Non-alcoholic fatty liver disease in children: How reducing stress, obesity, and poor diet minimise risk

Non-alcoholic fatty liver disease (NAFLD) in children is often diagnosed late due to non-specific symptoms, typically discovered during routine exams (Image: Canva)

Non-alcoholic fatty liver disease (NAFLD), now called Metabolic Associated Steatotic Liver Disease (MASLD), was once thought to mainly affect adults. However, recent studies show that it’s becoming more common in children too. This condition occurs when excess fat builds up in the liver without alcohol being the cause.

According to a study published in PubMed, MASLD (Metabolic Associated Steatotic Liver Disease) is marked by liver damage due to metabolic dysfunction, inflammation, and fibrosis, which can progress to cirrhosis or hepatocellular carcinoma (HCC). It is often diagnosed late due to non-specific symptoms, typically discovered during routine exams. In children, MASLD can present with features of metabolic syndrome, like obesity, making early diagnosis critical. The term “metabolic” in MASLD may also cause confusion, as it overlaps with inborn errors of metabolism, which are classified separately.

Also read | Fatty liver disease: Here's what you should know to prevent obesity, diabetes, metabolic disorders

NAFLD, or MASLD, occurs when excess fat accumulates in the liver cells, causing inflammation and damage over time. In children, this condition is often linked to obesity, poor dietary habits, and a sedentary lifestyle, says Dr Neelam Mohan, Senior Director and HOD, Department of Gastroenterology, Hepatology, and Liver Transplantation at Medanta The Medicity, Gurugram. She explains, “While NAFLD was once primarily known as a disease in adults, cases in children are on the rise. The data from a recent study highlights the worrying trend that 35.4% of children are affected, with the prevalence being even higher among obese children.”

NAFLD can progress to fibrosis and cirrhosis in children and adolescents. If left untreated, it can lead to end-stage liver disease, eventually requiring a liver transplant. It is important to catch this condition early to prevent long-term complications. With its rising prevalence among the younger population, it’s crucial for parents to be aware of the symptoms, and preventive steps.

Dr Mohan shares the symptoms to watch out for and suggests some preventive tips:

NAFLD often develops gradually, and many children may not show clear signs in its early stages. However, as the condition progresses, certain symptoms may emerge:

Fatigue: Unexplained tiredness or weakness.

Pain: Mild to moderate discomfort in the upper right abdomen.

Enlarged liver: An enlarged liver that can be felt under the ribs.

Jaundice: Yellowing of the skin and eyes in rare cases.

Confusion: Difficulty concentrating due to the liver's impaired ability to detoxify the blood (rare in children).

Also read | Stop excessive fat build-up in liver with these smart lifestyle choices, beat NAFLD

How to prevent NAFLD/ MASLD in children:

Preventing NAFLD in children starts with promoting a healthy lifestyle at home. Dr Mohan emphasises the importance of a balanced diet and regular physical activity to prevent fatty liver disease. She suggests the following tips:

Diet: Parents should focus on limiting sugary foods and drinks like candies, chocolates, and sodas, as well as fast foods rich in unhealthy fats. A diet rich in vegetables, fruits, whole grains, and lean proteins is essential.

Exercise: Encouraging regular physical activity is key. Limiting screen time and promoting outdoor play can help combat sedentary behavior that contributes to obesity.

Monitor growth: Regularly tracking your child’s weight and height and maintaining a growth chart with your pediatrician is an effective way to identify potential issues early. Obesity screening should be a priority, especially for those at risk of fatty liver disease.

Stress free: High stress levels can lead to unhealthy eating habits, such as binge eating, which contributes to obesity. Helping children manage stress through activities like mindfulness or hobbies can support both their mental and physical health.

Disclaimer: This article, including health and fitness advice, only provides generic information. Don’t treat it as a substitute for qualified medical opinion. Always consult a specialist for specific health diagnosis.