Analysis of Dietary Behavior and Quality in Children and Adolescents with Non-alcoholic Fatty Liver Disease Using the Korean Nutrition Quotient Score.

Purpose: Nutritional intervention is critical in managing pediatric non-alcoholic fatty liver disease (NAFLD). This study assessed eating habits and dietary quality of Korean children and adolescents with NAFLD using the Nutrition Quotient (NQ). Methods: In this prospective multicenter study across seven pediatric centers in Korea, children diagnosed with NAFLD completed the NQ questionnaire. Participants were grouped as mild, moderate, or severe based on hepatic steatosis grade on ultrasonography. Total and subfactor NQ scores were compared among groups. Results: Of 163 participants, 26.4% had mild, 52.8% moderate, and 20.8% severe steatosis. Total NQ scores decreased with steatosis severity (mild 59.3±16.9, moderate 54.2±12.9, severe 52.9±14.2; Conclusion: Children with NAFLD had lower NQ scores than healthy peers reported in previous studies, reflecting poorer dietary quality. Lower moderation and practice scores, along with frequent fast food consumption, were associated with greater hepatic steatosis. These findings underscore the urgent need to improve eating habits through family-based nutritional education and sustained dietary management to mitigate NAFLD progression.