Pediatric Nonalcoholic Fatty Liver Disease in 2009

Over the last decade, there has been a growing recognition of NAFLD as pediatric disease. In view of the lack of longitudinal studies describing the natural history of the disease and, particularly, poor diagnostic means of distinguishing benign from progressive forms, it is important to prevent fatty liver in children and attempt to intervene as soon as it is suspected. Promoting physical activity and healthy eating early in the lives of children may decrease the risk of NAFLD. In the early preschool years, parents should be educated to include healthy food choices and active play into the lifestyles of their entire families. Obese children presenting with concurrent metabolic abnormalities merit at the very least an assay of liver enzyme and ultrasound evaluation for fatty liver. Monitoring of liver histology can be worthwhile in extremely obese children with severely impaired metabolism, because they may develop fibrosis and hepatic insufficiency as young adults.