Researchers looked at 31 studies involving 1,722 young people to find the best ways to treat a condition where fat builds up in the liver. They tested different approaches including diet changes, supplements, medicines, and exercise. The good news: eating less sugar and taking certain supplements helped improve liver health and cholesterol levels. However, scientists say we need more research to figure out the right doses and make sure these treatments are completely safe for kids and teens.

The Quick Take

  • What they studied: Which treatments work best for kids and teenagers with fatty liver disease (a condition where too much fat builds up in the liver)
  • Who participated: 1,722 young people (children and teenagers) from 31 different research studies conducted between 2010 and 2025
  • Key finding: Low-sugar diets and certain supplements (like probiotics) showed the most promise for improving liver health and cholesterol levels in young people with fatty liver disease
  • What it means for you: If a young person has fatty liver disease, eating less sugar and possibly taking certain supplements may help. However, talk to a doctor before making big changes, since we still need more research to know the best amounts and long-term safety

The Research Details

Scientists conducted a ‘meta-analysis,’ which means they gathered and combined results from 31 different research studies that tested various treatments for fatty liver disease in kids and teens. Each of these 31 studies was a randomized controlled trial, which is considered the gold standard in medical research because it randomly assigns people to different treatment groups to make fair comparisons.

The researchers looked at four main types of treatments: changes to diet (like eating less sugar or fat), supplements (like probiotics), medicines, and exercise programs. They carefully reviewed studies published between January 2010 and July 2025, checking each one for quality and bias to make sure the results were trustworthy.

They measured success by looking at blood tests that show liver health (called AST and ALT) and cholesterol levels (triglycerides and LDL). This approach allowed them to combine data from thousands of young people to see which treatments actually worked best.

This research approach is important because fatty liver disease in kids is becoming more common, but doctors aren’t always sure which treatments work best. By combining results from many studies, scientists can see patterns that might not show up in just one study. This gives us stronger evidence about what actually helps.

This meta-analysis is considered high-quality research because: (1) it only included randomized controlled trials, which are the most reliable type of study; (2) researchers checked each study for bias using a standard tool; (3) the study was registered in advance (PROSPERO), which prevents researchers from changing their methods to get better results; (4) it included a large total of 1,722 participants across multiple studies, making the findings more reliable

What the Results Show

The research found that a low-sugar diet showed the strongest benefits. When kids and teens ate less sugar compared to eating their normal diet, their triglyceride levels (a type of fat in the blood) dropped significantly. The improvement was clear and measurable.

When comparing a low-sugar diet to a low-fat diet, the low-sugar approach was better at improving liver health markers (specifically AST levels). This suggests that cutting back on sugar might be more helpful than just cutting back on fat.

Probiotics (helpful bacteria supplements) also showed promise. When young people took probiotics instead of a placebo (fake pill), their LDL cholesterol (the ‘bad’ cholesterol) improved. This is important because high cholesterol often goes along with fatty liver disease.

Other supplements and dietary changes also helped improve liver enzymes and cholesterol levels, though the improvements were smaller than with the low-sugar diet approach.

The research also looked at other liver health markers like ALT and GGT (different enzymes that show liver damage). These also improved with various treatments, though not as dramatically as the main findings. The researchers noted that exercise programs and certain medicines also showed benefits, but there wasn’t enough data to make strong conclusions about these approaches. Importantly, the studies reviewed didn’t report serious side effects from the treatments tested, though the researchers noted that more information about safety is still needed.

This research builds on earlier studies that suggested diet and supplements might help with fatty liver disease. What’s new here is that by combining 31 studies, scientists can now say with more confidence that low-sugar diets appear to be one of the most effective approaches for young people. Previous research in adults suggested similar benefits, so this finding in kids and teens is reassuring and consistent with what we already knew.

The researchers were honest about what we still don’t know: (1) Most studies were relatively short, so we don’t know if benefits last over many years; (2) The studies tested different doses of supplements and different types of diets, making it hard to know the ‘perfect’ approach; (3) There wasn’t enough information about side effects and long-term safety; (4) Some studies were small or had quality issues; (5) The research doesn’t tell us which treatment works best for which individual kid, since everyone is different

The Bottom Line

Based on this research, here are evidence-based suggestions: (1) Reducing sugar intake appears to be the most helpful dietary change (moderate-to-strong evidence); (2) Probiotics may help improve cholesterol levels (moderate evidence); (3) Regular exercise and other dietary changes likely help but need more research (moderate evidence); (4) Always work with a doctor before starting supplements or making major diet changes, especially for young people

This research is most relevant for: kids and teenagers diagnosed with fatty liver disease, their parents and guardians, and their doctors. It’s also important for anyone with a family history of liver disease or obesity. However, these findings don’t apply to people with other types of liver disease (like hepatitis). Always get personalized advice from a healthcare provider before making changes.

Based on the studies reviewed, improvements in liver health markers typically appear within 8-12 weeks of starting treatment. However, some benefits (like weight loss or complete reversal of fatty liver) may take several months. It’s important to be patient and consistent with any changes, and to have regular check-ups with a doctor to monitor progress.

Want to Apply This Research?

  • Track daily sugar intake (in grams) and weekly liver enzyme test results if available. Set a goal to reduce sugar by 25-50% from baseline and monitor changes over 8-12 weeks. Users can log meals and see their sugar totals, making the abstract concept concrete and measurable.
  • Start with one practical change: replace sugary drinks with water or unsweetened beverages. This single change can significantly reduce daily sugar intake. The app could send reminders and track this specific behavior, celebrating weekly milestones to build motivation.
  • Create a monthly check-in system where users log how they’re feeling, energy levels, and any changes they notice. If the user has access to blood test results, they can log these quarterly to see objective improvements in liver enzymes and cholesterol. The app could show trends over time to demonstrate progress.

This research summary is for educational purposes only and should not replace professional medical advice. Fatty liver disease in children and teenagers is a serious condition that requires diagnosis and monitoring by a qualified healthcare provider. Before making any dietary changes, starting supplements, or changing exercise routines, parents and young people should consult with their doctor or a registered dietitian. This summary describes research findings but individual results may vary. Always seek personalized medical advice for your specific situation.