Relationship Between Lifelines Diet Score (LLDS) with Severity of Non-Alcoholic Fatty Liver Disease in Children and Adolescents: A Cross-Sectional study

The alarming rise of non-alcoholic fatty liver disease (NAFLD) among children and adolescents highlights the need for further research into its causes and prevention. Emerging research indicates a connection between dietary patterns and NAFLD development. The newly established Lifelines Diet Score (LLDS) provides a thorough evaluation of diet quality, is a valuable instrument for exploring potential associations with NAFLD. A cross-sectional study involving 123 children aged 7-18 years with NAFLD was conducted in Kermanshah, Iran. Dietary information was collected using a food frequency questionnaire (FFQ) to generate the LLDS. Anthropometric measurements, biochemical tests, and liver ultrasounds were performed for each participant. The FIB-4 and HSI were employed to assess fibrosis and hepatic steatosis, respectively. Participants in higher LLDS quartiles exhibited significantly lower triglyceride levels (P = 0.005) and LDL levels (P = 0.024) compared to those in the lower quartiles. Additionally, a significant relationship was perceived between LLDS and FIB-4, indicating a decreasing trend in NAFLD severity with higher LLDS scores (LLDSQ4 vs LLDSQ1: 0.172 ± 0.04 vs 0.204 ± 0.05, P = 0.026). Our outcome suggests that a higher adherence to the LLDS is accompanying with a lower severity of NAFLD as measured by FIB-4 in children and adolescents.