title: Assessment of Diet and Physical Activity in Paediatric Non-Alcoholic Fatty Liver Disease Patients: A United Kingdom Case Control Study.
abstract: Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in children, with prevalence rising alongside childhood obesity rates. This study aimed to characterise the habitual diet and activity behaviours of children with NAFLD compared to obese children without liver disease in the United Kingdom (UK). Twenty-four biopsy-proven paediatric NAFLD cases and eight obese controls without biochemical or radiological evidence of NAFLD completed a 24-h dietary recall, a Physical Activity Questionnaire (PAQ), a Dutch Eating Behavior Questionnaire (DEBQ) and a 7-day food and activity diary (FAD), in conjunction with wearing a pedometer. Groups were well matched for age and gender. Obese children had higher BMI z-scores (p = 0.006) and BMI centiles (p = 0.002) than participants with NAFLD. After adjusting for multiple hypotheses testing and controlling for differences in BMI, no differences in macro- or micronutrient intake were observed as assessed using either 24-h recall or 7-day FAD (p > 0.001). Under-reporting was prevalent (NAFLD 75%, Obese Control 87%: p = 0.15). Restrained eating behaviours were significantly higher in the NAFLD group (p = 0.005), who also recorded more steps per day than the obese controls (p = 0.01). In conclusion, this is the first study to assess dietary and activity patterns in a UK paediatric NAFLD population. Only a minority of cases and controls were meeting current dietary and physical activity recommendations. Our findings do not support development of specific dietary/ physical activity guidelines for children with NAFLD; promoting adherence with current general paediatric recommendations for health should remain the focus of clinical management.
authors.affiliation: Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK. pippa.s.gibson@gmail.com.
authors.forename: Philippa S
authors.initials: PS
authors.lastname: Gibson
authors.affiliation: Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK. lang.sarah16@gmail.com.|Department of Nutrition and Dietetics, Monash University, Melbourne, 3168, Australia. lang.sarah16@gmail.com.
authors.forename: Sarah
authors.initials: S
authors.lastname: Lang
authors.affiliation: Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK. marianne-gilbert@hotmail.com.
authors.forename: Marianne
authors.initials: M
authors.lastname: Gilbert
authors.affiliation: Paediatric Liver Centre, King's College London School of Medicine at King's College Hospital, London SE5 9RS, UK. deepa.kamat@nhs.net.
authors.forename: Deepa
authors.initials: D
authors.lastname: Kamat
authors.affiliation: Paediatric Liver Centre, King's College London School of Medicine at King's College Hospital, London SE5 9RS, UK. sanjay.bansal@nhs.net.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Bansal
authors.affiliation: Adolescent Surgical Weight Loss Clinic, Department of Child Health, King's College Hospital, London SE5 9RS, UK. martha.ford-adams@nhs.net.
authors.forename: Martha E
authors.initials: ME
authors.lastname: Ford-Adams
authors.affiliation: Adolescent Surgical Weight Loss Clinic, Department of Child Health, King's College Hospital, London SE5 9RS, UK. ashishdesai@nhs.net.
authors.forename: Ashish P
authors.initials: AP
authors.lastname: Desai
authors.affiliation: Paediatric Liver Centre, King's College London School of Medicine at King's College Hospital, London SE5 9RS, UK. anil.dhawan@kcl.ac.uk.
authors.forename: Anil
authors.initials: A
authors.lastname: Dhawan
authors.affiliation: Paediatric Liver Centre, King's College London School of Medicine at King's College Hospital, London SE5 9RS, UK. emer.fitzpatrick@kcl.ac.uk.
authors.forename: Emer
authors.initials: E
authors.lastname: Fitzpatrick
authors.affiliation: Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK. j.b.moore@surrey.ac.uk.
authors.forename: J Bernadette
authors.initials: JB
authors.lastname: Moore
authors.affiliation: Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK. k.hart@surrey.ac.uk.
authors.forename: Kathryn H
authors.initials: KH
authors.lastname: Hart
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D003625:Data Collection; D004032:Diet; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D011939:Mental Recall; D009043:Motor Activity; D065626:Non-alcoholic Fatty Liver Disease / Q000453:epidemiology* / Q000209:etiology*; D011795:Surveys and Questionnaires
keywords: adolescence; children; eating behaviour; non-alcoholic fatty liver disease; nutrition; obesity; physical activity