Physical activity and nutrition attitudes in obese Hispanic children with non-alcoholic steatohepatitis

Abstract

Aim: To assess nutrition, physical activity and healthful knowledge in obese children with biopsy-proven non-alcoholic steatohepatitis (NASH or NA) compared to children without liver disease.

Methods: Children with biopsy-proven NASH comprised the NASH group. Age, sex and ethnicity matched control groups consisted of obese (OB) and lean (CO) children with no liver disease. Subjects were administered the School Physical Activity and Nutrition Survey and one blood draw was obtained.

Results: Fifty-seven patients were enrolled with a mean age of 12.1 ± 2.1 years, and all were Hispanic. Even though the OB and NA had a similar increased body mass index (%), 35% of the NA group always read nutrition labels compared to none in the OB (P < 0.05), and more NA children felt their diet is "less healthy". NA consumed the least amount of fruits with only 25% having ≥ 1 fruit/d vs 45% in OB and 64.7% in CO (P < 0.05 NA vs CO). Only 15% of NA subjects performed light exercise vs 35% and 59% of OB and CO groups, respectively (P = 0.02). The mean physical activity score was lowest in the NA group (P < 0.05). Amongst the subjects with NASH, we found that 100% of patients with grade 2 or 3 fibrosis had a sedentary score > 2 compared to only 63.6% of those with grade 1 or no fibrosis (P < 0.05).

Conclusion: Children with NASH had increased se-dentary behavior, decreased activity, and fruit intake. Larger studies may determine the benefit of changing these behaviors as treatment for NASH.

Keywords: Hispanic; Non-alcoholic steatohepatitis; Nutrition; Nutrition survey; Pediatric; Physical activity; School physical activity.

Figure 1

Intake of milk, fruits and fries. This figure plots the percentage of subjects responding to school physical activity and nutrition questions regarding food consumption. Non-alcoholic steatohepatitis subjects reported consuming significantly less fruits than obese and lean control subjects. CO: Lean controls; OB: Obese controls; NA: Non-alcoholic steatohepatitis subjects. ^aP < 0.05, vs CO group; ^cP < 0.05, vs OB group.

Figure 2

Physical activity and sedentary behavior. This figure demonstrates the physical activity scores and sedentary scores of obese children with non-alcoholic steatohepatitis (NASH) compared with obese controls and lean controls. NASH subjects reported significantly less physical activity than obese and lean controls. CO: Lean controls; OB: Obese controls; NA: Non-alcoholic steatohepatitis subjects. ^aP < 0.05, vs CO group; ^cP < 0.05, vs OB group.

Figure 3

Milk intake and sedentary score by severity of fibrosis in non-alcoholic steatohepatitis subjects. This figure demonstrates milk consumption and sedentary scores amongst subjects with non-alcoholic steatohepatitis. All subjects with advanced fibrosis (grades 2 or 3), had a sedentary score > 2 compared to only 63.6% of those with grade 1 or no fibrosis (^aP < 0.05, vs group 1).