title: Estimation of fish and ω-3 fatty acid intake in pediatric nonalcoholic fatty liver disease.
abstract: OBJECTIVE
  Fish and ω-3 fatty acids are reported to be beneficial in pediatric nonalcoholic 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.
  
  
  METHODS
  This was a cross-sectional analysis of 223 children (6-18 years) who participated in the Treatment of Nonalcoholic Fatty Liver Disease in Children trial or the NAFLD Database study conducted by the Nonalcoholic 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: *University of Hawaii, Honolulu †Washington University, St Louis, MO ‡Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD §Columbia University, New York, NY.
authors.forename: David E
authors.initials: DE
authors.lastname: St-Jules
authors.forename: Corilee A
authors.initials: CA
authors.lastname: Watters
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Brunt
authors.forename: Lynne R
authors.initials: LR
authors.lastname: Wilkens
authors.forename: Rachel
authors.initials: R
authors.lastname: Novotny
authors.forename: Patricia
authors.initials: P
authors.lastname: Belt
authors.forename: Joel E
authors.initials: JE
authors.lastname: Lavine
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D017195:Adolescent Nutritional Physiological Phenomena; D000818:Animals; D002648:Child; D002652:Child Behavior; D002664:Child Nutritional Physiological Phenomena; D003430:Cross-Sectional Studies; D004032:Diet / Q000009:adverse effects*; D004198:Disease Susceptibility; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage* / Q000032:analysis; D005234:Fatty Liver / Q000209:etiology* / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005399:Fishes; D006293:Health Promotion; D006801:Humans; D008099:Liver / Q000276:immunology / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D008297:Male; D065626:Non-alcoholic Fatty Liver Disease; D018673:Nutrition Policy; D010349:Patient Compliance; D017747:Seafood / Q000032:analysis; D012720:Severity of Illness Index; D014481:United States
chemical_list: D015525:Fatty Acids, Omega-3