Caro-Sabido E A, Larrosa-Haro A
Instituto de Nutrición Humana, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México; Departamento de Salud Pública, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México.
Instituto de Nutrición Humana, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México.
Rev Gastroenterol Mex (Engl Ed). 2019 Apr-Jun;84(2):185-194. doi: 10.1016/j.rgmx.2019.02.001. Epub 2019 May 15.
To identify and discuss the efficacy of dietary interventions, antioxidant supplementation, physical activity, and nutritional and psychologic counseling in the treatment of children and adolescents with non alcoholic fatty liver disease associated with obesity.
A scoping review of studies on nutritional and educational interventions and physical activity in pediatric patients with non alcoholic fatty liver disease was conducted. A search for randomized clinical trials or quasi-experimental studies published up to December 2017 was carried out, utilizing seven databases (Medline, EBSCO, OVID, Science Direct, JSTOR, Wiley, and Biblioteca Digital UDG).
From a total of 751 articles, 729 were excluded due to the criteria of age, design, language, diagnostic method, and outcome variables. The analysis included 22 articles. The most frequently used intervention variables were diet and physical activity. The interventions had different durations, but most were carried out for one year. Some authors employed ascorbic acid, vitamin E, or omega-3 fatty acid supplementation. There were varying degrees of improvement in the variables analyzed in the majority of the studies, such as a decrease in ALT levels, a reduced frequency of steatosis determined through imaging studies, and a decrease in body mass index.
The dietary interventions, omega-3 fatty acid supplementation, physical activity, and nutritional and psychologic counseling were identified as efficacious measures in the treatment of non alcoholic fatty liver disease associated with obesity in children and adolescents, according to biochemical or imaging study indicators, within the time frame of the intervention.
确定并讨论饮食干预、补充抗氧化剂、体育活动以及营养和心理咨询在治疗与肥胖相关的儿童和青少年非酒精性脂肪性肝病中的疗效。
对有关儿童非酒精性脂肪性肝病营养和教育干预及体育活动的研究进行了范围综述。利用七个数据库(Medline、EBSCO、OVID、Science Direct、JSTOR、Wiley和Biblioteca Digital UDG)检索截至2017年12月发表的随机临床试验或准实验研究。
在总共751篇文章中,由于年龄、设计、语言、诊断方法和结果变量等标准,排除了729篇。分析纳入了22篇文章。最常用的干预变量是饮食和体育活动。干预持续时间各不相同,但大多数持续一年。一些作者使用了抗坏血酸、维生素E或补充ω-3脂肪酸。在大多数研究中,所分析的变量有不同程度的改善,如丙氨酸转氨酶(ALT)水平降低、通过影像学研究确定的脂肪变性频率降低以及体重指数下降。
根据生化或影像学研究指标,在干预时间范围内,饮食干预、补充ω-3脂肪酸、体育活动以及营养和心理咨询被确定为治疗儿童和青少年与肥胖相关的非酒精性脂肪性肝病的有效措施。