FATTY LIVER DISEASE IN 8% of LEAN TEENS!
FATTY LIVER DISEASE IN 8% of LEAN TEENS!
Check out this shocking article in Med Page Toady about recent studies demonstrating the incredibly high
rate of fatty liver disease in children, EVEN LEAN CHILDREN! As a reminder, excessive fat accumulation
in the liver can progress to fibrosis and liver cirrhosis, and potentially end-stage liver disease and liver
transplantation.
“While nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in obese
children and adolescents, evidence now suggests it’s under-recognized among patients who are lean and could
be present in upwards of 8% OF THE LEAN PEDIATRIC POPULATION. [“Lean” was defined as a BMI
less than the 85th percentile.]Studies have shown that the prevalence of NAFLD in children and adolescents is highly variable, ranging
from 30% to 70% in obese children.“But there is a recent evolving concept of patients who have normal BMI [body mass index] — they’re not
obese and they’re not overweight — but they have fat in the liver. In other words, lean or non-obese
NAFLD,” said Praveen Selvakumar, MD, a pediatric gastroenterologist at the Cleveland Clinic, who was lead
author of an editorial in the Journal of Pediatric Gastroenterology and Nutrition about NAFLD in lean adolescents.Recent studies in lean adults have suggested a prevalence of 12% to 20% and that rate varies between
different ethnic-genetic populations. This adds to the reasons to look at younger cohorts, but population-
based studies looking at the prevalence of NAFLD in lean adolescents are lacking, he said.Selvakumar noted that not all obese children will develop NAFLD, but in the same spirit, not all lean children
will avert the disease. Generally, it’s more of a diagnosis of exclusion.”The researchers found that those adolescents with NAFLD “had significantly higher indicators of metabolic
syndrome, such as low HDL-cholesterol, hypertriglyceridemia, and insulin resistance, compared with their
lean healthy counterparts. Presence of insulin resistance increased the likelihood of having suspected NAFLD
by four-fold among lean adolescents.”“In lean adolescents with NAFLD, contributing factors are visceral adiposity, a high-carbohydrate diet, a
genetic predisposition, and possibly an unfavorable gut microbiome. To affect change, lifestyle modifications
are key.“Lifestyle modification is the most efficient and consistent with respect to improvement in NAFLD, with
weight loss being the number one strategy,” Selvakumar noted. Generally, 10% less than baseline weight
improves NAFLD.Patients should be advised to reduce or avoid food loaded with carbohydrates at every pediatric wellness visit,
he added. They should also be told to avoid simple sugars, candies, and juices.There are different approaches to dietary changes, including strategies to reduce portions and cut calories, or
to switch to a low-carbohydrate diet or follow the Mediterranean diet, he said. Parents can be directed to
dietitians and nutritionists for help.In addition, exercise — whether it’s aerobic or resistance training — has been shown to decrease liver fat.”
We are ready to help you or your loved ones reduce risks! At Comprehensive Gastrointestinal Health, not
only do we have the knowledge on how to evaluate and care for liver disease, but we have the holistic
approach and comprehensive team to help achieve weight loss goals and improvement in the metabolic risk
factors that cause fatty liver disease. Come visit our gastroenterologist, nurse practitioner, registered dietitian,
behavioral counselor, and licensed physical therapist/fitness consultant to start making meaningful change
and optimizing your liver health. Call 224.407.4400 or visit compgihealth.com to schedule an appointment.