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It is very important to take care of our liver right from early childhood. There is an exponential rise in the prevalence of fatty liver in the last 5-6 years in developing countries like ours owing to the exposure of our young children to an “obesogenic” environment.
This complex and multidimensional scenario is composed by diverse factors that promote a child’s overall energy imbalance (towards a sustained positive energy balance) such as increased availability (food supply) and overconsumption of low-nutrient, energy-dense foods, modern sedentary lifestyle, higher screen time, among others, leading a state of excess fat deposition in the body and liver in particular.
Studies have shown that 22.4 percent children have fatty liver; 18.9 percent in normal-weight and 45.6 percent in overweight category.
Childhood fatty liver disease is an acquired liver disease characterized by accumulation of fat in the liver in the absence of metabolic or genetic causes or infection. Fatty liver in children is fast becoming the most common liver disease in kids and one of the most common causes of liver transplant in adults.
Fatty liver in children is more severe than in adults, with up to 15 percent of cases diagnosed with advanced stage. Progression of liver disease to advanced fibrosis and cirrhosis can occur during childhood. Children with fatty liver disease have 14 times the risk of progression to severe liver disease or death when compared to children without fatty liver disease.
Among the preventable infections of liver in children, the most important are Hepatitis A and Hepatitis E. Together, Hepatitis A and E infection are the major contributor to the overall childhood liver disease burden. Children usually get hepatitis A and E by eating cooked food in unhygienic conditions or in sewage-contaminated water. This happens especially with in monsoon season and hence cases rise drastically during July- October each year.
After the virus enters the body, there is an incubation period lasting 2 to 7 weeks until illness begins.
1. Lifestyle modifications to improve diet and increase physical activity are recommended from early childhood. Energy restriction is the most effective strategy for avoiding obesity/overweight. Balanced healthy diet consisting of whole cereals, pulses, green leafy vegetables and fresh fruits.
2. Basic principle of all the dietary strategies is higher intake of legumes, cereals as whole grains, fruits and vegetables, moderate to high consumption of fish, low consumption of meat and meat products and moderate consumption of dairy products.
3. Intake of red meat, viscera, refined-grains, and/or sugars should be avoided
4. Avoid excessive intake of processed foods- bakery items, deep fried foods, confectionary items, fast foods, juices, energy drinks Avoid sugar-sweetened beverages.
5. Regular physical activity must be a part of recreation and leisure (play, games, sports or planned exercise), physical education, transportation (wheeling, walking and cycling).
6. Avoid self-administration of complementary and alternate medications.
7. Avoid sedentary lifestyle behaviours. Screen time including smartphone, tablet use, TV viewing, video game playing, computer use must be limited to 2 hours per day.
8. Avoid intake of uncooked (salads, cut fruits) or cooked foods in unhygienic conditions, especially during the rainy season. Promote fluid intake to maintain adequate hydration
9. Seek early medical advice in case of any symptoms of liver disease.