Children today face a unique nutritional challenge: while food is abundant, an increasing number are overweight or obese, leading to a rise in related health conditions like hypertension, type 2 diabetes, and nonalcoholic fatty liver disease (NAFLD). NAFLD has emerged as one of the most prevalent chronic liver diseases in children. With the rise in childhood obesity, pediatric NAFLD is rapidly becoming a significant public health concern. Early research identified NASH in children in the 1980s, and it is now widely recognized as a critical condition tied to insulin resistance and obesity, with boys more often affected than girls.

Children with NAFLD exhibit features like hyperinsulinemia and insulin resistance, which are central to the disease’s development. Unlike adults, children with NAFLD often display different histological patterns in the liver, with less common features like ballooning degeneration of hepatocytes and Mallory bodies. Diagnosis of pediatric NAFLD typically involves liver biopsies, and treatment focuses on lifestyle changes aimed at weight loss and improving metabolic health. As pediatric obesity continues to grow globally, there is an urgent need for better prevention and management strategies for childhood NAFLD, which may require societal changes, including public health initiatives to reduce obesity and improve early-life nutrition.

Reference: Roberts EA. Pediatric nonalcoholic fatty liver disease (NAFLD): a “growing” problem? J Hepatol. 2007 Jun;46(6):1133-42. doi: 10.1016/j.jhep.2007.03.003. Epub 2007 Mar 26. PMID: 17445934.