Dietitian-led lifestyle modification programme for obese Chinese adolescents with non-alcoholic fatty liver disease: a randomized controlled study

Chan, Daniel; So, Hung-Kwan; Hui, Steve C.N.; Chan, Randolph C. H.; Li, A. M.; Sea, Mandy Man-Mei; Chu, Winnie C.W.; Chan, Michael C. W.; Woo, Jean; Nelson, E. A. S.

doi:10.1038/s41366-018-0010-8

Cited by 19 publications

(72 citation statements)

References 26 publications

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“…Currently, the main therapeutic strategies for NAFLD depend on lifestyle changes as there is no specific pharmacological option for the treatment of NAFLD [ 17 – 19 ]. But due to poor adherence to life style modification, finding new therapeutic agents to treat NAFLD or preventing its progression has attracted many interests.…”

Section: Introductionmentioning

confidence: 99%

Sheng‐Jiang Powder Ameliorates High Fat Diet Induced Nonalcoholic Fatty Liver Disease via Inhibiting Activation of Akt/mTOR/S6 Pathway in Rats

Zhu

Zhang

et al. 2018

Evidence-Based Complementary and Alternative Medicine

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Background and Aims Nonalcoholic fatty liver disease (NAFLD) is an alarming public health problem that directly contributes to increased prevalence of liver cirrhosis and hepatic cell cancer, but without any specific pharmacological option. Sheng-jiang powder (SJP), an empirical Chinese medicine formula to treat NAFLD, showed great efficacy but the specific mechanisms have never been reported. Therefore, we performed this study to explore the effect of SJP on NAFLD and the potential mechanism. Methods NAFLD was induced by high fat diet (HFD) feeding. Rats were treated with SJP/normal saline daily for 10 weeks and all rats were euthanized after 12 weeks' feeding. Liver tissue samples were obtained for biochemistry test and pathological evaluation. Additionally, oleic acid induced LO2 cells were employed to simulate a cell model of NAFLD. Cells were subjected to western blotting for Akt, mTOR, S6, SREBP1-c, and FASN detection after coincubated with SJP, LY294002 (a selective PI3K inhibitor), or the combination for 24h. Results HFD significantly induced hepatic steatosis. Plenty of lipid droplets were observed under transmission electron microscope. The ultrastructure of liver cells showed distinct changes with obvious endoplasmic reticulum expansion, mitochondrial contraction, and cell matrix solidification. Although no difference was detected in serum hepatic enzymes and tissue proinflammatory cytokines, the tissue level of SOD and GSH-px was much lower and the pathologic injuries were much severe in HFD feeding rats. However, SJP treatment significantly attenuated the ultrastructure changes and protected rat liver against inflammatory injury. Abundant of lipid droplets and high expression of pAkt, pmTOR, pS6, and FASN were observed in oleic acid treated LO2 cells, while these changes were restored by SJP treatment. Conclusions SJP is efficient in attenuating HFD induced NAFLD in rats and this effect might be partly related to the inhibition of Akt/mTOR/S6 pathway.

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Section: Introductionmentioning

confidence: 99%

Sheng‐Jiang Powder Ameliorates High Fat Diet Induced Nonalcoholic Fatty Liver Disease via Inhibiting Activation of Akt/mTOR/S6 Pathway in Rats

Zhu

Zhang

et al. 2018

Evidence-Based Complementary and Alternative Medicine

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“…Regarding the completion rates of the studies, Agustini et al [29] and Schwimmer et al reported 100%, Ramon-Krauel et al [27] reported 94%, Jin et al [28] reported 91.7%, while Goss et al [31] reported only 78%. Of the eligible studies, six RCTs evaluated the effects of dietary modifications in pediatric NAFLD patients [26][27][28][29][30][31], three evaluated the effects of diet plus exercise modification [25,32,33], whereas no studies assessed exercise as the sole intervention. In this category, only one study was analyzed [34], which assessed the effects of different types of exercise, although dietary and psychological support were also given to both groups.…”

Section: Interventions Based On Dietmentioning

confidence: 99%

“…Three studies [25,32,33] evaluated the effects of diet plus physical activity interventions on NAFLD. Study characteristics are shown in Table 2.…”

Section: Interventions Based On Diet Plus Physical Activitymentioning

confidence: 99%

“…Dietary interventions were based either on a specific dietary plan by Wang et al [32] or on nutrition modification sessions of Koot et al [25] and Chan et al [33]. Physical activity interventions were based on aerobic exercise sessions, in the studies of Wang et al [32] and Chan et al [33], or on high-intensity aerobic exercise, in the study by Koot et al [25]. In total, 164 children with NAFLD (i.e., 82 in the intervention group and 82 in the control group), aged between 8 to 18-years old participated in these studies.…”

Section: Interventions Based On Diet Plus Physical Activitymentioning

confidence: 99%

“…In total, 164 children with NAFLD (i.e., 82 in the intervention group and 82 in the control group), aged between 8 to 18-years old participated in these studies. Duration of intervention varied between studies, from 1 month [32] to 16 weeks [33] and 6 months [25]. Finally, follow-up measurements were made in two studies [25,33], after 18 months (24 months from baseline) [25] and after 52 weeks (68 weeks from baseline) [33].…”

Section: Interventions Based On Diet Plus Physical Activitymentioning

confidence: 99%

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Effects of Dietary and Lifestyle Interventions on Liver, Clinical and Metabolic Parameters in Children and Adolescents with Non-Alcoholic Fatty Liver Disease: A Systematic Review

et al. 2020

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Non-alcoholic fatty liver disease (NAFLD) affects 5.5–10.3% of children worldwide, while in obese individuals, it increases to almost 34%. Pediatric NAFLD is consistently associated with metabolic syndrome and insulin resistance. As no pharmacological agents exist for the treatment of NAFLD, lifestyle modifications remain the only therapy. However, as not all overweight/obese children have NAFLD, high-quality data, focused exclusively on NAFLD population are needed. Therefore, the present systematic review assessed the efficacy of lifestyle (diet or exercise) based on randomized controlled clinical trials (RCTs) on liver, anthropometric, glucose, and lipid parameters in children, with imaging or biopsy-proven NAFLD. In general, the results were inconclusive and therefore no specific recommendations could be drawn. In most studies, differences were derived from within group comparisons, which are known to be highly misleading. However, both low-carbohydrate and low-fat diets could benefit liver outcomes, as long as weight loss is achieved, but not necessary glucose and lipid parameters. No RCTs were found on exercise alone, as compared to no intervention on pediatric NAFLD. Concerning diet plus exercise interventions, all studies led to improvements in liver outcomes accompanied with weight loss. Resolution of NAFLD was found in considerably high percentages, while improvements were also seen in glucose but were modest in lipid parameters.

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Lifestyle modifications for nonalcohol-related fatty liver disease: a network meta-analysis

Buzzetti

Linden

Best

et al. 2021

Cochrane Database of Systematic Reviews

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Dietitian-led lifestyle modification programme for obese Chinese adolescents with non-alcoholic fatty liver disease: a randomized controlled study

Abstract: A dietitian-led lifestyle modification intervention reduced IHTC, BMI z-score and body fat in obese Chinese adolescents with NAFLD. To sustain the effect of this intervention, regular parental and paediatrician involvement may be important.

Cited by 19 publications

References 26 publications

Sheng‐Jiang Powder Ameliorates High Fat Diet Induced Nonalcoholic Fatty Liver Disease via Inhibiting Activation of Akt/mTOR/S6 Pathway in Rats

Sheng‐Jiang Powder Ameliorates High Fat Diet Induced Nonalcoholic Fatty Liver Disease via Inhibiting Activation of Akt/mTOR/S6 Pathway in Rats

Effects of Dietary and Lifestyle Interventions on Liver, Clinical and Metabolic Parameters in Children and Adolescents with Non-Alcoholic Fatty Liver Disease: A Systematic Review

Lifestyle modifications for nonalcohol-related fatty liver disease: a network meta-analysis

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