You Are Only as Healthy as Your Liver

As the largest internal organ in the body, the liver is a heavy lifter. It removes toxins, maintains healthy blood sugar levels, regulates blood clotting, stores and even makes certain vitamins and minerals, regulates amino acid levels, plays a role in healthy digestion, and more. In fact, it performs more than 500 vital functions in the body, so keeping the liver healthy is crucial for overall health.²

When it comes to liver disease, there’s a long-running misconception that you can only damage the liver by drinking too much alcohol, using drugs, or by taking medications that can harm this vital organ (one reason MASLD goes unrecognized in children), but the reality is that risk factors like obesity, a sedentary lifestyle, and a poor diet wreaks havoc on liver health—and are the main factors contributing to the rise of MASLD in children and adolescents.

MASLD in children is associated with hyperlipidemia (excess fat in the blood), insulin resistance, and obstructive sleep apnea.³ Studies also show that children and young adults with MASLD have significantly higher rates of cancer, liver-related death, and cardio-metabolic mortality.⁴ According to research, “The worldwide prevalence of MASLD in children is a worrying phenomenon because this disease is closely associated with the development of both cirrhosis and cardio-metabolic syndrome in adulthood.”⁵

According to one report, the incidence of NAFLD in children and adolescents (0-17 years) has increased by nearly 170% since 2017.¹

Over the past decade, the incidence of MASLD has increased significantly in children. The percentages of age groups diagnosed with MASLD are as follows: adults (25%), adolescents 15 to 19 years (17%), children 10 to 14 years (11%) and children ages 5 to 9 years (3%).⁶ What’s more, approximately one-third of obese male children and one-quarter of obese female children are estimated to have MASLD.⁷ Race can also determine the risk of MASLD, with Asian-American and Latino children thought to be at a higher risk compared to their white and African-American counterparts.^{8 9} Although the majority of children with MASLD are overweight or obese, there is an increasing subset of children with a normal body mass index with so-called “lean MASLD.”

Research has determined that “The current standard-of-care treatment of MASLD in children is lifestyle change and increased physical activity.” In other words, a better diet and more movement.

Less Screens, More Steps

How can we motivate our kids to get active again? Reduce screen time, for starters. Our “smart” technology has played a huge role in this modern health crisis—in the last decade, an increase in screen time has led to an increase in a sedentary lifestyle and obesity rates among children and adolescents. On average, children ages eight to 12 in the United States spend four to six hours a day watching or using screens from televisions, smartphones, tablets, or computers. Teens spend up to nine hours a day on said devices. While screens can entertain, teach, and keep children occupied, too much use can lead to problems such as sleep issues, weight problems, less time outdoors and a reduction in physical activity.^{10 11 12 13 14}

Yes, it can be challenging, but reducing your child’s screen time opens up room for more play and movement. It may take some encouragement on your part, but even something as simple as a daily family walk goes a long way! A 2023 study found that just 150-minutes of moderate to intense exercise a week significantly reduces liver fat.¹⁵

A New Threat to Children’s Liver Health

PFAS are a group of man-made chemicals known as “forever chemicals” for their ability to persist in the environment. PFAS bioaccumulate in humans where they act as endocrine disrupters and have been linked to a range of health conditions, including impaired immunity, reduced fertility, and several types of cancer, and now MASLD in adolescents can be added to the list. A 2026 study found that higher blood levels of certain PFAS, especially during adolescence, were linked to greater odds of MASLD. PFAS are commonly found in non-stick cookware, carpeting, synthetic fabrics, fast-food packaging, and water. In general, steer clear of products labeled “stain-resistant,” “grease-resistant,” or “water-proof,” and choose filtered water to avoid PFAS.

4 Nutritional Tips to Maximize Your Kids’ Health and Combat MASLD as a Family

1. Raid your pantry and pitch the processed foods. Avoid fast food. Cut out sodas and other sugary drinks. You’ve heard this before: processed foods are just not good for you or your kids, even in moderation. They’re loaded with artificial flavors, colors, additives, and preservatives and are over-processed, stripping the “food” of any nutritional value. They are also a main driver of the development of MASLD.¹⁶ Saying no to drinks with high-fructose corn syrup is particularly important. Fructose induces liver inflammation, promotes insulin resistance, and dyslipidemia—abnormally elevated fats (lipids) in the blood—all of which are linked to the development of fatty liver disease.¹⁷
2. When it comes to prioritizing liver health—and overall health—for the whole family, choose organic. Research has found that higher exposures to certain pesticides are associated with higher rates of MASLD.¹⁸ And conventional produce typically has not one, or even two, pesticide residues, but many. Take for example the strawberry, a favorite among children: One Environmental Working Group (EWG) report found 36 types of pesticides on conventional strawberries.¹⁹ But don’t stop at produce—include a cleanup of your everyday grocery items, too. That’s because studies show that even ultra-low levels of residues of the herbicide glyphosate found in grocery items like cereal, oatmeal, crackers, etc., can increase the risk of developing MASLD.²⁰
3. Eat more organic fruits and veggies and grass-fed, humanely raised meats. Incorporate fruits, such as berries that can reduce inflammation in the liver, leafy greens that contain fiber and nutrients like vitamin K to support liver health, cruciferous veggies like cabbage, broccoli, and cauliflower that can help protect the liver against environmental chemicals, and grass-fed meats and wild-caught fish that contain higher ratios of healthy omega-3s as well as liver-protective, anti-inflammatory, and antioxidant nutrients.^{21 22}
4. Supplement wisely. A multivitamin provides all of the foundational nutrients and is a good idea for any child or adolescent. Supplements that have been specifically researched for MASLD include the omega-3 fats EPA and DHA, ginger, n-acetylcysteine (NAC), and polyphenols including resveratrol, quercetin, and curcumin. The omega-3s have been shown to reduce liver inflammation, increase insulin sensitivity, and decrease triglyceride levels in pediatric MASLD.²³ Ginger supplements were shown to improve liver enzymes and have a beneficial effect on liver function and insulin resistance.²⁴ In a 2024 study, 16 weeks of NAC supplementation (600 mg or 1200 mg/day) was associated with improvements in liver fat and liver stiffness, liver enzyme levels, as well as favorable changes in biomarkers related to inflammation, oxidative stress, and insulin resistance in a small group of children aged 8-18 with obesity and MASLD.²⁵ Polyphenols like resveratrol have also been found to reduce inflammation and oxidative stress in the liver as well as improve liver enzymes.²⁶

It’s up to us as adults to ensure we give our children the foundation they need for a lifetime of good health. With less screen time, more movement, a cleanup of their diet, and a few select supplements, a healthy liver—and a healthy body—are possible.

References

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16. Henney, A. E., Gillespie, C. S., Alam, U., Hydes, T. J., & Cuthbertson, D. J. (2023). Ultra-Processed Food Intake Is Associated with Non-Alcoholic Fatty Liver Disease in Adults: A Systematic Review and Meta-Analysis. 1Nutrients, 115(10), 2266. 1https://doi.org/10.3390/nu15102266
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23. Rahimlou, M., Ahmadnia, H., & Hekmatdoost, A. (2015). Dietary supplements and pediatric non-alcoholic fatty liver disease: Present and the future. World journal of hepatology, 7(25), 2597–2602. https://doi.org/10.4254/wjh.v7.i25.2597 
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