A systematic review on Factors Associated with Non-Alcoholic Fatty Liver Disease (NAFLD) among Adolescents

Dr Vishnu Raj, a third-year Doctor of Public Health student under the supervision of Prof Hazreen Abd Majid, Dr Maslinor Ismail, and Prof Chan Wah Keong from the Department of Gastroenterology, Universiti Malaya Medical Centre has published his first peer-reviewed paper titled A Systematic Review on Factors Associated with Non-Alcoholic Fatty Liver Disease (NAFLD) among Adolescents in Clinical Nutrition ESPEN.

Non-Alcoholic Fatty Liver Disease (NAFLD) is a global public health risk. Adolescent NAFLD coincides with high rates of overweight and obesity, with an unhealthy lifestyle also playing a role. Data on prevalence and factors contributing to NAFLD among Asian adolescents is lacking as most studies focus on adults. This systematic review aims to determine the prevalence and factors contributing to NAFLD among adolescents.

The study found six studies, and most were of high quality, with the majority reporting no association between lifestyle factors and NAFLD. The prevalence of NAFLD among adolescents varied between 8.0 % (Fraser et al., 2007) in a study on 5586 adolescents aged 12–19 and 16.0% (Chen et al.,2009) in another survey of 1,724 adolescents aged 12–13. Snacking habits and lack of physical activity had potential associations with adolescent NAFLD. Current evidence shows that lifestyle factor (Western dietary pattern) is associated with a higher risk of developing NAFLD among adolescents. Lifestyle factors, including snacking habits and lack of physical activity, were associated with a higher risk of developing NAFLD among adolescents from high-income countries. The difference in the prevalence of NAFLD between countries with different incomes requires further investigation.

Recommendation and Rationale of the Study

This study will be significant in providing information for researchers, guideline developers, and policy-makers about the burden of NAFLD among adolescents globally, thereby supporting the identification of priorities in healthcare towards the prevention of NAFLD. In addition, this study would give rise to the critical evidence to support policy-making decisions in designing and creating much more effective exercise programs and nutritional interventions for obesity and NAFLD.

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