The Centers for Disease Control and Prevention report childhood obesity has more than tripled in the past 30 years. Approximately 30 to 40 percent of children in the United States are classified as overweight and about half of these are in the obese category. This dramatic increase has led to a host of corresponding pediatric health problems ranging from psychological distress, hypertension, type-2 diabetes, degenerative joint problems and liver disease known as non-alcoholic fatty liver disease (NAFLD).
An Alarming Rise
NAFLD is an elevated accumulation of fat in the liver. It is known that abnormally high weight status correlates with higher NAFLD prevalence. In recent years, the division of pediatric gastroenterology and hepatology (the study of the liver) at Maria Fareri Children’s Hospital at Westchester Medical Center has seen a significant and alarming rise in cases of obesity-related, pediatric nonalcoholic fatty liver disease. In fact, NAFLD is by far the most common liver disease in North America.
The exact natural history of pediatric NAFLD is not yet known, however, liver inflammation known as steatohepatitis and fibrosis may result in significant liver injury such as scarring. Rarely, in extreme cases, the liver may be irreversibly damaged and a liver transplant is necessary. Luckily Maria Fareri Children’s Hospital has a pediatric organ transplant program.
The Good News
The good news is that when screening investigations rule out other potential causes of NAFLD or other co-morbid liver disease, it can often be treated with lifestyle changes. In early stages of liver disease, simple intervention with diet and exercise can melt it away – studies have shown that regular aerobic exercise and modest weight control improve liver function. In some cases, medications may be necessary.
No Symptoms
Usually there are no obvious or outward symptoms of chronic liver disease, except in rare advanced cases. Therefore, it is important for parents to be aware of the risk. This is especially true for parents with children who are overweight and members of certain ethnic groups in whom the disease seems to be more prevalent, such as males in some Hispanic populations.
Given the wide-ranging health implications of obesity, parents should collaborate with their child’s pediatricians to address the problem of NAFLD. Clinical experience at Maria Fareri Children’s Hospital has shown that a multi-disciplinary team approach results in the best outcomes, which involves, if necessary, pediatric cardiologists, pediatric endocrinologists, nutritionists, pediatric psychologists, exercise therapists and others. Recognizing the risk is an important first step since NAFLD is a preventable and treatable form of liver disease, particularly in children.
Richard Rosencrantz, M.D., is a pediatric hepatolgist at Maria Fareri Children’s Hospital at Westchester Medical Center. If you would like to learn more about the pediatric hepatology, gastroenterology and organ transplant programs at Maria Fareri Children’s Hospital, please visit www.westchestermedicalcenter.com/mfch.
