Obesity management programs do not need to be intense to improve outcomes for children with nonalcoholic fatty liver disease (NAFLD), according to a recent study led by researchers at Cincinnati Children’s.
The study, published online March 19, 2013, in the Journal of Pediatric Gastroenterology &Nutrition, tracked children who completed one year in a “clinically feasible” weight-loss program that involved 30-minute patient visits every three months to set and monitor nutrition and exercise goals.
The study was led by Rohit Kohli, MBBS, MS, a member of Cincinnati Children’s Steatohepatitis Center and Stephanie DeVore, a clinical research coordinator at the center. Stavra Xanthakos, MD, MS, co-director of the center, was senior author.
The researchers found that children who stayed with a recommended weight loss program experienced statistically significant improvements in Body Mass Index (BMI), total cholesterol levels and two key NAFLD biomarkers: alanine aminotransferase (ALT) and aspartate aminotransferase (AST).
Fatty liver disease affects 10 percent of US children. Its more severe form -- nonalcoholic steatohepatitis (NASH) – occurs in about 2 percent of US children. Experts have known for years that weight loss helps manage the disease. However, many medical centers have struggled to develop diet and exercise programs that work for patients and can be conducted within the limitations of a busy gastroenterology clinic setting.
In this program patients met with a gastroenterologist and dietician every 3 months for 30 minutes to set individualized goals and monitor progress. Exercise regimens were recommended, but not directly provided. Dietary goals focused on reducing added sugar and saturated fat intake.
“Despite the lack of frequent visits,” Kohli and DeVore wrote, “the improvement in our program is comparable to improvement seen in a more intensive pediatric weight management programs.”
These observations are significant, the authors say, because insurance coverage for more intensive weight management services can be hard to obtain in the US. The findings indicate that positive results can be achieved even within a less intensive weight management program within a gastroenterology clinic setting.