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Effect of a 10-week Weight Loss Camp on Fatty Liver Disease and Insulin Sensitivity in Obese Danish Children

Grønbæk, Henning*; Lange, Aksel; Birkebæk, Niels H.; Holland-Fischer, Peter*; Solvig, Jan; Hørlyck, Arne; Kristensen, Kurt; Rittig, Søren; Vilstrup, Hendrik*

Journal of Pediatric Gastroenterology & Nutrition: February 2012 - Volume 54 - Issue 2 - p 223–228
doi: 10.1097/MPG.0b013e31822cdedf
Original Articles: Hepatology and Nutrition

Background and Objective: Childhood nonalcoholic fatty liver disease (NAFLD) associated with insulin resistance and obesity is a growing problem and increases the risk of cirrhosis, type 2 diabetes mellitus, and cardiovascular complications. We examined the effects of a 10-week “weight loss camp” residency in obese children on the prevalence and degree of NAFLD and insulin sensitivity with 12-month follow-up.

Methods: At the camp, 117 obese white children (body mass index 28.0 ± 3.6 kg/m2, age 12.1 ± 1.3 years) exercised moderately for 1 hour/day and restricted their energy intake to induce weight loss. NAFLD was diagnosed and graded using ultrasound and transaminasemia. Insulin sensitivity and glucose tolerance were assessed using homeostasis model assessment and oral glucose tolerance test. We performed anthropometric measurements and determined body composition using bioimpedance. Data were collected from 71 of 117 children at entry, after the 10 weeks at the camp, and 12 months after the camp ended.

Results: The children showed an average weight loss of 7.1 ± 2.7 kg during the camp. At baseline, 43% had ultrasonographic liver steatosis, 50% elevated transaminases (>25 IU/L), and reduced insulin sensitivity. These abnormalities were mutually related and improved significantly during the camp (P ≤ 0.05). Liver fat improvement was sustained at 12 months. At the 12-month follow-up, 17 of 71 (24%) children maintained the body weight.

Conclusions: This short-term diet and exercise program induced weight loss, markedly improved all aspects of the threatening condition of NAFLD, and reduced insulin sensitivity in childhood obesity; 24% of the children maintained weight loss at least until the 12-month follow-up.

*Department of Medicine V (Hepatology and Gastroenterology)

Department of Pediatrics

Department of Radiology, Aarhus University Hospital, Aarhus, Denmark.

Address correspondence and reprint requests to Henning Grønbæk, MD, PhD, Department of Medicine V (Hepatology and Gastroenterology), Aarhus University Hospital, 44 Noerrebrogade, DK-8000 Aarhus C, Denmark (e-mail: henning.gronbaek@dadlnet.dk).

Received 16 April, 2011

Accepted 5 July, 2011

The present study received financial support from Sygekassernes Helsefond, the Rosalie Petersen Fundation, the Beckett Fundation, Århus Amts Lægekredsforenings Forskningsfond, the NOVO Nordisk Fundation, and Børnefonden.

The authors report no conflicts of interest.

Copyright 2012 by ESPGHAN and NASPGHAN