This liver condition increases the risk of other health problems, including cardiovascular disease, which is the No. 1 cause of death in people who have it. It can cause jaundice, swelling in the legs and abdomen, mental confusion and much more.
NAFLD Has Become a Health Emergency Among Children
STORY AT-A-GLANCE
NAFLD is characterized by excess fat buildup in your liver. Without proper treatment, it can lead to serious liver problems including nonalcoholic steatohepatitis (NASH), which causes inflammation and fibrosis, or scarring of the liver. NAFLD also increases the risk of other health conditions, including cardiovascular disease
The first documented cases of nonalcoholic fatty liver disease (NAFLD) didn’t come about until 1980. Today, NAFLD affects 32.4% of people globally, and it’s the most common cause of liver transplant in adults under the age of 50
NAFLD also affects up to 9.6% of American children aged 2 to 19, making it as common as asthma. In 15- to 19-year-olds, prevalence is as high as 17.3%. Prevalence among children 0 to 17 has risen 168.3% since 2017, with a particularly precipitous rise starting in 2020
The dramatic rise in NAFLD in early 2020 may in part be due to the COVID lockdowns, which had the effect of raising childhood obesity rates by 8.3% to 13.4%, depending on the age group
Maternal obesity and high consumption of diet soda and/or junk food during pregnancy have both been linked to NAFLD in offspring, and one theory is that artificial sweeteners may be programming the metabolism of the fetus to favor fat storage over energy production
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Fatty liver disease used to be a disease seen almost exclusively in the elderly, primarily heavy drinkers. The first documented cases of nonalcoholic fatty liver disease (NAFLD) didn’t come until I was in medical school in 1980.1 At the time, the researchers described it as a "hitherto unnamed liver disease of unknown cause."
In June 2023, scientists proposed rebranding NAFLD to "metabolic dysfunction-associated steatotic liver disease," to highlight its relation to other metabolic conditions such as diabetes. What connects all metabolic conditions is that your body is not converting food to energy in an efficient manner.
In the video above, independent health researcher Jay Feldman investigates the true causes of NAFLD. This is Part 2 of an eight-part series. It’s like a master’s course on NAFLD, as he goes over virtually everything you could possibly want or need to know about it. If you or someone you know is currently struggling with NAFLD, I strongly encourage you to view all eight episodes.
In the featured episode, he explains why fructose is NOT the main culprit as commonly thought, how your liver produces fat from both fructose and dietary fats, and how impaired energy production in your mitochondria results in NAFLD.
What Is NAFLD?
NAFLD is characterized by excess fat buildup in your liver. Without proper treatment, it can lead to serious liver problems including nonalcoholic steatohepatitis (NASH), which causes inflammation and fibrosis, or scarring of the liver.
NASH may lead to cirrhosis, which increases the risk of liver cancer, and end-stage liver disease. NAFLD also increases the risk of other health conditions, including cardiovascular disease, which is the No. 1 cause of death in people with NAFLD. NAFLD often has no symptoms, although it may cause fatigue, jaundice, swelling in the legs and abdomen, mental confusion and more. Your liver carries out more than 500 functions that are essential for health. This includes the production of bile (which breaks down dietary fats and carries away waste), converting excess glucose into glycogen, and regulating amino acids in the blood. It’s also important for detoxification, helping to clear your blood of toxins.
The good news is that your liver, more than almost any other tissue in your body, has phenomenal regeneration capabilities. Even if 90% of it has been removed, it can regrow to its normal size. NAFLD can also be successfully reversed in its early stages via lifestyle changes, like healthy eating and exercising.
NAFLD Prevalence Has Skyrocketed
Today, NAFLD affects 32.4% of people globally,2 and it’s the most common cause of liver transplant in adults under the age of 50.3 NAFLD also affects up to 9.6% of American children aged 2 to 19,4 making it as common as asthma.5 In 15- to 19-year-olds, prevalence is as high as 17.3%.6
What’s particularly strange is that the skyrocketing prevalence in children and teens is quite new. As illustrated in the graph below from Trilliant Health,7 prevalence of NAFLD has risen 168.3% since 2017, with a particularly precipitous rise starting in 2020.
Obesity Is a Primary Risk Factor for NAFLD
As reported in a March 2021 paper on pediatric NAFLD:8
"The largest risk factor for NAFLD is obesity. Obesity and NAFLD in children are often associated; however, they are not concomitant.
In a 2019 study in 408 children with obesity using whole liver magnetic resonance imaging–proton density fat fraction, the prevalence rate of NAFLD was 26.0%, or roughly one in every four children. In the Teen LABS study of adolescents with obesity severe enough to warrant weight loss surgery, the prevalence rate of NAFLD was higher at 59%."
The dramatic rise in NAFLD in early 2020 may in part be due to the COVID lockdowns, which had the effect of raising childhood obesity rates by 8.3% to 13.4%, depending on the age group.9
Artificial Sweeteners May Impair Metabolism
That said, NAFLD also occurs in an estimated 8% of normal weight children.10 Inherited predisposition may be part of the problem. But the environment in utero can also influence a child’s risk of NAFLD,11 and this is a far more likely explanation for the recent explosion in prevalence among children.
Maternal obesity and high consumption of diet soda and/or junk food have both been linked to NAFLD in offspring. Artificial sweeteners may be programming the metabolism of the fetus to favor fat storage over energy production.
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