When Stacy Anderson’s teenage son CJ described feelings of dizziness and abdominal pain while eating two years ago, the 43-year-old mother of five suspected that her then 13-year-old son was just experiencing minor indigestion. But when such symptoms became routine and CJ often significantly lacked energy and frequently broke out in cold sweats during dinner, Mrs. Anderson knew something was seriously wrong.
“CJ would have bouts of feeling lethargic, having nausea, cold-sweats, headaches, chest pain and abdominal pain,” the Missouri mother said. “He just had no gumption to do much of anything. It became a daily occurrence, which raised my concern.”
After several blood tests performed by liver specialists at the Cardinal Glennon Children’s Medical Center in St. Louis showed “elevated enzymes” and “fatty infiltration” in CJ’s liver, he was diagnosed with non-alcoholic fatty liver disease (NAFLD), a hazardous accumulation of fat in the liver, which can lead to inflammation, cirrhosis and premature death if left untreated.
But CJ was not alone. He represents a growing trend in the United States that the Center for Disease Control (CDC) is struggling to identify and reverse. CJ is one of approximately 6.5 million children and teens nationwide who have been diagnosed with NAFLD, according to a 2006 study done by the University of California at San Diego.
Currently, initial stages of NAFLD are occurring in 2 to 5 percent of obese and overweight American children age five and older, according to the American Liver Foundation. Such statistics make NAFLD more than three times more widespread in teenagers that Attention Deficit Hyperactive Disorder (ADHD) and Juvenile Diabetes. Children suffering from NAFLD also have greater chances of developing serious heart diseases, according to experts at the American Heart Association.
“A lot of overweight people are starving to death nutritionally,” said Dr. Eugene Charles, a chiropractor and diplomat on the International Board of Applied Kinesiology, who has treated patients with fatty liver disease using milk thistle, a natural detoxifier to cleanse the liver and “restore the endocrine system.”
Obesity, defined by the CDC as having a body mass index (BMI) greater than 30, has been rising significantly in children as data from two National Health and Nutritional Examination Surveys confirm. Both examinations — one taken between 1976 and 1980 and the other between 2003 and 2004 — demonstrate that for children 2 to 5 years old, prevalence in obesity increased from 5.0 percent to 13.9 percent; for those 6-11 years old, from 6.5 percent to 18.8 percent; and for those 12-19 years old, from 5.0 percent to 17.4 percent.
“The rate of obesity is absolutely rising,” said Elyse Weisenfeld-Indelicato, a youth fitness trainer who owns her own gym for teenagers in Commack, N.Y. and a strong advocate for healthy food choices in the Smithtown School district. “Much of it is due to the sedentary lifestyles that many children lead as well as poor nutritional choices. It’s things like that which lead to obesity and cause health complications like fatty liver.”
Pediatric gastroenterologists warn of other serious illnesses that have been known to affect adolescents with NAFLD. Two of the greatest risks are cardiovascular disease and Type II Diabetes, according to Dr. David A. Rudnick, a pediatric gastroenterologist in St. Louis.
Cardiovascular diseases, such as hypertension and coronary heart disease, sit high on the list of consequences of obesity, according to the CDC. Overweight children with NAFLD had significant cardiovascular risks including higher levels of fasting glucose, insulin, total cholesterol and low-density lipoprotein, according to an article published in the Journal of the American Heart Association.
Studies also show that NAFLD is more prevalent in overweight children who have a significant amount of abdominal fat. A study conducted by the Department of Medicine at the University of Illinois on ethnicity and NAFLD in 567 obese patients revealed that aminotransferase levels (the marker for NAFLD) is most common in Hispanics (39 percent), then Caucasians (28 percent), and rarely in African-Americans (12 percent), according to the National Center for Biotechnology Information. The study also revealed that males are more prone to NAFLD than females.
According to experts, the only way NAFLD can be treated and managed is by making healthy lifestyle changes.
“Good diet and exercise are still the only ‘treatments’ we have to offer non-alcoholic fatty liver disease patients,” said Rudnick. “Many other ideas have been tested but none have been proven with benefit.”
A study completed by a team of liver specialists led by Professor Li Liang that was published in the Mar. 14, 2008 edition of the World Journal of Gastroenterology suggested that Vitamin E is effective in managing NAFLD, but only in a small amount of cases.
Most liver specialists and health advocates agree that eating right and exercising regularly are also the only preventative measures that can be taken.
“Rather than waiting until children have health problems, we need to do what we can to make healthy habits a normal part of children’s lives,” said Emily Nuzzo, the educational program coordinator for the American Liver Foundation, whose Illinois chapter is currently part of a new outreach program to educate local public schools on healthy lunches and nutritional choices. “My life’s mission is to increase the fruit and vegetable intake of every individual in the United States.”
Positive changes in nutritional choices and exercising regularly made a huge change in CJ Anderson’s life. He cut sugared drinks out of his diet completely and lost 10 pounds within a week and a half. From this, he regained a significant amount of energy and was inspired to make more changes to his diet.
“At home, our dinners are now more grilled or baked foods rather than breaded or fried with lots of whole grain side dishes and vegetables,” Mrs. Anderson said. “CJ also started taking our family dog for a 15-minute walk each day and we, as a family, joined the YMCA.”
It has been two years since CJ’s diagnosis with NAFLD and the changes he has made have benefited him physically as well as emotionally. Not only has CJ become more conscientious about what he eats, he has also lost several pounds, is able to sustain more energy and has been free from the troubling symptoms caused by NAFLD. There is a general rule of thumb to follow in order to ensure that symptoms do not reoccur and that is consistency in lifestyle choices.
“CJ’s done a great job of being consistent about it,” Mrs. Anderson said.
