Combination of the effect of ginger and anti-inflammatory diet on children with obesity with nonalcoholic fatty liver disease: A randomized clinical trial.

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of liver disease in children. Following earlier reports on an increase in the prevalence of childhood obesity, NAFLD is now becoming increasingly common in children. Although no definitive cure exists, early management, early diagnosis, and treatment can reduce its complications. This study aims to determine the effectiveness of the combination of ginger and an anti-inflammatory diet (AID) in children with obesity on fatty liver management. This randomized clinical trial was conducted on 160 children with obesity aged 8-11 years, with a mean (SD) weight of 65.01 (9.67) kg, mean (SD) height of 139.87 (7.37) cm, and mean (SD) body mass index of 33.40 (5.59) kg/m 2 . The study duration was 12 weeks. Children were divided into four groups: ginger (G), AID, ginger plus an AID (GPA), and control. Ginger capsules comprised 1000 mg of ginger, whereas the AID comprised fruits and vegetables, fish, turkey, and chicken (without skin) with lean meat, omega-3 sources, nuts, legumes, probiotic products, and elimination of inflammatory food. Following the intervention, serum fasting blood sugar and high-sensitivity C-reactive protein levels were significantly decreased in the AID ( p  = .006 and .002, respectively), G ( p  = .04 and <.001, respectively), and GPA ( p  <.001 in both cases, respectively) groups. Further, in the G and GPA groups, there was a significant decrease in body mass index ( p  = .04 in both cases, respectively), waist circumference ( p  = .009 and .003, respectively), waist-to-height ratio ( p  = .02 and .005, respectively), alanine aminotransferase ( p  = .004 and <.001, respectively), total cholesterol ( p  = .0002 and .0001, respectively) and low-density lipoprotein-cholesterol ( p  < .001 and <.001, respectively). Eventually, serum aspartate aminotransferase was decreased ( p  < .001) and high-density lipoprotein-cholesterol ( p  = .03) was increased significantly in the GPA group. As a main finding of this study, hepatic steatosis significantly decreased in the G and GPA groups. Ginger supplementation can effectively improve NAFLD in children, and its effectiveness was further increased when combined with an AID.