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Nutrition Science Initiative launches study on nonalcoholic fatty liver disease in children

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Holly Korschun

Nutrition Science Initiative (NuSI) has launched the first-ever randomized, controlled clinical trial to determine whether removing added sugars from the diet can treat or even reverse nonalcoholic fatty liver disease (NAFLD) in children.

Once considered a disease of adults and virtually unheard of in children, the prevalence of NAFLD in adolescents has become increasingly rampant with one in 10 children in the U.S.—more than 7 million—afflicted with the disease, according to recent estimates from the CDC. A rapidly growing epidemic, 40 million adults in the United States also suffer from NAFLD, which is now recognized as the most common form of liver disease in the Western world.

NAFLD is characterized by increased fat deposits in the liver known as hepatic steatosis. If left unchecked, the excess fat buildup can lead to serious health problems, including inflammation and fibrosis in the liver, and eventually advance to cirrhosis. By the time it reaches that point, the disease—referred to as nonalcoholic steatohepatitis, or NASH—may be irreversible and ultimately can result in liver failure or a deadly type of liver cancer known as hepatocellular carcinoma. Currently, there are no safe or effective drugs recommended to treat children or adults with this liver disease.

The NuSI funded study will be a collaborative effort led by principal investigators Miriam Vos, MD, assistant professor of gastroenterology at Emory University School of Medicine and a pediatric hepatologist at Children’s Healthcare of Atlanta, and Jeffrey Schwimmer, MD, professor of clinical pediatrics at University of California San Diego School of Medicine and director of the Weight and Wellness Center and the Fatty Liver Clinic at Rady Children’s Hospital, San Diego.

The eight-week trial will include 40 children who have been diagnosed with NAFLD. Half of them will eat and drink what they normally do while the rest will be put on sugar-free meals and snacks, all of which will be provided for them and their families. The researchers will monitor the participants and keep track of their liver fat content to determine if taking in high levels of sugars may be what gets the disease started and drives its progression.

The pilot study will be followed by two larger studies—one in children to determine whether the type of added sugar consumed (solid versus liquid) affects fatty liver disease progression, and one in adults to determine the relative roles of calories, fats, and carbohydrates in the diet on fatty liver disease progression. Taken together, these complementary trials will help provide the data necessary to design an effective lifestyle change that can work as both treatment and prevention for NAFLD without drugs or surgery.

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