For years, parents grew up hearing the same comforting line: “Don’t worry, it’s just baby fat.” And sometimes, that’s true. Kids grow, bodies change, and phases pass. But doctors today are seeing something different. And it’s making them nervous.Extra weight in children isn’t always harmless anymore. In fact, in some kids, it’s quietly damaging an organ most parents never think about, the liver. “Fatty liver has grown to be the most prevalent chronic liver disease in children all over the globe,” says Dr Tushar Madke Consultant in the Department of Transplant Hepatology at Ruby Hall Clinic, Pune.“Fatty liver disease is closely associated with other metabolic obesity diseases. It has now become the hepatic expression of the metabolic syndrome. The fatty liver usually accompanies insulin resistance in children, thereby elevating their susceptibility to type 2 diabetes, dyslipidaemia (abnormal cholesterol levels), and hypertension in children,” the expert adds.Glaucoma: Doctor explains why people with “perfect” sight are often diagnosed with this vision problem
“But my child eats okay”
That’s something doctors hear all the time. Parents aren’t lying. Many kids with fatty liver eat regular home food. They go to school. They play. They’re just a bit heavier than average. But today’s environment makes weight gain easier than ever. Bigger portions. Sugary drinks. Packaged snacks. Screens everywhere. Less outdoor play. So even kids who don’t overeat can slowly gain extra weight without anyone noticing.And the liver doesn’t complain. There’s usually no pain. No warning signs. Sometimes the only clue is a routine blood test or an ultrasound done for another reason.This myth stems from another idea that fatty liver is an adult health issue. Dr Tushar explains why fatty liver is no longer a disease of adults and why parents must be careful about liver health in kids, even though they have a healthy diet. “Children tend to have younger liver inflammation and fibrosis and the liver injury may follow a different pattern which often targets the portal areas of the liver in contrast to the adult pattern. Due to the early onset of the disease, affected children have a high probability of having advanced liver disease, such as cirrhosis, at a significantly earlier age than adults in case it remains undiagnosed and untreated at the initial stages,” he says.
Why parents shouldn’t brush it off
Calling excess weight “baby fat” can feel kind. It sounds reassuring. But sometimes, reassurance delays action. And that delay can cost a child their long-term health.“Research demonstrates that obese children with fatty liver disease are at a high risk of early cardiovascular disease, which can be detected through elevated carotid intima-media thickness and distorted lipid ratios. As a matter of fact, it is cardiovascular disease and not liver failure that is likely to cause a major cause of long-term illness and mortality among people who contract fatty liver disease early in life,” says Dr Tushar. And here’s the hard part. The longer fatty liver sticks around, the harder it is to reverse.
Know your risk factors
Let’s be clear. This isn’t about shaming kids or parents. No child chooses their environment. And most parents are doing the best they can with busy schedules, tight budgets, and tired evenings.Doctors aren’t saying, “You did something wrong.” They’re saying, “Let’s not ignore this.” They are asking you to pay attention to the risk factors.“Overweight and obesity (especially excess abdominal (central) fat) is the most valuable risk factor. Other key risk factors are; a sedentary lifestyle, excessive consumption of foods rich in calories, high consumption of ultra-processed and highly processed foods, sugary drinks, and those containing fructose. Other risk factors are a family history of obesity, type 2 diabetes, or fatty liver disease; genetic predisposition; being a male; changes during puberty; and having some medical conditions, including hypothyroidism, polycystic ovary syndrome (PCOS), and sleep disorders. Higher risk has also been attributed to low birth weight and rapid increase in weight during childhood,” explains Dr Tushar. Weight is a sensitive topic. It’s emotional. And kids pick up on everything. So the goal isn’t strict diets or constant comments about food. That can do more harm than good.
Small changes really do matter
The good news is that fatty liver in children is often reversible, especially when caught early. The liver can heal. It just needs support.“Currently, lifestyle change is the main pillar of prevention and treatment of pediatric fatty liver disease. Liver fat, liver enzyme levels, and inflammation can be greatly reduced by even slight weight loss (5-10 percentages of body weight),” says Dr Tushar.That usually means gradual changes. “A healthy diet high in fruits, vegetables, whole grains, lean proteins, and healthy fats, coupled with the decrease in sugar, refined carbohydrates, and beverages sweetened by sugars has been proven to be especially effective. Physical activity, at least at least 60 minutes moderate to vigorous daily in children, enhances insulin sensitivity and liver health, without any major weight loss. Notably, changes that are based on the family are much more effective than those that are child-oriented,” he recommends.Sleep matters too. So does stress. All of it adds up.And kids don’t need perfection. They need consistency.Medical experts consulted This article includes expert inputs shared with TOI Health by: Dr Tushar Madke, Consultant in the Department of Transplant Hepatology at Ruby Hall Clinic, PuneInputs were used to explain why fatty liver disease is prevalent among children and why parents should pay attention to liver health.
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