Adolescents with nonalcoholic fatty liver disease (NAFLD) often have emotional and behavioral concerns associated with their disease; evaluation and treatment of these dietary and mental health problems is vital, according to a study published in the Journal of Pediatric Gastroenterology and Nutrition.
Although unhealthy eating behaviors (UEB) and NAFLD have been associated with symptoms of psychopathology, relationships between these variables have not been explored in adolescents presenting for bariatric surgery. Since diet plays a role in the development and persistence of NAFLD, the researchers evaluated the prevalence of UEB, whether these behaviors varied by NAFLD or non-alcoholic steatohepatitis (NASH) disease state, and the association of psychopathology with NAFLD.
In all, 159 adolescents (mean age, 16.4 years; mean body mass index [BMI]53.7kg/mtwo; 73% girls; 62.3% White) self-reported the presence or absence of 10 UEBs before undergoing metabolic and bariatric surgery (MBS). The presence of NAFLD and NASH was assessed by intraoperative liver biopsy. A medical comorbidity index was created to assess the presence of prediabetes/diabetes, dyslipidemia, and elevated blood pressure in participants. Psychopathology was assessed in a subgroup of 98 teenagers who completed the Youth Self-Report: A validated tool used to assess adolescent symptomatology over a 6-month period.
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The researchers found that binge eating disorder symptoms were associated with higher odds of NAFLD, while frequent eating out (eating out for ≥1 meal ≥3 times per week) was associated with lower odds of NAFLD.
Approximately 37% of NAFLD patients had borderline or confirmed NASH. Among those with NAFLD, frequent eating out was associated with higher odds of borderline or confirmed NASH; eating at night was associated with lower odds of NASH.
Patients with a higher number of comorbidities were associated with a higher probability of NAFLD.
This study was limited by a lack of diversity among the patient cohort, which reduced its generalizability. Further studies in more diverse populations should be conducted.
“Overall, it would be beneficial to screen adolescents with severe obesity and NAFLD for frequent eating away from home, night eating, internalizing disorders, and BED, and referring them for supportive care when indicated,” the researchers concluded.
Reference
Ley SL, Zeller MH, Reiter-Purtill J, Kleiner DE, Dixon J, Xanthakos S, for the Teen View Study Group and in collaboration with the Teen-LABS Consortium. Unhealthy eating, psychopathology, and nonalcoholic fatty liver disease in youth presenting for bariatric surgery. JPGN. 2021;73(6):670-676. doi:10.1097/MPG.0000000000003253
This article originally appeared on Gastroenterology Advisor
