Kids with nonalcoholic steatohepatitis (NASH) have a buildup of fat in the liver. The liver is also inflamed (swollen). Over time, NASH can lead to scarring of the liver (fibrosis) and liver failure. Losing weight through healthy diet choices and regular exercise can help kids with NASH get better.

Work with your health care team and child to come up with a weight management plan. This works best if the whole family supports the plan.

Some helpful tips for healthy eating:

• Prepare meals at home when possible. Limit trips to restaurants and fast-food places.
• Eat together as a family as often as possible.
• Offer nutritious meals and snacks. Try to avoid processed foods such as cakes, chips, and sweetened breakfast cereals.
• Help your child understand portion sizes. If you aren't sure what portion sizes are right for your child, talk to your care team. Teach your child to read food labels so they can limit sugar, salt, cholesterol (found in meat, eggs, whole milk, butter, and cheese), and saturated fats (found in meat, butter, shortening, lard, cheese, and whole milk).
• Teach your child to avoid trans fats (found in baked goods, fried foods, stick margarines, and shortening).
• Serve whole grains, fruits, vegetables, beans, and some healthy fats, like those in olive oil and nuts. Encourage your child to eat 5 servings of fruits and vegetables every day.
• Don't give your child soda, sugary drinks, or juice.

Other Healthy Habits

• Help your child to be physically active for at least 1 hour every day.
• Make family rules about screen time. Don't let screen time get in the way of being active, getting enough sleep, and connecting with family and friends.
• Kids who get enough sleep are less likely to be overweight. Help your child get enough sleep:
  • Kids 6–12 years old need 9–12 hours of sleep a night.
  • Teens need 8–10 hours of sleep a night.
• If your child or anyone else at home smokes, go to smokefree.gov or call 1-800-QUIT-NOW (1-800-784-8669) to get help quitting.
• Give any prescribed medicines or vitamins as directed by the care team. Do not give any other medicines without checking with the care team first.
• Be sure your child gets all immunizations as recommended by the care team.
• Go to all regular follow-up visits with your care team. This way, they can check your child's weight and liver regularly.

Your child:

• is unwilling to make changes in their diet and exercise routine
• is thirstier, drinks more, and is peeing more often than usual
• snores
• has very low energy
• seems sad or not interested in doing things they used to enjoy

What causes NASH? Doctors and scientists think that NASH usually comes from being overweight. People who have diabetes also are more likely to get NASH, and it can run in families.

How do health care providers diagnose NASH? If a child is overweight, health care providers usually do blood tests. Sometimes, they'll order a liver biopsy (taking a tiny sample of the liver for testing in a lab) or imaging tests (such as an ultrasound, CT, or MRI).

Do kids with NASH have symptoms? Most kids with NASH don't have any symptoms. But sometimes NASH can cause low energy or belly pain.

Can NASH lead to other problems? Some people with NASH develop liver scarring (called cirrhosis) and liver failure. The best way to prevent these and to live a healthier life overall is for your child to reach a healthy weight, eat a healthy diet, and get plenty of exercise.