Overweight Kids Risk Liver Damage
June 26, 2000 -- Being fat when you're a kid can do more than
harm your self-esteem. Childhood obesity has now been shown to lead to yet
another disease in children: liver disease. Even more alarming is the finding
that obese teens who drink even modest amounts of alcohol are at even higher
risk for developing chronic liver problems, according to a recent study.
Obese teens are at increased risk for developing a condition
known as nonalcoholic steatohepatitis, in which fat is built up in the liver
and eventually causes scar tissue to form. This scar tissue increases the risk
of developing a severe liver disease, called cirrhosis, in later life.
Obesity is one of the risk factors for this condition. Other
risk factors include diabetes, inadequate protein in the diet, heart disease,
and previous treatment with steroids.
Although more common in adults, nonalcoholic steatohepatitis is
being seen more frequently in children because of the growing number of
children who are either overweight or obese.
In the study from a recent issue of TheJournal of
Pediatrics, Richard S. Strauss, MD, and other researchers found that 8% of
obese adolescents aged 12 to 18 reported modest alcohol intake of at least four
drinks per month. Of these, half had an abnormal liver function test.
Children of normal weight who consumed the same amount of
alcohol showed no such abnormalities in liver functioning. In addition, obese
teens who drank regularly were 10 times more likely to have abnormalities than
obese teens who drank less or not at all. Overall, 92% of these obese teens
regularly drinking were boys.
The interaction between obesity and teen drinking "is
particularly important because adolescent alcohol ingestion may lead to the
rapid development of cirrhosis," write Strauss and colleagues.
Teen-agers, their parents, and pediatricians should be aware of
this risk, talk openly about it, and work to overcome problems with obesity and
teen drinking, says Ronald J. Sokol, MD, in an editorial that accompanied the
Sokol stresses the importance of managing obesity in children,
stressing that it not only causes problems in childhood but may also foreshadow
health problems as adults.
"As a result of this epidemic of childhood obesity, a
multitude of chronic illnesses and risk factors for adult disease are now
starting in childhood rather than in adulthood," he writes, adding that
childhood obesity is associated not only with liver problems, but with gall
bladder disease, type 2 diabetes, high blood pressure, and orthopaedic
A co-author of the study, Sarah E. Barlow, MD, tells WebMD that
weight loss in adolescents is key. "Changes in liver function are probably
common in overweight kids. It's important for parents to know that even if
liver enzyme levels are modestly elevated in their overweight kids, it is most
likely related to the children being overweight. If the children will lose
weight and repeat the liver function tests, they will usually normalize."
Barlow is assistant professor of pediatrics at St. Louis University School of
Medicine, in Missouri.
"Our changing lifestyle, high-fat and fast foods, and
developing computer-based technology with increased reliance on the Internet
will most likely keep this childhood epidemic [obesity] around for a long
time," Sokol writes, "despite current efforts toward improving
nutritional health and raising the activity level of our youth."