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Children and NAFLD

Children have NAFLD markers as a result of obesity

(Credit: Obesity Action Coalition)
Approximately 35 percent of eight-year-olds with obesity had elevated ALT versus 20 percent of those with normal weight

A study by researchers from the Columbia University has shown that weight gain may have a negative impact on liver health in children as young as eight years old. The study found that bigger waist circumference at age three raises the likelihood that by age eight, children will have markers for nonalcoholic fatty liver disease (NAFLD).

The study, ‘Associations of Early to Mid-Childhood Adiposity with Elevated Mid-Childhood Alanine Aminotransferase Levels in the Project Viva Cohort’, published in the Journal of Pediatrics, looked for fatty liver risk factors in younger children.

"With the rise in childhood obesity, we are seeing more kids with nonalcoholic fatty liver disease in our paediatric weight management practice," said Dr Jennifer Woo Baidal, assistant professor of pediatrics at Columbia University Vagelos College of Physicians and Surgeons and lead author of the paper. "Many parents know that obesity can lead to type 2 diabetes and other metabolic conditions, but there is far less awareness that obesity, even in young children, can lead to serious liver disease."

The researchers measured blood levels of a liver enzyme called ALT - elevated ALT is a marker for liver damage and can occur in individuals with nonalcoholic fatty liver disease and other conditions that affect the liver - in 635 children from Project Viva, an ongoing prospective study of women and children in Massachusetts.

By age eight, 23 percent of children in the study had elevated ALT levels. Children with a bigger waist circumference (a measure of abdominal obesity) at age three and those with greater gains in obesity measures between ages three and eight were more likely to have elevated ALT. Approximately 35 percent of eight-year-olds with obesity had elevated ALT versus 20 percent of those with normal weight.

"Some clinicians measure ALT levels in at-risk children starting at around 10 years old, but our findings underscore the importance of acting earlier in a child's life to prevent excess weight gain and subsequent liver inflammation," said Baidal, who is also director of pediatric weight management and a pediatric gastroenterologist in the Center for Adolescent Bariatric Surgery at NewYork-Presbyterian Morgan Stanley Children's Hospital. "Currently, the best way for kids and adults to combat fatty liver disease is to lose weight, by eating fewer processed foods and getting regular exercise. We urgently need better ways to screen, diagnose, prevent, and treat this disease starting in childhood."

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