Research: ST-JULES and COLLEAGUES,

Listed in Issue 238

Abstract

ST-JULES and COLLEAGUES, (1)*University of Hawaii, Honolulu †Washington University, St Louis, MO ‡Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD §Columbia University, New York, NY evaluated  the dietary intake of fish and ω-3 fatty acids in children with biopsy-proven non-alcoholic fatty liver disease (NAFLD), and examined their association with serological and histological indicators of disease.

Background

Fish and ω-3 fatty acids are reported to be beneficial in pediatric non-alcoholic fatty liver disease (NAFLD), but no studies have assessed their relation to histological severity. The objectives of this study were to evaluate the dietary intake of fish and ω-3 fatty acids in children with biopsy-proven NAFLD, and examine their association with serological and histological indicators of disease.

Methodology

This was a cross-sectional analysis of 223 children (6-18 years) who participated in the Treatment of Non-alcoholic Fatty Liver Disease in Children trial or the NAFLD Database study conducted by the Non-alcoholic Steatohepatitis Clinical Research Network. The distribution of fish and ω-3 fatty acid intake was determined from responses to the Block Brief 2000 Food Frequency Questionnaire, and analyzed for associations with serum alanine aminotransferase, histological features of fatty liver disease, and diagnosis of steatohepatitis after adjusting for demographic, anthropometric, and dietary variables.

Results

The minority of subjects consumed the recommended 8 ounces of fish per week (22/223 [10%]) and 200 mg of long-chain ω-3 fatty acids per day (12/223 [5%]). Lack of fish and long-chain ω-3 fatty acid intake was associated with greater portal (P = 0.03 and P = 0.10, respectively) and lobular inflammation (P = 0.09 and P = 0.004, respectively) after controlling for potential confounders.

Conclusion

Fish and ω-3 fatty acid intake was insufficient in children with NAFLD, which may increase susceptibility to hepatic inflammation. Patients with pediatric NAFLD should be encouraged to consume the recommended amount of fish per week.

References

St-Jules DE(1), Watters CA, Brunt EM, Wilkens LR, Novotny R, Belt P, Lavine JE; Nonalcoholic Steatohepatitis Clinical Research Network. Estimation of fish and ω-3 fatty acid intake in pediatric nonalcoholic fatty liver disease.  J Pediatr Gastroenterol Nutr. 57(5):627-33. doi: 10.1097/MPG.0b013e3182a1df77. Nov 2013.

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