https://pubmed.ncbi.nlm.nih.gov/35897136/ NAFLD

J Pediatr Gastroenterol Nutr. 2022 Jul 28.
doi: 10.1097/MPG.0000000000003578.Online ahead of print.

Macronutrient and Micronutrient Intake in Adolescents with Non-Alcoholic Fatty Liver Disease: the Association with Disease Severity

Ariel Porto 1, Zhaoxing Pan 2, Wenru Zhou 2, Ronald J Sokol 3, Kelly Klaczkiewicz 3, Shikha S Sundaram 3
Affiliations expand
PMID: 35897136

DOI: 10.1097/MPG.0000000000003578

Abstract

Objectives: To 1) assess the macronutrient and micronutrient intake in adolescents with liver biopsy proven NAFLD (with and without NASH) and lean controls; 2) determine nutritional predictors of disease severity amongst these groups.

Methods: Adolescents with biopsy proven NAFLD and lean controls completed the Harvard Food Frequency Questionnaire.

Results: 28 NAFLD and 15 lean controls were studied. NAFLD with (n=20) and without NASH (n=8) had similar total calorie, protein, fat and carbohydrate intake. Subjects with NASH had higher total sugar (122.3 ± 48.3 vs 83.1 ± 38.8 gm), glucose (24.3 ± 9.3 vs 15.2 ± 7.5 gm), sucrose (42.3 ± 16.9 vs 28.8 ± 11.7 gm) and fructose (29.4 ± 12.5 vs 18.1 ± 8.0 gm) intake than those with NAFLD but without NASH (p<0.05). Both NAFLD groups had similar micronutrient intake. ALT correlated with total caloric intake (ρ=0.4, p=0.04). Total carbohydrate calories correlated with a higher NAS summary score (ρ=0.38, p=0.04) and lobular inflammation (ρ=0.50, p=0.007). Percent calories from added sugar and glucose correlated with worsening NAS summary score (ρ=0.44, p=0.02; ρ=0.48, p=0.009) and lobular inflammation (ρ=0.51, p=0.006; ρ=0.53, p=0.004).) Percent calories from fructose correlated with lobular inflammation (ρ=0.56, p=0.002). Total daily calories, protein, fat, carbohydrate and micronutrient intake were similar between NAFLD and lean controls.
Conclusion: NASH patients consume similar total calories, protein, and fat as those without NASH, but have significantly higher sugar intake. NAFLD and lean children, however, have similar macro/micronutrient intake. Histologic disease severity correlates with total carbohydrate and added sugar intake, supporting a role for simple sugar intake in NAFLD progression.