Are Our Children Eating Themselves to Poor Liver Health? (Article)

A newly recognized, silent liver disease (hepatitis) is spreading across America among children; it is called NASH or non alcoholic steatohepatitis. While the cause is not fully understood, the injury to these children’s livers seems to be associated with an excess intake of food, calories, and high fructose corn syrup so common in our diets. Yes, these children seem to be literally eating themselves into a seriously poor health. Their excess consumption of food seems to cause the normal red brown healthy liver tissue to be replaced with yellow fatty sick liver tissue. Recent studies estimate that 1 out of every 10 children in the United States, or more than 7 million children, have fatty liver disease, the first step in the progression to the development of NASH and possibly irreversible cirrhosis or scarring of liver. A cirrhotic liver has had the healthy liver cells replaced with scar tissue; a liver that simply cannot keep a child growing and healthy. Unfortunately, once a liver has become cirrhotic, there is no going back to healthy.

Here is what experts are currently thinking is behind this newly recognized liver disease: a major excess intake of certain foods  first triggers the development of a fatty liver, followed by a type of hepatitis called NASH, and finally, for some unfortunate children, cirrhosis. All of this can occur without symptoms. Currently, about 40% of obese children (those with a BMI greater than 30) seem to be afflicted with fatty livers and possibly the more serious NASH or cirrhosis.  Mexican American children seem to be unusually susceptible, while interestingly, African American children seem to be more protected from the disease.

Based on current knowledge, many experts suggest the following:

  • Children who are obese should have blood testing to check their liver function as well as the other related conditions such as diabetes and elevated blood cholesterol.
  • If a child is found to have abnormal liver function tests, weight loss through diet and exercise is imperative.
  • Vitamin E supplement as well as a diet rich in green leafy vegetables seems to help reduce the liver inflammation.
  • Elimination of foods produced with high fructose corn syrup may also help.

If your child struggles with their weight, the emergence of NASH is yet another reason to make some radical life changes for the sake of their health.

Your comments are welcome at  Until next time.

Smo Notes:

1.Wang, Shirley, Fatty Liver: More Prevalent in Children, Wall Street journal, September 9th, 2013

Plate size and calorie intake in children (Article)

Plate and portion size turn out to have a lot to do with how much we eat. We all know that restaurant portion sizes, along with the average adult waist circumference, have gradually increased over the past 25 years. We know that adults tend to eat more when given larger portions of food; is the same true for children? Do children consume more food when presented with larger plates? It turns out that the answer is YES.

A recent study in Pediatrics, the journal of the American Academy of Pediatrics, claims that dishware size influences a child’s self-served portion sizes and food intake, as well as other eating behaviors. The authors gave child-sized dishware to one group of children and adult-sized dishware, the surface area of which was twice as large, to another group of children during their elementary school lunch. The authors found that the children took and consumed more food when using adult-sized dishware.

In light of this research, I recommend that a child’s food be served on small plates or bowls at home and school. I also suggest that parents stop insisting that children “clean their plates” or eat every morsel of food they are served. Experts recommend a daily calorie intake for four to eight year olds of 1200 to 1400, and for nine to thirteen year-olds of 1600-1800.  Dishware size may affect a child’s daily caloric intake.

Eating small portions is a healthy habit, so we should encourage it. Help your child develop good eating habits now for a life-long healthy weight.

I welcome your comments at While you are there, check out the literally hundreds of podcasts, articles and now videos covering a myriad of pediatric and parenting topics. Until next time.

Smo Notes:

Written collaboratively by John Eun and Paul Smolen MD

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