HOME
Return to Table of Contents
033 LIFESTYLE MODIFICATION IN NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD): DOES EXERCISE IMPROVE METABOLIC AND LIVER FUNCTION IN ADOLESCENTS WITH NAFLD? DR Mager1,2, T Pateman1, EA Roberts1,2,3 INTRODUCTION: Non-alcoholic fatty liver disease (NAFLD) can cause liver disease in adolescents that ranges from a simple fatty liver with large droplet steatosis to inflammation and fibrosis (nonalcoholic steatohepatitis) to cirrhosis. Little is known regarding the effectiveness of lifestyle modification in adolescents with NAFLD. We hypothesized that increased physical activity would result in improved metabolic and liver biochemical function in obese adolescents with NAFLD.
1Division of Gastroenterology, Hepatology and Nutrition, 2Metabolism Research Group, The Hospital for Sick Children; 3Departments of Paediatrics, Medicine & Pharmacology, University of Toronto, Toronto, Ontario
METHODS: We prospectively studied the impact of a 6 week exercise intervention program using pedometers in 14 adolescents with NAFLD (6F, 8M; 15.4 ± 2.5 yrs) on body composition (weight, BMI, waist circumference, skin fold measures, fat-free mass [FFM] and fat mass [FM]), insulin resistance (as assessed by HOMA-IR) and liver biochemical function (AST, ALT). Step counts were measured using pedometers at baseline (4 days) and on a daily basis over the intervention period (6 weeks) to ensure weekly step goals were met. Weekly step goals were set at incremental step increases of 2500 steps/d up to a maximum of 15,000 steps/d.
RESULTS: Mean number of steps increased by 36.5% (p<0.05) over 6 weeks; with final goals steps met at 5.3 ± 1.6 weeks. Seven out of 14 children lost weight (1.9%) and had clinically important reductions in serum liver biochemistries (52% ALT; p=0.15), HOMA-IR values (20%; p=0.05), serum triglycerides (20%, p=0.15), and BMI (7.2%; p=0.06). FM decreased significantly in all children (36.7%; p=0.03; n=14) over the 6 week intervention period.
CONCLUSION: Increased physical activity in adolescents with NAFLD results in clinically important reductions in serum liver biochemistries, triglycerides, insulin resistance and body composition. Pedometers offer a simple, reliable and effective way to promote lifestyle modification in obese adolescents with NAFLD.