Lifestyle intervention for non-alcoholic fatty liver disease: prospective cohort study of its efficacy and factors related to improvement

Background Non-alcoholic fatty liver disease (NAFLD) has a high prevalence in obese children. Lifestyle intervention is the primary treatment for NAFLD. However, limited data are available regarding the efficacy of lifestyle interventions. Objectives To prospectively determine the efficacy of a lifestyle intervention programme on NAFLD in severely obese children and identify the clinical parameters related to improvement in NAFLD. Methods Children admitted to a lifestyle intervention programme were screened for NAFLD. Steatosis was defined as increased echogenicity of the liver on ultrasonography. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were used as surrogate markers for steatohepatitis. The lifestyle intervention programme consisted of physical exercise, dietary counselling and behavioural counselling for a period of 6 months. Results 144 children were included with a mean age of 14.1 (±2.3) years, BMI z-score of 3.35 (±0.40) kg/m2. Lifestyle intervention significantly reduced the prevalence of steatosis (31.2–11.9%, p