Nutrition assessment and MASH severity in children using the Healthy Eating Index

Area of Science:

• Pediatric Gastroenterology
• Hepatology
• Nutritional Science

Background:

• Metabolic-associated fatty liver disease (MAFLD) in children is a growing global concern.
• Lifestyle modifications are the primary treatment, yet detailed dietary analysis is often lacking.
• This study investigates the impact of objectively measured diet quality on pediatric MAFLD.

Purpose of the Study:

• To assess the relationship between diet quality, using the Healthy Eating Index (HEI), and MAFLD in children.
• To determine if specific dietary components influence metabolic risk factors and liver histology.
• To highlight the importance of precise dietary assessment in managing pediatric MAFLD.

Main Methods:

• Dietary intake was evaluated using the Nutrition Data System for Research (NDSR) in 119 children across 10 centers.
• The Healthy Eating Index (HEI) score (0-100) and individual food components were determined.
• Children were categorized into low, mid, and high HEI groups based on their diet quality.

Main Results:

• Children with a high HEI (healthier diet) exhibited lower body weight and improved lipid profiles (triglycerides and HDL).
• Reduced intake of added sugars (≤10% of calories) was associated with less severe liver steatosis.
• Higher fat consumption correlated with increased lobular inflammation in the liver.

Conclusions:

• A higher Healthy Eating Index (HEI) in children with MAFLD is associated with reduced body weight and more favorable lipid profiles.
• Dietary components like added sugar and fat intake significantly impact liver histology.
• Objective dietary assessment is crucial for understanding and managing metabolic risk factors and liver injury in pediatric MAFLD.