1, 2016in Journal of Hepatology 18.95
Giovanni Targher58
Estimated H-index: 58
Christopher D. Byrne53
Estimated H-index: 53
(NIHR: National Institute for Health Research)
+ 2 AuthorsCorrado Barbui50
Estimated H-index: 50
(University of Verona)
Background & Aims There have been many studies of the effects of non-alcoholic fatty liver disease (NAFLD) and the risk of cardiovascular disease (CVD), but these have produced conflicting results. We performed a meta-analysis of these studies to quantify the magnitude of the association between NAFLD (and NAFLD severity) and risk of CVD events. Methods We searched PubMed, Google scholar, and Web of Science databases using terms "NAFLD", "cardiovascular events", "cardiovascular mortality", "prog...
Published on Dec 1, 2014in BMC Gastroenterology 2.25
Svanhildur Haflidadottir4
Estimated H-index: 4
Jon Jonasson49
Estimated H-index: 49
(University of Iceland)
+ 4 AuthorsEinar Bjornsson36
Estimated H-index: 36
(University of Iceland)
Background Few studies have compared the prognosis and liver-related mortality in patients with NAFLD (nonalcoholic fatty liver disease) and AFLD (alcoholic fatty liver disease). We aimed to investigate the etiology and liver-related mortality of patients with liver biopsy verified fatty liver disease in a population based setting.
Vicki S. Conn40
Estimated H-index: 40
(MU: University of Missouri),
Richelle J. Koopman25
Estimated H-index: 25
(MU: University of Missouri)
+ 3 AuthorsAdam R. Hafdahl17
Estimated H-index: 17
Objective: Although exercise can improve insulin sensitivity, no adequate synthesis exists of exercise intervention studies with regard to their effect on insulin sensitivity. This comprehensive meta-analysis synthesized the insulin sensitivity outcomes of supervised exercise interventions. Method: Extensive literature searching located published and unpublished intervention studies that measured insulin sensitivity outcomes. Eligible studies tested supervised exercise interventions among health...
Published on Sep 1, 2013in Journal of Hepatology 18.95
Vincent Wai-Sun Wong58
Estimated H-index: 58
(CUHK: The Chinese University of Hong Kong),
Ruth Chan21
Estimated H-index: 21
(CUHK: The Chinese University of Hong Kong)
+ 11 AuthorsMandy Man-Mei Sea18
Estimated H-index: 18
(CUHK: The Chinese University of Hong Kong)
Background & Aims Healthy lifestyle is the most important management of non-alcoholic fatty liver disease (NAFLD). This study aimed at assessing the efficacy of a community-based lifestyle modification programme in the remission of NAFLD. Methods This was a parallel group, superiority, randomized controlled trial. 154 adults with NAFLD identified during population screening were randomized to participate in a dietitian-led lifestyle modification programme at 2 community centres or receive usual ...
Published on Aug 1, 2012in Clinics in Liver Disease 5.23
Evelyn Hsu10
Estimated H-index: 10
(Seattle Children's),
Karen F. Murray33
Estimated H-index: 33
(Seattle Children's)
Published on Mar 1, 2012in Gut 17.94
Vincent Wai-Sun Wong58
Estimated H-index: 58
Winnie C.W. Chu38
Estimated H-index: 38
+ 9 AuthorsJean Woo85
Estimated H-index: 85
Objective Knowledge of the epidemiology of non-alcoholic fatty liver disease (NAFLD) is incomplete because liver biopsy cannot be performed on the general population to assess disease severity. New non-invasive tests allow accurate and safe assessment in healthy individuals. The aim of this study was to examine the prevalence of NAFLD and advanced fibrosis in the general Hong Kong Chinese population. Methods Subjects were recruited from the community by random selection from the government censu...
Published on Dec 1, 2011in Pediatric Clinics of North America 2.27
Ali Mencin14
Estimated H-index: 14
(Columbia University),
Joel E. Lavine49
Estimated H-index: 49
(Columbia University)
Published on Oct 1, 2010in International Journal of Obesity 4.51
K Widhalm1
Estimated H-index: 1
E Ghods1
Estimated H-index: 1
Background: Nonalcoholic fatty liver disease (NAFLD) is the most common cause of pediatric liver disease. Its prevalence is related to the growing epidemic in childhood obesity during the past decades. At present, NAFLD and nonalcoholic steatohepatitis (NASH) are increasingly recognized worldwide. In spite of alarming trend in the epidemiology in pediatric field and growing risk of end stage liver disease, there is no significant advance in its diagnosis and treatment. Aim: To provide a detailed...
Published on Jul 1, 2010in Current Opinion in Clinical Nutrition and Metabolic Care 3.57
Anna Alisi37
Estimated H-index: 37
Mattia Locatelli1
Estimated H-index: 1
Valerio Nobili49
Estimated H-index: 49
Purpose of review The intent of this review is to provide a concise overview of all recent acquisitions in terms of therapies and early noninvasive diagnostic approaches for nonalcoholic fatty liver disease (NAFLD) in children. Recent findings NAFLD is increasingly being diagnosed in children. If undiscovered and if certain risks are present (i.e. obesity), nonalcoholic steatohepatitis, the most severe form of NAFLD, may silently progress to cirrhosis, hepatocarcinoma and liver-related death in ...
Cited By1
Juan Li6
Estimated H-index: 6
(Sichuan University),
Lv Zhu2
Estimated H-index: 2
(Sichuan University)
+ 7 AuthorsWen-Fu Tang13
Estimated H-index: 13
(Sichuan University)
Background and Aims. Nonalcoholic fatty liver disease (NAFLD) is an alarming public health problem that directly contributes to increased prevalence of liver cirrhosis and hepatic cell cancer, but without any specific pharmacological option. Sheng-jiang powder (SJP), an empirical Chinese medicine formula to treat NAFLD, showed great efficacy but the specific mechanisms have never been reported. Therefore, we performed this study to explore the effect of SJP on NAFLD and the potential mechanism. ...