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Diet and Exercise in Pediatric Liver Transplant Recipients: Behaviors and Association With Metabolic Syndrome

Objective: The aim of the study is to analyze the impact of physical activity and eating behaviors on precursors of cardiovascular disease—including overweight/obesity, hypertension, low high-density lipoprotein, and impaired glucose tolerance—in pediatric liver transplant (LT) recipients and matched controls. Method: Cross-sectional study of pediatric LT recipients 8 to 30 years, matched to controls from the National Health and Nutrition Examination Survey. Dietary intake assessed with 24-hour recall. Physical activity assessed by standardized questionnaires. LT recipients ≥12 years completed a confidential survey on alcohol consumption. Results: LT recipients (n = 90) were 0.9 to 24.7 years post-transplant. LT recipients and controls were equally likely to consume excess carbohydrates (32% vs 34%) and sugar, per age- and gender-specific recommended dietary intake guidelines. LT recipients spent more hours sedentary or on the computer daily and fewer days each week physically active for >60 minutes than controls. More overweight/obese LT recipients spent 3+ hours at the computer than non-overweight LT recipients (49% vs 27%; P = 0.02). Normal weight LT recipients spent more days doing vigorous activity each week (median 5 days, interquartile range 2–6) than did the overweight/obese LT recipients (median 3 days, interquartile range 2–4; P = 0.01). Among LT recipients, neither dietary intake nor physical activity were consistently associated with measures of hypertension, glucose intolerance, or dyslipidemia. Among LT adolescents and young adults (n = 38), 36% reported ever consuming alcohol; 38% of these reported significant alcohol consumption by frequency or quantity. Conclusions: Additional counseling during routine post-LT care on the importance of physical activity and healthy diet may be useful. However, it is unlikely that these factors alone explain the increased prevalence of metabolic syndrome components in pediatric LT recipients.