Management of Paediatric Fatty Liver Disease by Intermittent Fasting – a Pilot study

Background and Objectives: Paediatric Fatty Liver Disease (PFLD) is a potentially progressive condition presently the leading cause of paediatric chronic liver disease in developed country. A diet lifestyle change(DLS) mainstay management but long term-compliance always questionable. Fasting for significant period /day to treat metabolic syndromes got popular since Yoshinori Ohsumi won Nobel his research on Autophagy. This yet be tested population. We implemented fasting few adolescents with obesity fatty 1) Find out effect Intermittent (IF) obese liver2) Compare effects results dietary changes (DLS) without similar group Methods: retrospective chart analysis two groups consecutive attending outpatient tertiary centre from May 2020 July was done after institutional ethical approval. Wilson’s Disease, Hepatitis B&C, Coeliac Autoimmune hepatitis Drug induced Hepatopathy were excluded all. Height, weight, BMI, LFT, FBS &PPBS, CBC, Lipid profiles, Thyroid Function grades ultrasound recorded. The Diet Life Style practiced intake 1800 calorie, avoiding sweets fructose rich beverages 20 minutes exercise. IF Group followed home strict calorie restrictions, same exercises 16 hours (9pm at night 1pm next day) fast every day one normal Sunday 15 days. started 14 gradually built-up 2 weeks. Parents kept diary food, exercise time fasting. Children up week 1st month, then weeks by online consultation. At 3 months all reassessed physically blood tests scan radiologist. Results compared between student’s t test (with P value <0.05 as significant) Results: Eleven nondiabetic children BMI >97th centile (8 boys; 5 6 DLF group) studied. Median age 16.9 years (IQR 1.15) 17 1.3) DLS respectively. In 4(80%) had grade 1fatty liver; 3(50%) rest (50%) 1 liver. meticulously did not report any adverse effect. component like their diet-diary exceeded calories incorporation fried carbohydrates 17±2.2 SGPT, SGOT, Triglyceride levels reduced significantly (Table 1). Ultrasonography showed reduction patients (100%) only group. Limitation this study very small sample, some amount recall bias non-inclusion Fibroscan, MRI or biopsy. However observational documented better efficacy measures PFLD Conclusion• first ever world demonstrate practicality productivity intermittent adolescents.• It paved pathway larger prospective randomised evaluate Obesity Disease.• may prove superior other measure manage near future.Table 1Baseline post treatment physical biochemical parameters children.TreatmentGroupIntermittent group(IF)N=5Diet group(DLS)N=6P valueParametersPretreatmentMean±SD3months afterMean±SDPretreatmentMean±SD3months afterMean±SDBMI27.84±0.7725.61±0.6227.78±1.926.78±1.81.000026SGPT104±17.1158.8±4.2103.7±15.680.2±7.1.007163SGOT94.8±5.4552.8±4.697.8±4.581.7±4.3.000025Triglyceride177±19.7141.2±11.8189.3±16181±13.4.00007Cholesterol196.8±14.9171±6.9196.3±12.9171.2±5.9.46123Grade ultrasoundGrade 1: 4(80%)Grade 2: 1(20%)Reduction grade: 5(100%)Grade 2(33%)Grade 4(67%)Reduction 3(50%)0.0012BMI, body mass index; DLS, changes; SD, standard deviation. Open table new tab