Preventing Fatty Liver Disease in Kids

Michael is a happy, active 11-year old boy with a serious health problem. He has pediatric nonalcoholic fatty liver disease (NAFLD), a condition characterized by an abnormal buildup of fat in liver cells. NAFLD can lead to permanent liver damage and cirrhosis, and it’s the leading cause of liver disease among American adults. Unfortunately, NAFLD also affects millions of kids.

In spite of regular physical activity, Michael carries a lot of extra belly fat on his 4’9”, 149-pound frame. With a body mass index (BMI) of 32.2, he is considered obese. Michael’s weight likely contributed to the development of NAFLD, as it occurs in up to 35% of kids who are obese.

Jeanne Gibian, Pediatric Nurse Practitioner with YRMC Physician Care, works with kids with NAFLD. According to Jeanne, “We are seeing more kids with fatty liver disease, but we are also screening kids for this condition earlier and more frequently. If a child’s weight is over the 95^th percentile, we check blood lipid levels and liver enzymes. If liver enzymes are elevated, we then do an ultrasound as part of the workup to rule out NAFLD. We also screen kids who weigh over the 85^th percentile or who have a family history of hyperlipidemia. These children are at risk of developing NAFLD and preventive screening helps us catch it early.”

Diet and activity are the primary treatments for NAFLD, but adequate sleep and limited screen time are also important. Jeanne states, “I give parents a simple formula for both treatment and prevention – it’s 9-5-2-1-0. Kids should get 9 hours of sleep, eat 5 servings of fruits and vegetables, get no more than 2 hours of screen time (TV and computer), engage in 1 hour of exercise, and drink 0 sweetened beverages each day.”

Sweetened beverages and processed foods containing high fructose corn syrup, table sugar (sucrose), concentrated fruit juice, evaporated cane juice, honey, or other forms of added sugar may be the biggest contributors to NAFLD in kids and adults. Most added sweeteners contain a simple sugar called fructose, which can, when eaten in excess, be packaged as fat and stored in the liver. Natural fructose, found in whole fruit, isn’t problematic, but drinking too much fruit juice (or fruit smoothies) may be.

Excessive amounts of saturated animal fats and cholesterol may also contribute to NAFLD. Typical fast foods, including burgers, chicken nuggets, and pizza are loaded with harmful fats, as are many ‘kid’s meals’ like macaroni and cheese. Reducing the number of times children eat these foods can help reduce their risk of NAFLD.

The sugars in sodas and fruit smoothies turned out to be the main culprits causing Michael’s fatty liver disease. His family began substituting unsweetened, fruity herbal iced teas and homemade flavored waters for smoothies and soda and agreed to eat sweets only on special occasions. These small changes made big a difference in Michael’s health. In six months, Michael’s BMI dropped from 32.2 to 29. He is still considered obese, but is closer to a healthy weight. His liver enzymes also improved and are almost normal. Best of all, Michael and his family are happy with the changes they have made, and what at first seemed impossible is now just part of their everyday routine.

Reducing your family’s intake of added sugars, meat and unhealthy fats can help everyone enjoy better health.

For some healthy beverage ideas and a fun video on cooking a delicious pasta dish at home with your kids, check out the videos below or visit Your Healthy Kitchen.