Prior to the turn of the 21st century, only a handful of cases of pediatric fatty liver disease were documented in medical literature. Today the non-alcoholic liver disease affects millions of children and has more than doubled according to data from 2017-2021. Fatty liver disease is now estimated to be about as common as asthma in children.1
Researchers estimate that 5 -10 percent of all children in the United States have nonalcoholic fatty liver disease. Pediatric gastroenterologist at Kentucky Children’s Hospital calls it “the worst disease you’ve never heard of.” Experts say the sharp increase is due somewhat to more diligent reporting and testing but that the trend is unmistakable.
Children of Mexican descent, some Asian subgroups, and impoverished children are affected by fatty liver disease at higher rates. However, the disease is seen in all racial and socioeconomic groups across the nation.1
Adult Diseases on the Rise in Children
Pediatric liver disease is just one of the diseases once seen almost exclusively in adult populations that is escalating among children. Hypertension, high cholesterol, diabetes, and gallstones are plaquing more children in tandem with childhood obesity. Research published in The New England Journal of Medicine estimated that children today are expected to have shorter lifespans than their parents by an estimated 5 to 20 years and some doctors say the declining life expectancy is largely due to diseases related to environmental and behavioral factors, along with the consumption of processed foods.2
“Obesity is such that this generation of children could be the first basically in the history of the Western Civilization to live less healthful and shorter lives than their parents,” said David S. Ludwig, MD, Boston Children’s Hospital obesity program director. “We’re in the quiet before the storm,” he was quoted saying in 2005.3
Blame Put On Processed Foods, Environmental Toxins, Sedentary Lifestyles
The trends of adult diseases affecting children reflect many of the negative influences in society today , including highly processed foods, sedentary lifestyles, and high exposure to environmental toxins.
The liver is the largest solid organ in the body and is perhaps best known for its function to filter toxins. Small amounts of fat are normal in the liver, but if more than five percent of the liver cells contain fat, the liver’s ability to perform its job is impeded. Pediatric specialists have said that some children they have treated far exceed that number with between 30 to 40 percent fat, some even reaching as high as 60 percent fat.1 It is believed that exposure to negative influences, whether through poor nutritional food sources, pharmaceutical products, or toxic environmental exposures, may hinder the liver’s ability to functional optimally.
The Washington Post reports that doctors theorize that, in some individuals, a combination of genetics and exposure to ultra-processed foods that make up the majority of the American diet, triggers hormonal changes and unmanageable stressors on the body that result in chronic illnesses like non-alcoholic fatty liver disease.
“It creates a time bomb, and it is killing our kids,” said Barry Popkin, PhD, professor of nutrition at the University of North Carolina’s Gillings School of Global Public Health.1
Numbers of non-alcoholic fatty liver disease cases are continuing to increase at alarming rates in adult populations as well. In the U.S., cases are estimated to have increased from 83.1 million in 2015 to 100.9 million in 2030.1
Government Health Agencies Heavily Influenced by Big Food
The increase in cases of pediatric fatty liver disease came relatively suddenly, leaving professionals scrambling to better understand it’s etiology and seek a cure. Lifestyle related diseases are on the rise worldwide and many countries are increasing food industry regulations— banning chemicals known to be toxic such as titanium dioxide, food dyes and high fructose corn syrup.
But there has been criticism that the U.S. remains notoriously lackluster in its efforts and some are pointing to the lack of federal regulation of the food industry, alleging that government agencies seem more concerned with protecting corporations than they do with protecting the American people.
Questionable ties between U.S. government health agencies and the processed food industry are as old as the Food and Drug Administration (FDA) itself and have long been a concern for consumer advocate groups and citizens alike.
Just last month, a report revealed that almost half of the members of the Dietary Guidelines Advisory Committee (DGAC) had received financial incentives from processed food companies, big agriculture, weight loss drug companies, and other corporate organizations. This is significant when considering that the DGAC’s guidelines influence nutrition labeling, how foods are formulated, how federal food aid is distributed, and what foods are served in hospitals, schools, and military facilities.4
“The last thing that a food or pharmaceutical company wants to have is a federal agency that says ‘Don’t buy this stuff, don’t buy those products,’” Raskin said. “That could potentially be a mortal threat to companies’ profit stream. So they are extremely attuned and sensitive to that possibility, and lobby in lots of ways to make sure that never happens.”5
Food Industry Funds Science Downplays Harms of Processed Foods
The food industry is also well known for funding scientific studies with predictable outcomes, which benefit their image and bottom line. Coca-Cola spends millions of dollars on scientific research that distracts from or downplays the harms of their products as a sort of public relations move to increase sales. They have been criticized for their funding of this type of science and the lucrative contracts with researchers that allow Coca-Cola to terminate or ask for revisions to any research that does not support the company’s desired findings.5
In 2012, Coca-Cola executive Katie Bayne said, “There is no scientific evidence that connects sugary beverages to obesity.”6
In addition to highly processed foods, some nutrition experts also question the no fat craze that was strongly promoted by government health agencies and physicians for decades. The notion that fat was to be avoided ushered in artificial substitutes to make up for the changes in consistency, taste, or color of the foods the fat was removed from. Studies suggest that this negatively impacted the microbiome.1
Corn Syrup Solids in Baby Formula Linked to Obesity, Fatty Liver
A more recent change in infant formula seems to also be a cause for alarm contributing to pediatric fatty liver disease: the use of corn syrup solids. For several years, the formula industry has been advertising this type of formula as a “sensitive” option for babies who seem to struggle to digest cow’s milk formulas.
Research suggests that infants fed formula made with corn syrup solids developed a “disrupted patterns of eating behavior” that made the babies fussier about food. Researchers found that babies fed the corn syrup formula were at significant increased risk for obesity and, by extension, fatty liver disease, by the age of four. Infants who consumed the most formula with corn syrup solids had the highest risk for becoming obese children.1
Then 1980s trend of adding high fructose corn syrup to foods and soda coincided with the timeline of fatty liver disease influx in the general population.1 Still the FDA has determined that high fructose corn syrup and corn syrup solids—among a plethora of other questionable lab-made ingredients—are “safe” according to the science they choose to use to make their conclusions abut safety.
Tobacco and Food Industry Parallels
It is clear that researchers looking at the links between compromised food sources and fatty liver disease are concerned about these mixed messages, fueled largely by the industries that benefit from them.
The tobacco industry once operated from the same playbook. Companies marketing cigarettes paid scientists to deliver the right research and spent a lot of money to stop government action to label cigarettes as harmful and limit tobacco use. All the while, Big Tobacco manipulated and denied the addictive nature of their tobacco products and marketed to children to create lifelong consumers.
While some may see this comparison as extreme, the fact that there are increasing rates of obesity, fatty liver disease, and other formerly adult diseases in children speaks for itself.
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1 Eunjung Cha A. Fatty liver was a disease of the old. Then kids started getting sicks. The Washington Post Oct. 3, 2023.
2 Olshansky SJ et al., A potential decline in life expectancy in the United States in the 21st century. The New England Journal of Medicine Mar. 17, 2005.
3 Belluck P. Children’s life expectancy being cut short by obesity. The New York Times Mar. 17, 2005.
4 Perkins T. US nutrition panel’s ties to top food giants revealed in new report. The Guardian Oct. 6, 2023.
5 Wetsman N. Coca-Cola funds health research—and can kill the studies it doesn’t like. PopSci May 10, 2019.
6 ABC News. Coke executives answer questions about sugary drinks. June 7, 2012.