This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The rise in childhood obesity in the U.S. has produced concern for its serious related illnesses including type II diabetes, heart disease, high blood pressure and a form of liver disease not related to alcohol consumption, called nonalcoholic fatty liver disease (NAFLD). An elevation in the blood levels of substances (enzymes) produced by the liver indicate a possible risk for NAFLD. Currently, there is no proven therapy for the treatment of NAFLD in children or adults. Treatment of NAFLD can be divided into 1) treatment of underlying risk factors such as obesity; and 2) treatment using agents such as antioxidants that may prevent a chemical process that damages the liver called oxidation. Weight loss is routinely recommended for overweight patients with NAFLD, but there are no clear-cut studies that have tested weight loss as a treatment for NAFLD. Antioxidants such as vitamin E have been used in the treatment of several liver diseases including NAFLD, but not in well-controlled studies. Vitamin E has been shown to decrease elevated liver enzymes in children and adults in small studies. Vitamin E supplementation appears promising for the treatment of NAFLD. Given its low risk, it warrants further evaluation in children. This study will determine whether vitamin E is effective in the treatment of NAFLD, beyond weight loss alone. In this study, overweight children (ages 5-19 y) with elevated liver enzymes will be assigned to one of two groups; one group (n=35) will receive a daily capsule of vitamin E (400 IU/d) and the other (n=35) will receive an identical capsule with no vitamin E for six months, in conjunction with 12 sessions of the Weigh of Life Program for weight reduction.
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