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Should Your Child Be Screened for Fatty Liver Disease?

Children have an uncanny ability to bounce back from a variety of conditions and to buck the odds to achieve, over and over again, a state of good health that adults envy.

Nevertheless, the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition has recommended an NAFLD screening for all children who fall into the category of obese, warning that up to 38% of all obese children may have the condition – and not even know it.

Children’s Health: No Longer a Given

What’s daunting about this recommendation is that, like Type II diabetes, NAFLD is a condition we have traditionally associated with people who have been overweight for decades, not youngsters in the prime of life and peak of activity.

For generations, parents of slightly heavy children have been told by physicians not to worry and to await a growth spurt.

But things are changing, say experts. According to current information, one in six children is overweight in the U.S. today – and up to 38% of obese children and adolescents may have a fatty liver (NAFLD) condition.

What Constitutes “Overweight” (and Obese) in Children?

Children’s bodies – like those of adults – vary greatly, and it can be hard to determine what is some innocent “puppy fat” and what’s dangerous when it comes to a child’s weight.

According to the Centers for Disease Control (CDC), a body mass index (BMI) falling between the 85 and 94th percentile is considered overweight in children; 95th percentile and above is considered obese.

A healthy weight for a child is between the 5th and 84th percentile.

How BMI is Calculated

BMI is calculated for same-age, same-sex children and also depends upon the child’s height (height and weight are the two calculations for an adult BMI).

Though experts argue as to whether the body mass index is an accurate assessment in all cases (for example, dense, heavy muscle will take up less space than fat and is healthier, but will weigh the same), BMI remains, for now, the best way to average a healthy or non-healthy weight for any adult or child.

Technically, BMI is one’s weight in kilograms over his or her height in centimeters, squared. A simplified child’s BMI calculator can be found here.

What a Parent Should Do

If you’re concerned about your child’s weight, do NOT panic in front of her, use the word “fat” (or “big”), or express an excess of concern. Even if well-intended, any of these things ill make her self-conscious and frightened.

Instead, take her to the doctor for a routine checkup. If the doctor is concerned about your child’s weight, talk to the doctor outside of your child’s hearing if possible for recommendations.

If your child is categorized as obese, ask for an NAFLD screening.

Getting a Child’s Weight Under Control

Helping your child with his weight is slightly different than getting your own weight under control. Children are growing, and have different nutritional needs than adults.

With that in mind, calorie restriction isn’t generally the best way to go (unless medically indicated and supervised). Instead, changing the types of foods your child eats, and reducing the number of snacks (while allowing more whole foods at mealtimes), is the right way to help your child maintain his weight while he continues to grow taller.

Ask your child’s physician for a meal plan for your child, and make sure to check in with the doctor regularly on your child’s progress.

If Your Child Has NAFLD

If your child is diagnosed with NAFLD, don’t panic. Your child’s doctor will be able to assess how advanced your child’s NAFLD is and will give you recommendations on how to help.

DO NOT over-restrict your child, put her on a crash diet, or eliminate all “fun” foods. All of these will make her rebound, may encourage her to hide, hoard and stuff food and could make her seriously ill over time. Over-restricting food in children has physical and emotional consequences.

It’s not too late to turn things around for your child. Make it a new household activity to take a walk after dinner. Take your children to the playground and play with them there so you’re all in this together. Kick a ball around; play hockey; throw a frisbee. Invest in bicycles and take everyone for a bike ride several times a week. You’ll all get healthier, and your child won’t feel alone or singled out. In the end, you’ll all benefit.