학술논문
Nutrition assessment and MASH severity in children using the Healthy Eating Index
Document Type
article
Author
Jain, Ajay Kumar; Buchannan, Paula; Yates, Katherine P; Belt, Patricia; Schwimmer, Jeffrey B; Rosenthal, Philip; Murray, Karen F; Molleston, Jean P; Scheimann, Ann; Xanthakos, Stavra A; Behling, Cynthia A; Hertel, Paula; Nilson, Jamie; Neuschwander-Tetri, Brent A; Tonascia, James; Vos, Miriam B; Cavallo, Laurel; Garner, Donna; Hertel, Paula M; Mysore, Krupa R; Ortega, Taira Illescas; Tessier, Mary Elizabeth; Triggs, Nicole; Tsai, Cynthia; Arce-Clachar, Ana Catalina; Bramlage, Kristin; Cecil, Kim; Mouzaki, Marialena; Popelar, Ann; Trout, Andrew; Xanthakos, Stavra; Allende, Daniela; Bellar, Annette; Dasarathy, Jaividhya; Dasarathy, Srinivasan; Welch, Nicole; Yerrapothu, Rahul; Bashir, Mustafa; Diehl, Anna Mae; Guy, Cynthia; Kopping, Mariko; Piercy, Dawn; Suzuki, Ayako; Alazraki, Adina; Garcia, Carmen; Jara-Garra, Jorge; Karpen, Saul; Vos, Miriam; Chalasani, Naga; Cruz, Mandy; Cummings, Oscar W; Garrison, Lisa; Gawrieh, Samer; Adams, Kathryn Harlow; Jarasvaraparn, Chaowapong; Klipsch, Ann; Morlan, Wendy; Ragozzino, Emily; Samala, Niharika; Vuppalanchi, Raj; Angkanaworakul, Pannapat; Berihun, Achashman; Buysse, Andrew; Dorrian, Theresa; Gulati, Breanna; Kowdley, Kris V; Liu, Kevin; Misic, Sandra; Sohal, Adam; Anthony, Angela; Chapin, Catherine; Fishbein, Mark H; Carpenter, Danielle; Cattoor, Theresa; Freebersyser, Janet; Jain, Ajay K; Ajmera, Veeral; Alba, Amy; Behling, Cynthia; Goyal, Nidhi; Keyvan, Leila; Loomba, Rohit; Madamba, Egbert; Middleton, Michael S; Morfin, Rebecca; Newton, Kimberly; Richards, Lisa; Singh, Seema; Sirlin, Claude; Skonieczny, Jaret; Ugalde-Nicalo, Patricia; Wang, Andrew; Awe, Remilekun; Gill, Ryan; Hameed, Bilal; Olvera, Daisy; Terrault, Norah
Source
Hepatology Communications. 7(12)
Subject
Language
Abstract
BackgroundPediatric metabolic-associated fatty liver disease (MAFLD) is a global health problem, with lifestyle modification as its major therapeutic strategy. Rigorous characterization of dietary content on MAFLD in children is lacking. We hypothesized an objectively measured healthier diet would positively modulate MAFLD.MethodsDiet was assessed using the Nutrition Data System for Research in children enrolled from 10 tertiary clinical centers to determine the Healthy Eating Index (HEI, 0-100) and individual food components.ResultsIn all, 119 children were included (13.3 ± 2.7 y), 80 (67%) male, 67 (18%) White, and 90 (76%) Hispanic, with an average body mass index Z-score of 2.2 ± 0.5. Diet was classified as low HEI < 47.94 (n = 39), mid HEI ≥ 47.94 and < 58.89 (n = 41), or high HEI ≥ 58.89 (n=39). Children with high HEI (healthier diet) had lower body weight (p = 0.005) and more favorable lipids. Mean serum triglycerides for low, mid, and high HEI were 163, 148, and 120 mg/dL, respectively; p = 0.04 mid versus high, p = 0.01 low versus high. Mean HDL was 38, 41 and 43 mg/dL; p = 0.02 low vs high. Less severe steatosis was noted with added sugar ≤ 10% of calories (p = 0.03). Higher lobular inflammation is associated with a higher percentage of calories from fat (OR (95% CI) = 0.95 (0.91-1.00), p = 0.04).ConclusionsIn children with MAFLD, high HEI is associated with lower body weight and more favorable lipids, while added sugar and fat intake has individual histologic features. Differential consumption of major dietary components may modify both metabolic risk factors and histologic liver injury, highlighting the importance of objective diet assessments in children with MAFLD.