Food Insecurity Linked to Rise of Fatty Liver Disease in Latino Children


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Childhood cases of fatty liver disease have risen over the last decade, prompting researchers to search for answers in risk factors such as genes, birthweight, and malnutrition.

While studies involving adults that have fatty liver disease and liver fibrosis and food insecurity have been conducted, few focused on children — until now.

A recent study assessed the influence food insecurity – living without enough food for a healthy life for all family members – on the development of fatty liver disease in 4-year-old Latino children, and discovered that food-insecure Latino children experienced a higher risk for the disease.

Results of the Fatty Liver Disease Study

The study involved two groups of San Francisco Latino mothers and followed their child’s development from pregnancy into mid-childhood. They measured food insecurity of 136 children at age 4 and tested them annually for the disease between ages 5 and 12.

Source: Pediatric Obesity

Researchers determined that Latino children with fatty liver disease were twice as likely to have lived in food-insecure households when they were age 4 (48.6%), compared to 20.7% of food-insecure children without the disease.

The correlation between the disease and food insecurity is apparent, although less is known about how the two are connected.

Past studies have linked food insecurity with poor-nutrition diets, such as consuming foods with high sugar content, and irregular eating habits, which can have a negative impact on the way the body processes food, according to an accompanying article from the University of California, San Franscico.

“Given our findings and how young patients are presenting with the condition to our liver clinics, we believe screening for MASLD should begin earlier than current guidelines recommend, which is age 9-11 years for children with obesity and age 2-9 years for those with severe obesity,” Sarah Maxwell, MD, and the study’s lead author told the university. “Food insecurity screening is also important early on, especially for Latinx children who are at higher risk and could be connected to healthier food resources in their communities.”

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)

Often referred to as nonalcoholic fatty liver disease (NAFLD), MASLD is one of the most common chronic liver diseases in US children, impacting 5% to 10% of children in the US, according to the study and article.

MASLD is caused by non-alcoholic fat build-up that’s stored in the liver. Symptoms of MASLD are uncommon, rarely revealing the presence of the condition, according to Cleveland Clinic.

While MASLD impacts 25% of the world’s population, only 2% to 5% of people will experience complications, like inflammation that can result in liver damage known as steatohepatitis.

Many diagnosed with MASLD are diagnosed with the progression of steatohepatitis symptoms, which includes pain and swelling in the upper right abdomen.

Advanced steatohepatitis can lead to liver fibrosis, cirrhosis, which can bring on cancer and the need for an organ transplant, and end-stage liver disease.

Genetic, metabolic, and dietary risk factors such as obesity, diabetes, and high cholesterol can play a role in the development of the condition.

The disease is known to affect Latino children and adults more than white or Black Americans and is one of the main conditions associated with adult liver transplants, according to the university.

While symptoms are rare, a MASLD diagnosis can be revealed by a blood panel showing high levels of certain liver enzymes, an enlarged liver appearing on an imaging test, or undergoing a liver biopsy.

To manage the condition and prevent it from advancing, those diagnosed with MASLD can take steps to slow, stop, and reverse liver fat accumulation, such as controlling cholesterol levels, blood pressure, and blood sugar.

This can be done by reducing your body weight, which will reduce fat in your liver, exercising daily, and watching your fat and sugar intake.

However, this becomes difficult for people living with food insecurity.

Latinos and Food Insecurity

Out of the US children suffering from food insecurity in 2022, 13.2% of them come from Latino households — up 3.5% from 2021, according to the University of California, San Franscico.

Food insecurity also impacted 16% of children from Black households, up by 4% from 2021, and 5.5% children from white households, which rose by 2.1% from 2021.

To help low-income families suffering from food insecurity, the government created supplemental nutrition assistance programs like SNAP and WIC.

Of the 41 million Americans who participated in SNAP in 2021, one in five of them are Latino. Latinos also account for 40% of WIC recipients, according to an article published by UnidosUS.

Yet not all families meet the eligibility requirements for SNAP and WIC. Families in need who don’t qualify are forced to feed their families on tight budgets, limiting them to the types of foods they can afford, which tend to be high in sugar and fat, and stretching food resources to the brim.

If you have a poor nutritional diet – on SNAP or WIC or not – you not only have higher risk for fatty liver disease, but also obesity. In turn, obesity can heighten your risk of diabetes, heart disease, and cancer.

Obesity is a particular issue for Latinos.

Severe obesity among preschool-aged children in WIC recently increased, even after a decline occurred several years before when revisions of WIC food packages allotted extra cash for fruits, vegetables, and whole grains while limiting spending on milk, cheese, and juice.

That’s why we need to focus on “nutrition security,” according to Cara Rosenbloom, a registered dietitian and the president of Words to Eat By, in a Washington Post perspective.

“Many health professionals and policymakers think [food insecurity is] an inadequate term. Instead, they say, we should be focused on ‘nutrition security.’ That term emphasizes access, availability and affordability of foods that promote well-being and prevent or treat disease, not just foods that provide calories,” Rosenbloom wrote.

Food Access Where You Live

Where you live can also have an impact on the type of food available.

Some Latinos live in areas where the nearest grocery store can be as far as 10 miles away from where they live. These areas are known as food deserts.

On the other hand, there are areas with high numbers of convenience stores and fast-food restaurants that supply foods high in sugar and fat. These are known as food swamps.

Latinos make up 15% of those living in food desert communities.

Do you know if you live in a food desert or wasteland?

Find out by downloading a Salud America! Health Equity Report Card.

The Health Equity Report Card gives you the inside scoop on how many fast-food restaurants and grocery stores there are per capita and compares them to the rest of your state or the country.

With this information you can figure out a good location to start a food bank or advocate for the expansion of food assistance programs where you live.


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