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Lifestyle intervention in obese children with non-alcoholic fatty liver disease: two years follow-up study
  1. Thomas Reinehr (t.reinehr{at}
  1. Vestische Kinderklinik, University Witten- Herdecke, Germany
    1. Caroline Schmidt
    1. University of Witten/Herdecke, Germany
      1. Werner Andler
      1. Vesitsche Children Hospital, Germany
        1. Andre Michael Toschke
        1. King’s College London, Division of Health and Social Care Research, London, United Kingdom


          Objective: Non-alcoholic fatty liver disease (NAFLD) is the most common cause of liver disease in obese youth. Lifestyle intervention was demonstrated to improve NAFLD but follow-up studies after end of intervention are lacking. Furthermore the necessary degree of overweight reduction for improvement of NAFLD remains unknown.

          Methods: We examined SDS-BMI and transaminases in 152 obese children with NAFLD diagnosed by ultrasound at baseline, at end of a one-year intervention and 2y after baseline. Within subject changes of these parameters were compared by participation in the intervention based on physical activity, nutrition education, and behaviour therapy.

          Results: In contrast to 43 children without lifestyle intervention, participation in lifestyle intervention (n=109) was associated with a significant decrease of transaminases and overweight one and two years after baseline (1y: alanine transaminase (ALT) –10 U/l (-14 to -6), aspartate transaminase (AST) –5 U/l (-7 to -3); SDS-BMI –0.23 (-0.30 to –0.16); 2y: ALT –9 U/l (-12 to -6), AST –6 U/l (-7 to -4); SDS-BMI –0.30 (-0.37 to –0.22); data as mean changes and 95% confidence interval compared to baseline). Any degree of overweight reduction was associated with a significant decrease of NAFLD prevalence. The greatest decrease of NAFLD prevalence (1y: -89% (95%CI -72 to -100%); 2y: -94% (95%CI -83 to -100%)) was observed in children with the greatest overweight reduction (SDS-BMI decrease >0.5).

          Conclusions: Multidisciplinary lifestyle intervention is effective to improve NAFLD even in the 1 year follow-up after end of intervention. A minimal reduction of overweight led to an improvement of NAFLD.

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