Finnish researchers tracking 488 children from early childhood into adolescence have uncovered something striking: the roots of fatty liver disease may reach back to the womb—and to what babies eat in their first years.
The findings matter because fatty liver disease, officially called metabolic dysfunction-associated steatotic liver disease (MASLD), is increasingly common and can lead to serious health problems later in life. Yet most prevention efforts focus on adult habits: exercise, diet, weight loss. This new study suggests we're missing a critical window. What happens during pregnancy and in early feeding practices may shape a child's liver health for years to come.
The research, led by doctoral researcher Hanna de Ruyter at Tampere University and published in The Journal of Pediatrics, examined the medical records and lifestyle data of Finnish children, analyzing connections between maternal health during pregnancy, early nutrition, and early markers of liver disease. The team measured alanine aminotransferase (ALT), an enzyme that signals liver stress, alongside maternal factors, diet, body composition, and childhood metabolism.
One striking finding: maternal high blood pressure during pregnancy was associated with elevated ALT levels in children—both in childhood and into adolescence. "Maternal pre-pregnancy hypertension may be associated with elevated ALT levels in the child, both in childhood and adolescence," de Ruyter explained. "This suggests that maternal cardiometabolic health in the prenatal period may contribute significantly to the development of MASLD in the offspring."
The study also revealed the power of early feeding choices. Children who were breastfed for shorter periods and introduced to solid foods earlier showed higher ALT levels by adolescence. Meanwhile, diet itself played a measurable role: children consuming high amounts of animal-based foods, protein, and dairy products showed elevated ALT levels, particularly in later childhood and adolescence. In contrast, those eating more fruit, vegetables, and berries had lower levels.
The impact of body composition emerged as another key factor. Children with more visceral fat—the deeper fat that accumulates around organs—showed elevated ALT from early childhood onward, consistent with current research on metabolic health.
Importantly, approximately 12 to 15 percent of the children in this largely healthy cohort showed elevated ALT levels, suggesting early warning signs of metabolic trouble ahead. This matters because elevated ALT can signal the beginning of a path toward both liver disease and metabolic syndrome in adulthood.
Professor Kalle Kurppa of Tampere University noted that while these findings should be interpreted carefully and tested in other populations, they open a door to prevention. "The findings may, in time, contribute to the development of preventive strategies that address risk factors even before the onset of liver disease." Rather than waiting until adulthood to intervene, doctors might eventually screen pregnant women for cardiometabolic health and counsel families on early nutrition—potentially preventing years of silent organ damage.