Within the framework of International Fatty Liver Day (Metabolic Liver Disease), the Spanish Association for the Study of the Liver (AEEH) has warned that the incidence of this metabolic liver disease is increasing among children, when 10 years ago it barely affected them. and 3% of the child population already suffers from it. In Spain, fatty liver begins to occur between 6-8 years of age, reaching its highest level of prevalence between 10-12 years of age, and then improves in adolescence thanks to higher levels of physical exercise.
AEEH experts attribute this to the obesity epidemic, which already affects 30% of children and adolescents in our country and constitutes one of their main risk factors along with a sedentary lifestyle and an inadequate diet. Currently, it is estimated that more than 10 million Spaniards have fatty liver, of which around two million have liver inflammation (steatohepatitis) and about 400,000 have liver cirrhosis.
“The emergence of this disease in children aged 6-8 years is a phenomenon as worrying as it is unprecedented in our country, where the prevalence of fatty liver has always been concentrated between 40 and 80 years of age. The appearance of a prevalence of up to 3% in minors predicts a true emergence of this pathology in adults,” explains Dr. Rocío Aller, scientific secretary of the AEEH.
The president of the AEEH, Manuel Romero, has highlighted the seriousness of the problem and has warned that the numbers will increase exponentially as the consequences of the childhood obesity epidemic become apparent, a trend that is already observed in the United States and that is spreading to other advanced countries in Europe. “If we do not change consumption habits and lifestyles now, and take this issue seriously, obesity and diabetes rates will multiply and, with them, the prevalence of fatty liver,” he continues. .
“It’s hard to say, but we are creating patients, so we have to take measures,” said Romero, who has insisted on the need for a multidisciplinary and multi-institutional approach to address the problem, involving not only Public Health, but also schools, families and the media.
A recent study carried out between British and Finnish researchers also pointed to the increasing sedentary lifestyle among younger people, and pointed out that for every half hour of sedentary behavior greater than 6 hours per day, children had a 15% greater risk of developing severe chronic kidney disease. fatty liver, as well as liver cirrhosis at 24 years of age. However, the same work points to a possible and simple solution, since each additional half hour of light physical activity (LPA) beyond 3 hours a day reduced the risk of severe fatty liver disease by 33%.
Healthy diet and physical exercise can reverse fatty liver
One of the great difficulties of this pathology, as is the case in general with all liver diseases, is its silent nature. Symptoms are nonspecific and do not occur until liver damage is significant. In children, screening tests, although they have improved, are not as reliable as in adults. Diagnosing fatty liver in time, especially in children and young people, is crucial, since a change in diet and increased physical activity can reverse the disease in more than 80% of cases.
Specialists are also concerned about the increase in liver disease related to alcohol consumption. Both diseases, fatty liver and alcoholic liver disease, have surpassed viral hepatitis as the leading causes of cirrhosis, liver cancer, and the need for transplantation.
“The emergence of this disease in children aged 6-8 years is a phenomenon as worrying as it is unprecedented in our country, where the prevalence of fatty liver has always been concentrated between 40 and 80 years of age”
In Spain, one in five people is at risk of suffering from liver disease, which already represents the third cause of premature death and the second cause of years of working life lost, only behind cardiovascular diseases. For this reason, the AEEH proposes a National Plan focused on the prevention and early detection of these diseases, underlining the importance of changing lifestyles and reducing alcohol consumption from an early age, as well as intervening decisively in the prevention of obesity.
To prevent fatty liver, they consider it essential to change lifestyles and behaviors linked to the increase in non-viral liver diseases, as well as establish measures to avoid alcohol consumption at increasingly younger ages and to prevent obesity, which contributes to the progression of fatty liver.
To address sedentary lifestyle, Andrew Agbaje, doctor and professor (teacher) of clinical epidemiology and child health at the University of Eastern Finland who led the aforementioned study, highlights that “The most effective antidote against the devastating effects of childhood sedentary lifestyle in Health is not the much-hyped moderate to vigorous physical activity of 60 minutes a day. Rather, it is the light physical activity of 3 to 4 hours per day that is overlooked. Examples of LPA are outdoor games, playing on the playground, walking the dog, running errands for parents, or walking and biking. “We can encourage children and adolescents to participate daily in light physical activities to improve liver health, thus defusing a sedentary lifestyle, which is a ticking time bomb.”
Furthermore, early detection is key, so it is necessary to screen for liver disease in all people with risk factors such as diabetes, obesity or alcohol abuse, they conclude. “Liver damage is a silent killer disease that requires urgent public health surveillance in the young population,” concludes Agbaje.
