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But nonalcoholic fatty-liver disease is now the most common liver ailment worldwide among children, and the percentage of youngsters in the U.S. who may be affected by it more than doubled, going from 4% from 1988 to 1994 to nearly 11% from 2007 to 2010. "Their livers look exactly like someone who has been drinking for years," says Dr. Naim Alkhouri, director of the pediatric preventive cardiology and metabolic clinic at the Cleveland Clinic. And just like those heavy drinkers, the kids can go on to develop cirrhosis, with the fat damaging liver cells, preventing them from filtering toxins and waste from the body the way they're supposed to.
Eric's doctor told his parents the hard truth--that he had to lose weight and keep it off and that more than just his liver was on the line. "When the doctor said that he could have high blood pressure and then have sugar in his blood and that he could also have a heart attack and have cancer, I thought, Oh, my God, that cannot happen to my kid," Amador says. "I said, 'Can you give him medicine right away?' But he said, 'No, no, there is no medicine for him that will really work.'"
The reason for that has to do with the intimate and previously unappreciated connection between obesity and the aging process, something that begins in the cells--in this case, cells within fat tissue. Like other cells in the body, some fat cells have ways of protecting themselves from bacteria, viruses and other assaults by pumping out defensive chemicals and protein-shredding enzymes. But that same chemical warfare can be toxic to other cells in the vicinity. When too much of this collateral damage occurs, the result can be inflammation and a bodywide type of cellular damage that resembles changes seen in aging.
"It's looking more and more like obesity does some things that might just be tied to the fundamental aging processes," says Dr. James Kirkland, director of the Kogod Center on Aging at the Mayo Clinic. Worse, Kirkland says, the damage fat cells do to surrounding cells seems to be contagious, with other, otherwise unaffected cells effectively aging along with the damaged ones. That, at least, is the theory, and it gets a lot of support from studies of animals and elderly people--as well as kids in an entirely different population: childhood cancer survivors.
One of the terrible ironies of winning such a mortal battle so early in life is that in adulthood, cancer survivors tend to develop a number of diseases several decades earlier than average: they suffer heart attacks in their 40s rather than in their 60s or 70s and show signs of cognitive decline in middle age rather than in their 70s or 80s. The reason is not clear, but the research suggests that it's an as-yet-undefined result of the cancer, as well as the toxic consequences of radiation and chemotherapy. Whatever the cause, these patients show the same signs of accelerated cellular aging at the molecular level that researchers are starting to see in obese children.