P1177 - Management of Pediatric Fatty Liver Disease by Intermittent Fasting – A Pilot Study

Sunday, October 22, 2023

3:30 PM – 7:00 PM PT

Location: Exhibit Hall

Presenting Author(s)

Bhaswati C. Acharyya, MD, DNB (she/her/hers)

AMRI Hospitals
kolkata, West Bengal, India

Bhaswati Acharyya, MD, DNB, Meghdeep Mukhopadhyay, MD
AMRI Hospitals, Kolkata, West Bengal, India

Introduction: Paediatric Fatty Liver Disease (PFLD) is a potentially progressive condition. Fasting for a significant period /day to treat fatty liver is yet to be tested in Paediatric population. We planned the following prospective pilot study incorporating fasting to

1) Find out the feasibility and effect of Intermittent Fasting (IF) in overweight adolescents with fatty liver

2) Compare the results of fasting with the results of dietary and lifestyle changes (DLS) in similar children.

Methods: Consecutive overweight or obese adolescents with fatty liver, attending outpatient of a tertiary centre were randomised into an intermittent fasting (IF) and a diet and lifestyle(DLS) change groups. The DLS group practiced a dietary intake of 1800 calorie, avoiding sweets and fructose rich beverages with a 20 minutes exercise program. The IF Group followed home diet without strict calorie restrictions, same exercises and a 16 hours (9pm at night to 1pm next day) fast every day with one normal Sunday every 15 days. At 3 months all were reassessed physically with blood tests and ultrasound scan by the same radiologist.

Results: A total of 20 nondiabetic children (10 in each group) were studied. Median age was 16.9 years (IQR 16-17.2) and 17.2 years (IQR16.9-17.8) in IF and DLS groups respectively. IF(except 1, left after 1month) group followed the fasting meticulously and did not report any adverse effect. The DLS group’s diet-diary exceeded calories in 17±2.2 days. Limitation of this study were a very small sample, some amount of recall bias and non-inclusion of Fibroscan, MRI or Liver biopsy. (Table 1)

Discussion: This study is the first ever in the world to demonstrate the practicality and productivity of intermittent fasting in adolescents and proved superior to the other measure to manage PFLD

Treatment group	Intermittent Fasting group(IF) N=9		Diet and Life Style group(DLS) N=10		P value
Parameters	Pretreatment Mean±SD	3months after Mean±SD	Pretreatment Mean±SD	3months after Mean±SD	P value
BMI(kg/M²)	27.9+1.2	25.5±1.2	27.8±1.8	26.9±1.8	.000026
SGPT(U/L)	94.1±17.1	58±4.8	94.4±17.1	76.3±8.2	.007163
SGOT(U/L)	88.9±9.2	54±4.8	91.7±8.8	78.2+ 6.3	.000025
Triglyceride(mg/dL)	168.9±18.7	142.2±10.6	177.6±19.7	167.2±20.6	.00007
Cholesterol(mg/dL)	182.8±19.5	162.7±13.1	186.8±15.9	167.1±7.4	.46123
Fasting Insulin (mIU/l)	29.9±5.9	24.6±5.6	29.7±8.9	28.2±8.2	0.0072
Grade of fatty liver in ultrasound	Grade 1: 8(88%) Grade 2: 1(12%)	Reduction of fatty liver by one grade : 9(100%)	Grade 2 : 3((30%) Grade1: 7((70)	Reduction of fatty liver by one grade: 5(50%)	0.0012

Table: Table 1: Baseline and post treatment physical and biochemical parameters of children

Disclosures:

Bhaswati Acharyya indicated no relevant financial relationships.

Meghdeep Mukhopadhyay indicated no relevant financial relationships.

Bhaswati Acharyya, MD, DNB, Meghdeep Mukhopadhyay, MD. P1177 - Management of Pediatric Fatty Liver Disease by Intermittent Fasting – A Pilot Study, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.