AIM:To assess nutrition,physical activity and health-ful knowledge in obese children with biopsy-proven nonalcoholic steatohepatitis(NASH or NA)compared to children without liver disease.METHODS:Children with biopsy-proven NASH comprised the NASH group.Age,sex and ethnicity matched control groups consisted of obese(OB)and lean(CO) children with no liver disease.Subjects were adminis-tered the School Physical Activity and Nutrition Survey and one blood draw was obtained.RESULTS:Fifty-seven patients were enrolled with a mean age of 12.1±2.1 years,and all were Hispanic.Even though the OB and NA had a similar increased body mass index(%),35%of the NA group always read nutrition labels compared to none in the OB(P<0.05),and more NA children felt their diet is“less healthy”.NA consumed the least amount of fruits with only 25%having≥1 fruit/d vs 45%in OB and 64.7% in CO(P<0.05 NA vs CO).Only 15%of NA subjects performed light exercise vs 35%and 59%of OB and CO groups,respectively(P=0.02).The mean physical activity score was lowest in the NA group(P<0.05).Amongst the subjects with NASH,we found that 100% of patients with grade 2 or 3 fibrosis had a sedentary score>2 compared to only 63.6%of those with grade 1 or no fibrosis(P<0.05).CONCLUSION:Children with NASH had increased sedentary behavior,decreased activity,and fruit intake.Larger studies may determine the benefit of changing these behaviors as treatment for NASH. AIM: To assess nutrition, physical activity and health-ful knowledge in obese children with biopsy-proven nonalcoholic steatohepatitis (NASH or NA) compared to children without liver disease. METHODS: Children with biopsy-proven NASH was the NASH group. Age, sex and ethnicity matched control groups consisted of obese (OB) and lean (CO) children with no liver disease. Subjects were adminis-tered the School Physical Activity and Nutrition Survey and one blood draw was .RESULTS: Fifty-seven patients were enrolled with a mean age of 12.1 ± 2.1 years, and all were Hispanic. Even though the OB and NA had a similar increased body mass index (%), 35% of the NA group always read nutrition labels compared to none in the OB (P < 0.05), and more NA children felt their diet is “less healthy”. NA consumed the least amount of fruits with only 25% having ≥1 fruit / d vs 45% in OB and 64.7% in CO (P <0.05 NA vs CO) .Only 15% of NA subjects performed light exercise vs 35% and 59% of OB and CO groups, respectively (P = 0.02). The mean physical activity score was lowest in the NA group (P <0.05). Amongst the subjects with NASH, we found that 100% of patients with grade 2 or 3 fibrosis had a sedentary score> 2 compared to only 63.6% of those with grade 1 or no fibrosis (P <0.05) .CONCLUSION: Children with NASH had increased sedentary behavior, decreased activity, and fruit intake. Larger studies may determine the benefit of changing these behaviors as treatment for NASH.