How to protect your child from fatty liver disease

When someone is obese or overweight, excess fat gets stored in and around vital organs such as the liver.  

According to an article published in the International Journal of Molecular Sciences, non-alcoholic fatty liver disease (NAFLD) is now the most prevalent form of chronic disease, affecting 10 to 20% of the general paediatric population worldwide. It is also predicted that it will become the biggest cause of liver failure and subsequent liver transplants in children in the next decade.

The main reason for the occurrence of this condition in children is the rising numbers of obesity, according to an article published in the paediatric online journal Children. 

Unfortunately, NAFLD remains largely understudied and unrecognised.

How can NAFLD in children be prevented?

While research has shown in the past that obesity in children can lead to non-alcoholic fatty liver disease in later stages of their life, they can contract this disease while they are still young. 

According to a previous Health24 article, studies have shown that the number of cases of NAFLD among US adolescents has doubled since the 1980s. This is mostly linked to the growing incidence of obesity.

According to the most recent statistics, 14.2% of South African primary school children are currently obese. If these rates continue to grow, 3.91 million school children will be overweight or obese by 2025.

The main way to prevent NAFLD in children is to make changes to lifestyle factors that can lead to obesity. Here's what you can do:

1. Curb dependence on unhealthy foods

Fast food is undisputedly linked to childhood obesity. Unfortunately, in a fast-paced world it’s so easy for parents to rely on ready-made meals or junk food to feed their children. The increased caloric intake from unhealthy foods leads to fat being stored around the liver.

According to the Children’s Liver Disease Foundation, it is important to limit the amount of sugar and empty kilojoules your child consumes.

Junk food has minimal nutritional value and is often packed with saturated fat and sodium. Choose home-cooked meals over store-bought ready-made meals and junk food. Encourage your child to eat fresh fruit and vegetables and introduce the following in lunchboxes: 

• Boiled eggs
• Chopped carrots and cucumber, rosa tomatoes with hummus or homemade guacamole
• Fresh fruit
• Ostrich biltong
• Nuts and seed mixes (or bars)
• Wholewheat wraps with lean meat cuts like chicken or turkey

2. Encourage your child to be more active

Physical inactivity among children is a growing problem and is specifically linked to screen time, involving TVs, smartphones and computer games.

Unfortunately inactivity is one of the great contributors to an unhealthy childhood weight, which can ultimately lead to NAFLD.

The solution is less screen time and more physical activity. Encourage your child to take part in at least one extramural activity that requires movement, and introduce family activities such as going for walks. No time to get out? Keep your children active by doing the following:

• Play inexpensive games in the living room or garden – hitting a balloon over a volleyball net can provide hours of fun.
• Play a game of charades which involves a lot of movement.
• Dance together as a family.
• If you are unable to join the gym as a family, there are home workouts for all fitness levels on YouTube.
• Invest in a device that encourages "exergaming" – your children can have fun with video games, but with the added benefit of moving around.

3. Determine whether your child is at risk for prediabetes or type 2 diabetes

Insulin plays a big role in NAFLD. This hormone is important for regulating blood sugar levels. When fat cells get bombarded by too much sugar, they stop responding to insulin and the pancreas creates more insulin. When the liver is bombarded by the excess insulin, it allows more fat into the liver cells, leading to NAFLD.

When children are prediabetic, the increased amount of insulin in the liver can lead to permanent liver damage. It is therefore important to know your child’s diabetes risk by having their blood sugar levels tested, thereby avoiding problems at a later stage.

Controlling blood sugar levels is unfortunately not always enough. According to recent research, doctors are discovering more cases of NAFLD among diabetics with controlled sugar levels, as well as those with prediabetes.

It is therefore important to start reducing your child’s risk of prediabetes and type 2 diabetes from an early age.

How is non-alcoholic fatty liver disease treated?

The best way to prevent the problem of NAFLD for now is the modification of certain lifestyle factors, states Dr Dina Halegoua-Demarzio, director of the Fatty Liver Center at Thomas Jefferson University Hospital in Philadelphia, US. This can be achieved by “avoiding processed carbohydrates, getting regular exercise, and if a patient is obese, losing weight,” she says. 

How will I know if my child has a liver condition?

The Children’s Liver Disease Foundation states that liver disease in children can be diagnosed in the following ways:

• A liver function test or ultrasound, which is usually performed when a child has had abdominal pain for an extended period of time.
• A doctor will feel if the liver or spleen is enlarged.
• Blood is tested for abnormal liver function. 

The following signs and symptoms could also be indicative of liver disease: 

• Bones that break easily and/or bruising
• Pale stools
• Severely itchy skin
• Prolonged loss of appetite
• Lack of normal growth due to malnutrition

Consult your doctor immediately if your child shows any of the above symptoms. Generally it's also recommended that parents monitor their children's weight and enforce healthy habits from an early age. 

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