You may have heard of fatty liver and think of it as a disease that only adults with alcoholism get, but did you know it’s one of the fastest growing concerns for our children? The term we use to describe fatty liver in an adult or child that doesn’t heavily consume alcohol is Non Alcoholic Fatty Liver Disease (NAFLD), and 1 in 10 of our children are already suffering from NAFLD.
What you should know about fatty liver (NAFLD):
NAFLD is strongly tied to obesity. The risk rises proportionally to how obese a child is; if your child is obese the likelihood he/she has a fatty liver raises to 34%. A large study recently linked obese children and adolescents with NAFLD. The study shows for the first time that dietary fructose consumption is independently and positively associated with an actively inflamed and damaged liver (NASH). This means that what a parent feeds the child is creating so much stress on the liver that it gets damaged and replaced by inflammatory fat.
Race and ethnicity affect risk. Hispanic children have four times the risk of developing NAFLD compared to their peers. African-American kids are at the lowest risk.
Poor blood sugar control likely plays a role. Insulin resistance is a condition in which insulin becomes less effective at managing sugar levels in the blood glucose after eating or drinking anything that contains sugar. Insulin acts to open the doors of the cells, taking glucose out of the bloodstream and putting it into the cells for energy. When cells don’t respond enough to insulin, blood glucose levels rise increasing risk of diabetes down the road. Insulin resistance also includes an increase in the amount of free fat molecules that are circulating in the blood. NAFLD occurs when some of those fat molecules accumulate inside liver cells.
Sugar (in the form of fructose) is as bad for your liver as alcohol. Fructose is the sugar that makes fruit taste sweet. Eating fructose in its natural state (in the form of unprocessed fruit) is not toxic. But today, manufacturers concentrate fructose from corn, beets, and sugarcane, remove the fiber and nutrients in the process to infuse into every processed food you eat from fast-food to an organic bread. Getting frequent, high doses of fructose throughout the day, without fiber to slow it down, overwhelms the liver and creates fat. The worst offender, High fructose corn syrup, which has 50% fructose. Regular sugar that we use for baking is also 50% fructose.
The liver may become inflamed and scarred. Unfortunately, there may be no outward symptoms that would alert a child that their liver is in trouble. As more fat infiltrates the liver, patients can develop a more serious condition called Non Alcoholic Steatohepatitis, or NASH- which includes scarring and inflammation.
Abdominal pain could be the first sign. A “stomachache” may be the first outward sign of NAFLD in young patients. The pediatrician may also feel an enlarged liver or spleen on physical exam.
If your child shows signs of concern, ask your doctor to do a physical exam and take the following blood tests: Fasting Glucose, Liver Enzymes, Insulin, Uric Acid, HgA1C, CRP-hs.
To protect your children from getting fatty liver consider the single most important intervention – A LOW SUGAR diet consisting of non-processed, prepackaged food.
Science has proven that children with NAFLD who start eating a very low amount of sugar in their diet improve both fat and inflammation in the liver. As medical practitioners, our true ability to shift this unsettling health problem is in educating parents and kids on the dangers of processed and sugar laden meals, snacks and drinks. They are everywhere, and just because they are available to children or sponsored by a children’s organization does not mean they are healthy. Starting at home and extending through the school system and extracurriculars is critical to offer healthy options for our children to eat food for nourishment rather than poison.
What is a low sugar diet
* avoid fruit juices
* opt for fresh berries instead of maple syrup or honey on pancakes/waffles
* avoid cereal in general, try eggs or a protein smoothie for breakfast
* avoid coffee beverages with creams and sweeteners
* avoid sweet teas
* avoid fruit snacks and granola bars
* avoid gatorade-like beverages
* seldom allow ice-cream, cookies, shakes and candies
* avoid sauces such as catsup, bbq and sweet-n-sour
What is a non-processed diet
Foods that come already prepared such as one dish meals or meals with a few packets to add to an ingredient box are processed. These meals contain hidden binders, sugar shelf stabilization and chemicals to keep them fresh. Other processed foods are refined grains such as muffins, bagels, breads, crackers and noodles.
Exercise
The second most important prevention strategy for children’s NAFLD is daily movement. Exercise is an essential element to preventing blood sugar problems and obesity. Less screen time and more activities outside is an easy start.
