Children develop their eating habits from a young age. Getty
Children develop their eating habits from a young age. Getty
Children develop their eating habits from a young age. Getty
Children develop their eating habits from a young age. Getty

Fatty liver disease in children: diet and exercise tips to prevent and reverse the condition


Panna Munyal
  • English
  • Arabic

Obesity among children is expanding at an alarming rate, according to the latest statistics released following World Anti-Obesity Day earlier this month. "It is estimated that about 40 per cent of children in the UAE are either overweight or obese, and obesity increases their risk for a host of serious conditions, including high blood pressure, high cholesterol, type 2 diabetes, breathing problems and fatty liver disease," says Dr Sherif El-Refee, a consultant paediatric endocrinologist and diabetologist at Imperial College of London Diabetes Centre. Of these, non-alcoholic fatty liver disease (NAFLD) is on the rise; the prevalence of the disease in the paediatric population is estimated at between three and 12 per cent globally, but this can be as high as 70 to 80 per cent among obese children.

It is estimated that about 40 per cent of children in the UAE are either overweight or obese.

Fortunately, experts say much can be done for both prevention and treatment at home. Dr Sara Suliman, endocrinologist and diabetologist at the Imperial College London Diabetes Centre, says food choice in children is strongly associated with what they eat and are exposed to from a young age. “Parents have more influence on children than doctors. For children to lose weight and reverse the adverse effects of the condition, the whole family needs to make lifestyle and dietary changes.”

How diet plays a role

Victoria Tipper, a nutritionist in Dubai says parents can take the lead by avoiding keeping items such as soft drinks and sweets in the house, but that children must be part of the process, too. "We have to empower children to make their own healthy choices, and promote mindful eating and body wisdom so they are able to get in tune with their body," says Tipper. "This is a powerful educational tool to keep for life and can be done by asking questions such as: 'How did you feel after you had that fizzy drink? Did you have a lot of energy and then feel tired?'

"It is also important to stop using foods to reward children or to help improve their moods or appease them. This teaches them to become emotional eaters, which is not healthy."

Both parents and children must learn to read food labels, Tipper says, because added sugar is believed to be present in 74 per cent of packaged foods. "We all know that cakes, biscuits and sodas are high in sugar, but we can also find it in surprising places such as bread, pasta sauces and flavoured yoghurts, especially low-fat varieties."

Look instead to a Mediterranean diet, which is naturally low in the fruit sugar fructose, and high in healthy fats such as olive oil, nuts and seeds, avocados, fish, fruits and vegetables. Tipper says reducing fructose helps to reduce fat and inflammation in the liver.

A Mediterranean diet contains the B vitamins and other nutrients for healthy liver function. Getty
A Mediterranean diet contains the B vitamins and other nutrients for healthy liver function. Getty

The monosaccharide that is often added to sweeten foods and drinks, is most commonly consumed through sweetened drinks such as sodas, but even naturally sweet fruit juices are high in fructose. “Unlike glucose, fructose is totally metabolised by the liver, so overdosing on foods and drinks high in this sugar puts extra burden on the organ,” she says. Fructose has an addictive effect, making it especially difficult for children and adolescents to remove from their diets. in the past 20 years, the consumption of fructose has increased by 300 per cent.

A colourful plate is essential in providing a variety of nutrients to help support liver function. Think purple beets, orange carrots, yellow peppers and red berries. The liver also needs adequate B vitamins, found in brown rice, wild salmon, leafy greens, beans and lentils and organic chicken, says Tipper. Sulphur is also vital to help the detoxification process, and is found in onions, garlic, shallots, eggs, and cruciferous vegetables such as broccoli, cauliflower, cabbage, kale and Brussel sprouts.

Although it can be hard to ask children to eat lots of fruit and vegetables, Tipper suggests a daily smoothie with apple or berries to sweeten it. The dietary fibre helps the body remove toxins and elongates feelings of satiation, which prevents overeating and weight gain. Fibre can come in the form of chia seeds, flaxseeds, beans and lentils, while fermented foods that contain good bacteria can also support detoxification. This includes homemade kefir, sauerkraut and kimchi. Cooking at home and swapping foods such as table sugar for coconut sugar can make a huge difference, too.

Exercise must be implemented as well

Both aerobic and resistance workouts are beneficial for reducing hepatic fat in children
Both aerobic and resistance workouts are beneficial for reducing hepatic fat in children

Diet aside, Dr Suliman says exercise is a major element in the prevention and management of the potentially chronic condition. "Aerobic or cardiovascular exercises have been shown to lower elevated liver enzyme levels in people with NAFLD," she says. "As such, the best routine for people with the disease involves 30 to 45-minutes of cycling or 90 minutes of brisk walking or jogging, at least three times a week."

Tipper agrees that increasing physical activity is a must, not only for weight loss, but also to sweat out toxins to help cleanse the liver. One form of exercise she recommends for children is trampolining, now widely available with parks across the country. "It's great for liver and lymphatic health, and it's a fun activity that won't feel like a chore." She also suggests that screentime be reduced to no more than two hours a day

Lifestyle hacks

While no medication or supplement has been shown to be of significant value for the management of NAFLD in children yet, some natural lifestyle remedies are vital, says Dr Suliman. Regular exposure to morning sunlight is one easily accessible supplement, she says. “Some studies show that vitamin D deficiency may be related to more severe fatty liver disease. Your body makes vitamin D when you’re in the sun, so try to get as much natural sunlight as possible.” Detox baths using a few spoonfuls of epsom salts, sea salt or apple cider vinegar, also help liver function.

Dhadak 2

Director: Shazia Iqbal

Starring: Siddhant Chaturvedi, Triptii Dimri 

Rating: 1/5

The White Lotus: Season three

Creator: Mike White

Starring: Walton Goggins, Jason Isaacs, Natasha Rothwell

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Infiniti QX80 specs

Engine: twin-turbocharged 3.5-liter V6

Power: 450hp

Torque: 700Nm

Price: From Dh450,000, Autograph model from Dh510,000

Available: Now

War and the virus
The specs

AT4 Ultimate, as tested

Engine: 6.2-litre V8

Power: 420hp

Torque: 623Nm

Transmission: 10-speed automatic

Price: From Dh330,800 (Elevation: Dh236,400; AT4: Dh286,800; Denali: Dh345,800)

On sale: Now

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RESULTS
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Chef Nobu's advice for eating sushi

“One mistake people always make is adding extra wasabi. There is no need for this, because it should already be there between the rice and the fish.
“When eating nigiri, you must dip the fish – not the rice – in soy sauce, otherwise the rice will collapse. Also, don’t use too much soy sauce or it will make you thirsty. For sushi rolls, dip a little of the rice-covered roll lightly in soy sauce and eat in one bite.
“Chopsticks are acceptable, but really, I recommend using your fingers for sushi. Do use chopsticks for sashimi, though.
“The ginger should be eaten separately as a palette cleanser and used to clear the mouth when switching between different pieces of fish.”

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CHATGPT%20ENTERPRISE%20FEATURES
%3Cp%3E%E2%80%A2%20Enterprise-grade%20security%20and%20privacy%3C%2Fp%3E%0A%3Cp%3E%E2%80%A2%20Unlimited%20higher-speed%20GPT-4%20access%20with%20no%20caps%3C%2Fp%3E%0A%3Cp%3E%E2%80%A2%20Longer%20context%20windows%20for%20processing%20longer%20inputs%3C%2Fp%3E%0A%3Cp%3E%E2%80%A2%20Advanced%20data%20analysis%20capabilities%3C%2Fp%3E%0A%3Cp%3E%E2%80%A2%20Customisation%20options%3C%2Fp%3E%0A%3Cp%3E%E2%80%A2%20Shareable%20chat%20templates%20that%20companies%20can%20use%20to%20collaborate%20and%20build%20common%20workflows%3C%2Fp%3E%0A%3Cp%3E%E2%80%A2%20Analytics%20dashboard%20for%20usage%20insights%3C%2Fp%3E%0A%3Cp%3E%E2%80%A2%20Free%20credits%20to%20use%20OpenAI%20APIs%20to%20extend%20OpenAI%20into%20a%20fully-custom%20solution%20for%20enterprises%3C%2Fp%3E%0A
The specs

Engine: 2.0-litre 4cyl turbo

Power: 261hp at 5,500rpm

Torque: 405Nm at 1,750-3,500rpm

Transmission: 9-speed auto

Fuel consumption: 6.9L/100km

On sale: Now

Price: From Dh117,059

Stormy seas

Weather warnings show that Storm Eunice is soon to make landfall. The videographer and I are scrambling to return to the other side of the Channel before it does. As we race to the port of Calais, I see miles of wire fencing topped with barbed wire all around it, a silent ‘Keep Out’ sign for those who, unlike us, aren’t lucky enough to have the right to move freely and safely across borders.

We set sail on a giant ferry whose length dwarfs the dinghies migrants use by nearly a 100 times. Despite the windy rain lashing at the portholes, we arrive safely in Dover; grateful but acutely aware of the miserable conditions the people we’ve left behind are in and of the privilege of choice. 

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TUESDAY'S ORDER OF PLAY

Centre Court

Starting at 2pm:

Elina Svitolina (UKR) [3] v Jennifer Brady (USA)

Anastasia Pavlyuchenkova (RUS) v Belinda Bencic (SUI [4]

Not before 7pm:

Sofia Kenin (USA) [5] v Elena Rybakina (KAZ)

Maria Sakkari (GRE) v Aryna Sabalenka (BLR) [7]

 

Court One

Starting at midday:

Karolina Muchova (CZE) v Katerina Siniakova (CZE)

Kristina Mladenovic (FRA) v Aliaksandra Sasnovich (BLR)

Veronika Kudermetova (RUS) v Dayana Yastermska (UKR)

Petra Martic (CRO) [8] v Su-Wei Hsieh (TPE)

Sorana Cirstea (ROU) v Anett Kontaveit (EST)

SPECS
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What the law says

Micro-retirement is not a recognised concept or employment status under Federal Decree Law No. 33 of 2021 on the Regulation of Labour Relations (as amended) (UAE Labour Law). As such, it reflects a voluntary work-life balance practice, rather than a recognised legal employment category, according to Dilini Loku, senior associate for law firm Gateley Middle East.

“Some companies may offer formal sabbatical policies or career break programmes; however, beyond such arrangements, there is no automatic right or statutory entitlement to extended breaks,” she explains.

“Any leave taken beyond statutory entitlements, such as annual leave, is typically regarded as unpaid leave in accordance with Article 33 of the UAE Labour Law. While employees may legally take unpaid leave, such requests are subject to the employer’s discretion and require approval.”

If an employee resigns to pursue micro-retirement, the employment contract is terminated, and the employer is under no legal obligation to rehire the employee in the future unless specific contractual agreements are in place (such as return-to-work arrangements), which are generally uncommon, Ms Loku adds.

BMW M5 specs

Engine: 4.4-litre twin-turbo V-8 petrol enging with additional electric motor

Power: 727hp

Torque: 1,000Nm

Transmission: 8-speed auto

Fuel consumption: 10.6L/100km

On sale: Now

Price: From Dh650,000

MATCH INFO

Juventus 1 (Dybala 45')

Lazio 3 (Alberto 16', Lulic 73', Cataldi 90 4')

Red card: Rodrigo Bentancur (Juventus)

The Uefa Awards winners

Uefa Men's Player of the Year: Virgil van Dijk (Liverpool)

Uefa Women's Player of the Year: Lucy Bronze (Lyon)

Best players of the 2018/19 Uefa Champions League

Goalkeeper: Alisson (Liverpool)

Defender: Virgil van Dijk (Liverpool)

Midfielder: Frenkie de Jong (Ajax)

Forward: Lionel Messi (Barcelona)

Uefa President's Award: Eric Cantona

Al Jazira's foreign quartet for 2017/18

Romarinho, Brazil

Lassana Diarra, France

Sardor Rashidov, Uzbekistan

Mbark Boussoufa, Morocco

The specs: Lamborghini Aventador SVJ

Price, base: Dh1,731,672

Engine: 6.5-litre V12

Gearbox: Seven-speed automatic

Power: 770hp @ 8,500rpm

Torque: 720Nm @ 6,750rpm

Fuel economy: 19.6L / 100km

Company%20Profile
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What is blockchain?

Blockchain is a form of distributed ledger technology, a digital system in which data is recorded across multiple places at the same time. Unlike traditional databases, DLTs have no central administrator or centralised data storage. They are transparent because the data is visible and, because they are automatically replicated and impossible to be tampered with, they are secure.

The main difference between blockchain and other forms of DLT is the way data is stored as ‘blocks’ – new transactions are added to the existing ‘chain’ of past transactions, hence the name ‘blockchain’. It is impossible to delete or modify information on the chain due to the replication of blocks across various locations.

Blockchain is mostly associated with cryptocurrency Bitcoin. Due to the inability to tamper with transactions, advocates say this makes the currency more secure and safer than traditional systems. It is maintained by a network of people referred to as ‘miners’, who receive rewards for solving complex mathematical equations that enable transactions to go through.

However, one of the major problems that has come to light has been the presence of illicit material buried in the Bitcoin blockchain, linking it to the dark web.

Other blockchain platforms can offer things like smart contracts, which are automatically implemented when specific conditions from all interested parties are reached, cutting the time involved and the risk of mistakes. Another use could be storing medical records, as patients can be confident their information cannot be changed. The technology can also be used in supply chains, voting and has the potential to used for storing property records.

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England Test squad

Ben Stokes (captain), Joe Root, James Anderson, Jonny Bairstow, Stuart Broad, Harry Brook, Zak Crawley, Ben Foakes, Jack Leach, Alex Lees, Craig Overton, Ollie Pope, Matthew Potts

 
UAE currency: the story behind the money in your pockets
Arsenal's pre-season fixtures

Thursday Beat Sydney 2-0 in Sydney

Saturday v Western Sydney Wanderers in Sydney

Wednesday v Bayern Munich in Shanghai

July 22 v Chelsea in Beijing

July 29 v Benfica in London

July 30 v Sevilla in London

Wonka
%3Cp%3E%3Cstrong%3EDirector%3A%3C%2Fstrong%3E%C2%A0Paul%20King%3C%2Fp%3E%0A%3Cp%3E%3Cstrong%3EStarring%3A%C2%A0%3C%2Fstrong%3ETimothee%20Chalamet%2C%20Olivia%20Colman%2C%20Hugh%20Grant%3C%2Fp%3E%0A%3Cp%3E%3Cstrong%3ERating%3A%3C%2Fstrong%3E%202%2F5%3C%2Fp%3E%0A