title: Association between Adherence to the Mediterranean Diet and Presence of Nonalcoholic Fatty Liver Disease in Children.
abstract: The study's objective was to analyze the association between the adherence to the Mediterranean diet (MD) and the presence of nonalcoholic fatty liver disease (NAFLD) in children.
  
  
  
  The study consisted of three groups of children. Group 1 included obese/overweight children with recent diagnosis of NAFLD (n = 106, 12.4 ± 2.6 years). Group 2 included obese children without NAFLD (n = 21, 11.3 ± 2.6 years). Group 3 included the healthy children (without known chronic disease) with normal BMI (n = 54, 11.8 ± 2.9 years). Compliance to the MD was assessed by the KIDMED index score.
  
  
  
  KIDMED index score in obese children with NAFLD, without NAFLD, and healthy children were 2.6 ± 2.4, 4.6 ± 1.2, and 6.2 ± 1.9, respectively (p < 0.05 for group 1 versus 2, 1 versus 3, and 2 versus 3). Diet compliance was good in only 4.7% of the patients with NAFLD, whereas it was 31.5% in healthy children. KIDMED index score was negatively correlated with BMI (p < 0.05, r = -0.53), but no correlation was found with other parameters. The area under the receiver operation curve (AUROC) for predicting fatty liver disease in obese children (n = 127) with BMI and KIDMED index score was 0.78 (p < 0.05) and 0.24 (p < 0.05), respectively. BMI >26 has a sensitivity of 79.2% and specificity of 52.4%, and KIDMED index score ≤3 has a sensitivity of 66.9% and specificity of 76.1%.
  
  
  
  MD is an inexpensive and nontoxic dietary regimen and may be used as a therapeutic option in obese children with NAFLD.
authors.affiliation: 1 Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Karadeniz Technical University , Trabzon, Turkey .
authors.forename: Murat
authors.initials: M
authors.lastname: Cakir
authors.affiliation: 1 Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Karadeniz Technical University , Trabzon, Turkey .
authors.forename: Ulas Emre
authors.initials: UE
authors.lastname: Akbulut
authors.affiliation: 2 Department of Pediatric Endocrinology, Faculty of Medicine, Karadeniz Technical University , Trabzon, Turkey .
authors.forename: Aysenur
authors.initials: A
authors.lastname: Okten
mesh_terms: D052242:Adiponectin / Q000097:blood; D000410:Alanine Transaminase / Q000097:blood; D015992:Body Mass Index; D002648:Child; D003430:Cross-Sectional Studies; D038441:Diet, Mediterranean; D005260:Female; D006801:Humans; D008297:Male; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood / Q000178:diet therapy* / Q000517:prevention & control; D010349:Patient Compliance / Q000706:statistics & numerical data*; D063766:Pediatric Obesity / Q000097:blood / Q000178:diet therapy* / Q000517:prevention & control; D012307:Risk Factors; D014421:Turkey
chemical_list: D052242:Adiponectin; D000410:Alanine Transaminase