Five Things Everyone Should Know About Liver Health

The liver is one of the body’s largest organs and it is a busy one.  It has more than 500 functions!  Amongst its jobs, the liver

• Produces bile to help break down fat during digestion and carry away waste
• Produces some protein for the blood, and regulates protein levels in the blood
• Filters toxins and bilirubin from the blood (bilirubin is the substance that causes yellow skin and eyes common to jaundice)
• Regulates blood sugar and cholesterol levels (most of our cholesterol is made in the liver)
• Processes haemoglobin to help regulate iron levels in the blood
• Helps fight infection
• Regulates blood clotting.

Thankfully, the liver is resilient and able to regenerate, but we still need to look after it.

In order to metabolise products in our blood and clear the waste, the liver works a two-phase system with the phases named imaginatively: Phase 1 and Phase 2.  It is important that these phases work in sync if we are to feel good.  If either phase is running faster or slower than the other it can cause problems.

I don’t want to get too technical about the phases, but Phase 1 metabolism relies on cytochrome enzymes.  It is where substances are ‘broken down’ or metabolized.  Phase 2 metabolism relies on conjugation enzymes and is where the broken-down products are combined with amino acids or other natural/biological chemicals ready to transport them, or to make them more functional for the body.  Both phases can be supported by us consuming a range of vitamins (particularly the B vitamins), fruit and vegetables, herbs and spices.

As it is still “dry January”, I thought I’d start with one of the best known liver diseases.  Whenever we drink alcohol some of our liver cells die.  These can be replenished, but if heavy alcohol use continues for a long time (alcohol abuse), the liver’s ability to regenerate can be lost.  This can result in alcohol related disease.

There are three stages of Alcohol-Related Fatty Liver Disease:

Alcoholic fatty liver disease

When we drink heavily, fatty deposits form in the liver, even if our drinking is only for a few days.  The more often we drink, the more deposits we may have leading to a build-up that may not have any symptoms.  Because you don’t have symptoms, does not mean it is not an issue.  It is a sign that you are drinking too much and, if not addressed, may continue to develop into the next stage, alcoholic hepatitis.

The good news is that fatty liver disease is reversible.  Abstaining from alcohol for a couple of weeks after a binge, can help to reduce the fatty deposits again.

Alcoholic hepatitis

This type of hepatitis is not related to infectious forms of hepatitis.  It can develop as a result of continued alcohol abuse, but may occasionally develop following a binge-drinking session.  Unfortunately, since people with fatty liver disease often have no symptoms, this could be the first time people realise that their drinking is causing damage.  If the level of hepatitis is mild, it can still be reversed by stopping drinking; if severe, it can be life-threatening.

Cirrhosis

At this stage, the liver becomes significantly scarred.  But still, the individual may not have any obvious symptoms.  Unfortunately, at this stage the damage is often not reversible but its progression can be stopped by stopping drinking.  Continuing to drink at this stage can be life-threatening.

See my December post for more information about how alcohol can affect our nutritional health, and some useful links to further information and support.

Non-Alcohol Related Fatty Liver Disease

It is not just alcohol that can cause fatty liver disease!  The term non-alcohol related fatty liver disease simply refers to a build up of fat in the liver.  In the early stages it appears to cause no harm, but it can progress and eventually result in cirrhosis if not addressed.

High levels of fat in the liver is associated with diabetes, high blood pressure and kidney disease.

Evidence suggests that diets high in sugar and fructose (particularly as an added sugar or syrup) contribute to the development of this disease.

Viral Hepatitis

There are five types of viral hepatitis labelled A-E.  As the name suggests, these are caused by a virus, but if left untreated may cause cirrhosis.  While each type may be contracted through contact with an infected person’s bodily fluids, types A and E can also be contracted from unclean or badly cooked infected food or water.  Ensure you practice good personal and food hygiene (including washing fruit and vegetables before use) to reduce your risk of contracting the virus.  Ensuring you have a good level of vitamin D may also be helpful to support your immune response to the virus.

Gallstones

The gallbladder is located just below the liver and is used to store bile produced by the liver.  It is then released into the intestine when we eat to help us digest food, particularly fat and fat-soluble nutrients.  Without the gallbladder bile is released into the intestine continuously.  Gallstones are lumps of solid material that form in the gallbladder.  They can be of varying size but a build-up can cause problems, particularly if the duct becomes blocked.  Gallstones may be formed by cholesterol or bilirubin (pigmented gallstones).  Cholesterol gallstones are mainly caused by overproduction of cholesterol in the liver and slow emptying of the gallbladder.  Pigmented gallstones can result when bilirubin levels are higher than normal and form crystals which develop into stones.

Dietary measures to help support your gallbladder and reduce your risk of forming gallstones include, eating plenty of fibre (most of us consume less than half the recommended amount), eat more healthful fats such as oily fish and olive oil, eat fewer refined carbohydrates (especially sugar), and eat fewer unhealthy fats (such as in desserts and fried food).  Sudden weight loss may increase your risk of developing gallstones, so avoid very low energy/intensive short-term diets.

While there is some controversy around the impact of food on the liver, there is some supportive evidence too.  And, as we know everything we eat can support our health or damage it.  As always, I cannot say that eating or drinking any particular food/drink items will prevent liver damage, but I can suggest some foods that contains nutrients that are believed to support liver health including:

• Grapefruit – Contains antioxidants that are believed to help protect the liver from damage by reducing inflammation, protecting cells, a potentially positive effect on fat formation in the liver, and it may help the liver to metabolise alcohol and reduce its negative effects.

Check any medication you are taking for potential interactions with this fruit before tucking in!  It’s beneficial effects on the liver, can actually be a problem for medications.

• Coffee – The actual mechanism for how coffee is beneficial to the liver is unknown, but it is thought to help reduce the accumulation of fat and collagen in the liver.  It may also support antioxidant activity in the liver.  Drink no more than 4 cups of coffee per day (cup size being around 240ml) in order to protect other aspects of your health.

• Tea – Both green and black teas are rich in antioxidants that are great for the liver enzymes (proteins that support chemical processes in the liver), and may help reduce fatty deposits in the liver.

If you already have liver damage, avoid using green tea supplements as there have been cases where these have caused serious harm in people with liver disease.

• Berries – Rich in antioxidants.
• Grapes, particularly red and purple grapes – Grapes contain reservatrol that is thought to help reduce inflammation and increase antioxidant levels.

Be cautious with grapes if you need to manage your blood sugar levels as they have a relatively high sugar content.

• Beetroot, especially beetroot juice – A great source of antioxidants and nitrates which help blood flow and blood pressure within the body.  Be warned, beetroot juice may turn your urine a pinky-purple colour – don’t worry if it happens!

• Leafy greens – Antioxidants and a range of helpful nutrients.
• Nuts – A range of helpful nutrients including B vitamins.
• Oily fish – Omega-3 may helps to reduce liver fat and triglyceride levels.  Oily fish include salmon, trout and mackerel.  Tuna is no longer classed as an oily fish.

• Olive oil – Studies suggest olive oil can improve liver fat and enzyme levels, as well as improving blood flow.

• Food and Nutrition in the Pathogenesis of Liver Damage – Mega, Marzi, Kob, et al.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8073814/
• Modulation of Metabolic Detoxification Pathways Using Foods and Food-Derived Components: A Scientific Review with Clinical Application – Hodges and Minich.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4488002/