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Pediatric Metabolic Dysfunction-associated Steatotic Liver Disease and Food Insecurity

Description

This proposal addresses a critical gap in our understanding of the impact of household food insecurity (FI) on pediatric metabolic dysfunction-associated steatotic liver disease (MASLD) severity. There is evidence that children in families that do not have the ability to provide consistently healthy and high-quality foods, such as fruits and vegetables, have worse diet quality that children in households that are food secure. Additionally, evidence from adult studies link household FI to MASLD and liver fibrosis, and prior research of the PI has shown that exposure to household FI in early childhood was associated with a nearly 4 times increased odds of pediatric MASLD in middle childhood. Possible mechanisms linking household FI to pediatric MASLD include lower intake of fruits and vegetables, higher intake of caloric dense nutrient poor foods (e.g., sugar sweetened beverages), and less diversity of foods. Given consensus recommendations for the management of MASLD focus on lifestyle modification, i.e., diet and exercise to achieve weight loss, this proposal seeks to explore the association of household FI and pediatric MASLD disease severity and whether those effects are mediated by dietary intake. Study participants include children/adolescents with MASLD who are receiving care at UCSF's liver clinic and Weight Management for Teen and Child Health (WATCH) Clinic, a pediatric subspecialty clinic.

Study Overview

Study Details

Study overview

This proposal addresses a critical gap in our understanding of the impact of household food insecurity (FI) on pediatric metabolic dysfunction-associated steatotic liver disease (MASLD) severity. There is evidence that children in families that do not have the ability to provide consistently healthy and high-quality foods, such as fruits and vegetables, have worse diet quality that children in households that are food secure. Additionally, evidence from adult studies link household FI to MASLD and liver fibrosis, and prior research of the PI has shown that exposure to household FI in early childhood was associated with a nearly 4 times increased odds of pediatric MASLD in middle childhood. Possible mechanisms linking household FI to pediatric MASLD include lower intake of fruits and vegetables, higher intake of caloric dense nutrient poor foods (e.g., sugar sweetened beverages), and less diversity of foods. Given consensus recommendations for the management of MASLD focus on lifestyle modification, i.e., diet and exercise to achieve weight loss, this proposal seeks to explore the association of household FI and pediatric MASLD disease severity and whether those effects are mediated by dietary intake. Study participants include children/adolescents with MASLD who are receiving care at UCSF's liver clinic and Weight Management for Teen and Child Health (WATCH) Clinic, a pediatric subspecialty clinic.

Pediatric MASLD and Food Insecurity

Pediatric Metabolic Dysfunction-associated Steatotic Liver Disease and Food Insecurity

Condition
MASLD - Metabolic Dysfunction-Associated Steatotic Liver Disease
Intervention / Treatment

-

Contacts and Locations

San Francisco

University of California, San Francisco, San Francisco, California, United States, 94158

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility Criteria

  • * Children and adolescents receiving care in the liver and WATCH clinics.
  • * Family living in California.
  • * Parent/guardian speaks Spanish or English.
  • * Child is between the ages of 6 to \<17 years.
  • * Elevated ALT on at least 2 occasions within the past year:
  • * ALT \> 22 units/L for females.
  • * ALT \> 26 units/L for males.
  • * BMI for age/sex ≥ 85%.
  • * Alternatively, child has one elevated ALT within the past year and confirmed steatosis on imaging.
  • * Family does not intend to move out of California within the next year.
  • * Family is not already receiving EatSF SF Fruit and Vegetable Vouchers.
  • * Family is not participating in any other dietary education programs besides those offered by the WATCH or liver clinics.
  • * Child has an underlying condition or medication causing their weight gain (e.g., hypothyroidism, Prader-Willi syndrome, antipsychotic medications).
  • * Child is on, or expected to go on, or starts on a weight loss medication (e.g., Qsymia or GLP-1 receptor agonists).
  • * Child has another known cause of liver disease (not including MASLD or MASH), such as:
  • * Autoimmune hepatitis.
  • * Wilson's disease.
  • * Hepatitis A, B, or C.
  • * Acute infection.
  • * Genetic condition causing inflammation in the liver.

Ages Eligible for Study

6 Years to 17 Years

Sexes Eligible for Study

ALL

Accepts Healthy Volunteers

No

Collaborators and Investigators

University of California, San Francisco,

Sarah L Maxwell, MD, PRINCIPAL_INVESTIGATOR, University of California, San Francisco

Study Record Dates

2026-12-30