Geurtsen ML, Santos S, Felix JF, et al. – Via performing a population-based prospective cohort study involving 3,170 children aged 10 years, researchers assessed whether both liver fat accumulation across the full range and non-alcoholic fatty liver disease— defined as liver fat fraction ≥ 5.0% via MRI—are associated with cardiometabolic risk factors already in childhood. Children with ≥ 5.0% liver fat had the highest odds of cardio-metabolic clustering, defined as having ≥ 3 risk factors out of high visceral fat mass, high blood pressure, low HDL cholesterol or high triglycerides, and high insulin concentrations, compared with children with < 2.0% liver fat. Overall, higher liver fat was associated with an adverse cardiometabolic risk profile in childhood across the entire range and independently of BMI. The researchers indicated that future preventive strategies to improve cardiometabolic outcomes in later life may need to target the development of liver fat in childhood.