When I was in medical school, the primary cause of cirrhosis of the liver was alcohol abuse. Over the last 20 years, the obesity epidemic and associated fatty liver disease, NAFLD, has taken over first place. Unfortunately, this is no longer an adult only phenomena akin to type II diabetes mellitus. It is now the most common liver disorder in children. Incidence is now greater than 15%.

What is NAFLD? It is defined as greater than 5% of liver cells having fatty deposition and associated inflammation. Unchecked, this fat deposition will continue in more liver cells causing cell damage and ultimately leads to cirrhosis or liver death. The etiology is believed to be a combination of the Standard American Diet, SAD, and a sedentary lifestyle. Overconsumption of fructose sugar in the form of sweetened beverages and processed foods is the leading contributor to disease.

The inflammation that occurs in the liver destroys the powerhouse of the liver cells known as the mitochondria. As the liver cells become diseased the patient starts to real chronically fatigued and has nonspecific abdominal pain. As the disease progresses the child may experience right upper abdominal pain at the liver edge as well as an increase in liver size.

Obviously, we want to catch this disease well before these symptoms develop. If you or your child suffers from obesity, we highly encourage you to have your liver tested via screening blood test.

Treatment: The simple answer is always the one least well received.

1) Avoid simple refined sugar and flour in all of its forms.

2) Reduce the consumption of fruits especially as juice or smoothies until the liver and your weight are stabilized. Then adding back whole fruit and smoothies is a good idea.

3) Increase daily exercise to 60 minutes. Start slow and work your way up to 60 minutes. Walking as a family is a great start.

4) Minimize screen time as it encourages overeating and sedentary behaviors.

5) Talk to your Doctor about taking vitamin E oil to help protect the liver cells from damage.

Dr. M