Recommended levels of activity rarely achieved by obese children and those with liver disease

These children are also significantly far off meeting the recommended physical activity levels for children, which currently is 60 minutes five times a week. The findings further showed that excess weight is unlikely to be the only driving factor in NAFLD development with genetic susceptibility and ethnicity also likely to be implicated.

The team compared the habitual diet and behaviour patterns of 24 children in the UK with NAFLD with obese children who do not have liver disease. Using a short questionnaire and pedometers the results showed that:

•Children with liver disease were significantly more likely to be restrained eaters, suggesting that their diagnosis may have impacted on their eating behaviours

•Children with liver disease took more steps per day

•Sedentary behaviours were particularly prevalent at the weekend across both groups highlighting the important contribution of school-related active travel and in-school activity to this age group

"Rather than make new recommendations for obese children with NAFLD, our findings indicate that concerted efforts should be made to help children improve their current diet and activity patterns to achieve existing population guidelines," said lead author Dr Bernadette Moore from the University of Surrey.

"It also appears that the diagnosis of liver disease changes children's behaviours to a degree. Our study showed that children with NAFLD exhibited more restrained eating behaviours and were more likely to engage in exercise than obese children without liver disease."

Alison Taylor, Chief Executive of the Children's Liver Disease Foundation, added: "We have been delighted to fund this study which is the first to compare nutrient intake, eating behaviours and physical activity of children with NAFLD to obese children who do not have liver disease. The results make interesting reading and take us a step forward in our understanding of this condition."

NAFLD is a major public health challenge. It is currently the most common form of chronic livers disease in in children and adolescents in western countries, with prevalence rising alongside rates of childhood obesity. Caused by a build-up of fat in the liver cells, the condition is strongly linked to obesity and type 2 diabetes