University of Surrey

Test tubes in the lab Research in the ATI Dance Research

Systematic Review: Nutrition and Physical Activity in the Management of Paediatric Non-alcoholic Fatty Liver Disease

Gibson, Philippa, Lang, Sarah, Dhawan, Anil, Fitzpatrick, Emer, Blumfield, Michelle L, Truby, Helen, Hart, Kath and Moore, Jennifer (2017) Systematic Review: Nutrition and Physical Activity in the Management of Paediatric Non-alcoholic Fatty Liver Disease Journal of Pediatric Gastroenterology and Nutrition, 65 (2). pp. 141-149.

[img]
Preview
Text
__homes.surrey.ac.uk_home_.System_Desktop_Gibson et al 2017 - authors accepted.pdf - Accepted version Manuscript

Download (166kB) | Preview

Abstract

OBJECTIVES: The aim of the study was to evaluate efficacy of nutrition and physical activity interventions in the clinical management of paediatric nonalcoholic fatty liver disease. The prevalence of paediatric nonalcoholic fatty liver disease continues to rise alongside childhood obesity. Weight loss through lifestyle modification is currently first-line treatment, although supplementation of specific dietary components may be beneficial. METHODS: Medline, CINAHL, EMBASE, Scopus, and Cochrane Libraries were systematically searched to identify randomized controlled trials assessing nutritional and physical activity interventions. Primary outcome measures were changes to liver biomarkers assessed by imaging, histology, or serum liver function tests. Study quality was evaluated using the American Dietetic Association Quality Criteria Checklist. RESULTS: Fifteen articles met eligibility criteria investigating nutritional supplementation (vitamin E [n = 6], probiotics [n = 2], omega-3 fatty acids [n = 5]), dietary modification (low glycaemic load [n = 1] and reducing fructose intake [n = 1]). No randomized controlled trials examining physical activity interventions were identified. Vitamin E was ineffective at improving alanine transaminase levels, whereas omega-3 fatty acids decreased hepatic fat content. Probiotics gave mixed results, whereas reduced fructose consumption did not improve primary outcome measures. A low glycaemic load diet and a low-fat diet appeared equally effective in decreasing hepatic fat content and transaminases. Most studies were deemed neutral as assessed by the American Dietetic Association Quality Criteria Checklist. CONCLUSIONS: The limited evidence base inhibits the prescription of specific dietary and/or lifestyle strategies for clinical practice. General healthy eating and physical activity guidelines, promoting weight loss, should remain first-line treatment until high-quality evidence emerges that support specific interventions that offer additional clinical benefit.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Biosciences and Medicine
Authors :
NameEmailORCID
Gibson, Philippap.s.gibson@surrey.ac.uk
Lang, Sarah
Dhawan, Anil
Fitzpatrick, Emer
Blumfield, Michelle L
Truby, Helen
Hart, KathK.Hart@surrey.ac.uk
Moore, JenniferJ.B.Moore@surrey.ac.uk
Date : 1 August 2017
DOI : 10.1097/MPG.0000000000001624
Copyright Disclaimer : This is the author's version of a paper accepted for publication in Journal of Pediatric Gastroenterology and Nutrition, after peer-review. It is not the final published version, which can be accessed at https://www.ingentaconnect.com/content/wk/mpg/2017/00000065/00000002/art00010
Uncontrolled Keywords : fructose; omega 3 fatty acids; probiotics; vitamin E
Depositing User : Melanie Hughes
Date Deposited : 24 Aug 2018 14:51
Last Modified : 04 Sep 2018 14:58
URI: http://epubs.surrey.ac.uk/id/eprint/849102

Actions (login required)

View Item View Item

Downloads

Downloads per month over past year


Information about this web site

© The University of Surrey, Guildford, Surrey, GU2 7XH, United Kingdom.
+44 (0)1483 300800