Estimation of fish and ω-3 fatty acid intake in pediatric nonalcoholic fatty liver disease

David E. St-Jules, Corilee A. Watters, Elizabeth M. Brunt, Lynne R. Wilkens, Rachel Novotny, Patricia Belt, Joel E. Lavine, Stephanie H. Abrams, Ryan Himes, Rajesh Krisnamurthy, Leanel Maldonado, Beverly Morris, Kimberlee Bernstein, Kim Cecil, Stephanie DeVore, Rohit Kohli, Kathleen Lake, Daniel Podberesky, Crystal Slaughter, Stavra XanthakosGerald Behr, Ali Mencin, Nadia Ovchinsky, Elena Reynoso, Adina Alazraki, Rebecca Cleeton, Saul Karpen, Nicholas Raviele, Miriam Vos, Elizabeth Byam, Oscar W. Cummings, Cynthia Fleming, Ann Klipsch, Jean P. Molleston, Kumar Sandrasegaran, Girish Subbarao, Kimberly Pfeifer, Ann Scheimann, Michael Torbenson, Jeanne M. Clark, Erin Corless, Michele Donithan, Milana Isaacson, Kevin P. May, Laura Miriel, Alice Sternberg, James Tonascia, Aynur Ünalp-Arida, Mark Van Natta, Ivana Vaughn, Laura Wilson, Katherine Yates, Ronen Arnon, Mariel Boyd, Katie Amsden, Mark H. Fishbein, Elizabeth Kirwan, Saeed Mohammad, Ann Quinn, Cynthia Rigsby, Peter F. Whitington, Sarah Barlow, Jose Derdoy, Ajay Jain, Debra King, Pat Osmack, Joan Siegner, Susan Stewart, Dana Romo, Sandra Arroyo, Cynthia Behling, Jennifer Collins, Janis Durelle, Michael Middleton, Kimberly Newton, Melissa Paiz, Jeffrey B. Schwimmer, Claude Sirlin, Patricia Ugalde-Nicalo, Bradley Aouizerat, Linda D. Ferrell, Shannon Fleck, Ryan Gill, Camille Langlois, Emily Rothbaum Perito, Philip Rosenthal, Patrika Tsai, Kara Cooper, Simon Horslen, Evelyn Hsu, Karen Murray, Randolph Otto, Deana Rich, Matthew Yeh, Melissa Young, Kathryn Fowler

Research output: Contribution to journalArticlepeer-review


AIMS:: Fish and ω-3 fatty acids are reported to be beneficial in pediatric nonalcoholic fatty liver disease (NAFLD), but no studies have assessed their relation to histological severity. The objectives of this study were to evaluate the dietary intake of fish and ω-3 fatty acids in children with biopsy-proven NAFLD, and examine their association with serological and histological indicators of disease. METHODS:: This was a cross-sectional analysis of 223 children (6-18 years) who participated in the Treatment of Nonalcoholic Fatty Liver Disease in Children trial or the NAFLD Database study conducted by the Nonalcoholic Steatohepatitis Clinical Research Network. The distribution of fish and ω-3 fatty acid intake was determined from responses to the Block Brief 2000 Food Frequency Questionnaire, and analyzed for associations with serum alanine aminotransferase, histological features of fatty liver disease, and diagnosis of steatohepatitis after adjusting for demographic, anthropometric, and dietary variables. RESULTS:: The minority of subjects consumed the recommended 8 ounces of fish per week (22/223 [10%]) and 200 mg of long-chain ω-3 fatty acids per day (12/223 [5%]). Lack of fish and long-chain ω-3 fatty acid intake was associated with greater portal (P=0.03 and P=0.10, respectively) and lobular inflammation (P=0.09 and P=0.004, respectively) after controlling for potential confounders. CONCLUSIONS:: Fish and ω-3 fatty acid intake was insufficient in children with NAFLD, which may increase susceptibility to hepatic inflammation. Patients with pediatric NAFLD should be encouraged to consume the recommended amount of fish per week.

Original languageEnglish (US)
Pages (from-to)627-633
Number of pages7
JournalJournal of Pediatric Gastroenterology and Nutrition
Issue number5
StatePublished - Nov 2013


  • adolescents
  • fatty acid
  • fish
  • nonalcoholic fatty liver disease
  • ω-3

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Gastroenterology


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