Nonalcoholic Fatty Liver Disease in Children

What is Non Alcoholic Fatty Liver Disease (NAFLD)

Non Alcoholic Fatty Liver Disease (NAFLD) is defined as fatty infiltration of the liver exceeding 5% to 10% by weight. It is a spectrum of disorders ranging from simple fatty liver (steatosis without liver injury), to Non Alcoholic Steatohepatitis (NASH) (Steatosis with inflammation), and fibrosis/cirrhosis that resembles alcohol-induced liver disease but which develops in individuals who are not alcoholics. In short, NAFLD comprises liver injury in persons in the absence of intake of significant amount of alcohol, where fat deposition in the liver is a major feature and trigger for damage.

NAFLD in both adults and children has been linked to overweight/obesity. With increasing overweight/obesity in children and adults, it appears that NAFLD has reached the level of public health importance. The full spectrum of NAFLD is similar in both adults and children. It is likely that similar to obesity, majority of the NAFLD cases may also have roots in childhood.

Causes of fatty liver in children

Factors responsible for fatty liver in children are diverse and need to be viewed differently from that in older age groups. The growth and development along with continued changes in the body’s metabolic milieu creates a unique scenario in children.

Obesity is said to be the important factor responsible for fatty liver in children. It has been found that 17-40% of obese children in India - in the 8-20 years age group - are now being diagnosed with fatty liver. Faulty lifestyle such as excessive consumption of junk food and less physical exercise are the reasons. For instance, more and more children spend their time indoors and watch TV without active physical activity. It is also said that the disease is more common among boys than girls.

Unbalanced energy intake and genetic predisposition are other factors.

Symptoms of NAFLD in children

NAFLD im most children are asymptomatic. ie. it is usually not associated with symptoms. It is generally diagnosed through medical tests such as ultrasound examination and blood tests.

Prevention of NAFLD in children

Some preventive measures include

• Children should be encouraged to avoid ‘junk’ foods (eg. potato chips). These food items are high in unhealthy fats, salt, and carbohydrates that can increase blood sugar and cholesterol levels. They also contribute towards excess fat pile-up in the body, leading to weight problems.
• Children should be encouraged to eat nutritious food at regular meal timings.
• Children should be prevented from eating while watching television. This sometimes results in over-eating.
• Ensure that children avoid sweetened beverages like soft drinks. Instead fresh fruit juices and pure water are healthier.
• Insist that children set aside time to play active games which will provide them with the much needed exercise. Exhaustive physical movements will help them reduce their body weight.
• Regular health checkups are also required to take stock of the child's health condition.

Related Resource

1. Nonalcoholic Fatty Liver Disease in Children: Epidemiology & Risk Factors
2. Video resources from Children's Liver Foundation