The liver is a unique and often underrated organ. It works tirelessly for us, performing a multitude of tasks, 24/7. And yet, we treat it rather badly, not least because it never complains. The liver suffers in silence, and by the time we experience symptoms, the liver may already be in a sorry state.
According to the British Liver Trust, deaths caused by liver disease have increased by 400% since the 1970s and are now the third leading cause of death.
We want to take the recent Alcohol Awareness Week as an opportunity to tell you more about the liver and how you can give it some much needed TLC.
7 facts about the liver
- It is our largest gland, weighing in at 1.500g, which equates to approximately 2% of our body weight.
- The liver is the only organ that grows back if partially removed.
- The liver is the central organ of our metabolism. Nutrients from food absorbed via the small intestine first reach the liver, where they are temporarily stored and released into the bloodstream in a controlled manner. The liver also produces bile, needed to digest fat, as well as vital hormones, lipids and proteins, such as cholesterol and clotting factors.
- Harmful substances such as chemicals from food, alcohol and medicines are broken down in the liver as far as possible, repackaged and sent off for elimination via the gut.
- The liver has no pain receptors. A diseased liver often causes only diffuse symptoms that could have very different causes: fatigue, digestive problems, or itching are often considered everyday complaints and not taken seriously. Even an inflamed liver doesn’t cause pain. The first thing we may notice about a diseased liver might be pressure in the upper abdomen, which occurs when the liver has already stored large amounts of fat, causing it to expand.
- A poor diet can damage the liver just as much as alcohol.
- The liver has an incredible capacity to regenerate – up to a point. It forgives many of our sins, gets up, dusts itself off and carries on, but once we develop cirrhosis of the liver, we have passed the point of no return. Before that happens, however, there are countless opportunities to help it recover. Read on to find out how.
When things go wrong
The most common liver disease is hepatitis, which can be caused by infection with viruses, bacteria or parasites, but also poor diet and overconsumption of alcohol. If lifestyle-related, the hepatitis is preceded by a fatty liver. If left untreated and with no change in potentially contributing lifestyle habits, hepatitis can become chronic. Liver cells die and form scar tissue, causing cirrhosis of the liver, often referred to as end-stage liver disease, which can also turn into liver cancer.
The most common causes of liver disease are lifestyle-related: alcohol and obesity (together with hepatitis B, an infectious disease, often linked to drug use) account for 90% of cases. Alcoholic fatty liver disease is a problem we’ve known about for a long time. Non-alcoholic fatty liver disease (NAFLD) – although discovered as long ago as 1980 – used to be so rare that doctors hardly came across it. Some doctors, on establishing the poor state of their patient’s liver, harboured doubt about their honesty when they said that they did not drink or at least no more than the recommended amounts. Now, NICE states that between 20 and 30% of Brits have NAFLD, which progresses to non-alcoholic steatohepatitis (NASH) – a form of chronic hepatitis – in 2-3% of the population. NAFLD – though harmful in its own right – is also considered a predictor for cardiovascular disease.
The good news is that, in the majority of cases, it is in our hands whether or not we develop hepatitis in the first place.
Cut back on alcohol
The obvious first step to being kind to your liver is to cut back on alcohol. You don’t need us to tell you that; you already knew. But it can be challenging as in our culture, so many social gatherings centre around alcohol. Friends look at us quizzingly when we turn down a drink or even ask straight out: “What’s wrong with you? Are you pregnant/on a diet/on medication?” Being the only one not drinking can turn into an ordeal as the evening progresses, and the jokes become sillier. Plus, if you like alcoholic drinks, it is hard to resist the temptation and stick to soda and lime.
If you do feel like a treat on a special occasion (if they are allowed this year), try a cocktail created with one of the alcohol-free spirits that have become available in recent years, such as Caleño , Lyre’s , Seedlip and others. When preparing your alcohol-free cocktails though, make sure to go easy on the sugar – as that is thought to contribute to the other cause of fatty liver.
Cut back on sugar and carbs
For a long time, the cause of NAFLD remained unknown, although it was clearly associated with overweight and obesity because as patients lost weight, their liver values improved and their livers started to recover. So, does fat from food cause a fatty liver? Unfortunately, a similarly simplistic explanation is often chosen for the development of fatty livers, as it is for overweight and obesity: Too much fat in food makes us fat – and too much fat in food also causes a fatty liver – or that is the general opinion. But, of course, it is not quite that simple. In recent years, carbohydrates and sugar – and particularly fructose, a component of table sugar – have emerged as contributors.
Table sugar is composed of equal amounts of glucose and fructose. Our body uses glucose to generate energy but has no use for fructose. Fructose must be cleared by the liver, and in that process, it creates lipid (fatty) molecules called triglycerides. Those accumulate in and around the liver and other internal organs, leading to NAFLD. Another by-product of fructose metabolism is uric acid, contributing to gout.
Starches are – like sugar – carbohydrates, consisting of chains of glucose molecules. Once broken down in the digestive system, those glucose molecules are absorbed into the bloodstream. Too much sugar in the blood is hugely damaging, though. It must not remain there. With the help of the hormone insulin, as much of it as possible is transported into the body cells and used for the generation of energy. A small amount of the excess is converted back into a type of starch (glycogen) and stored in the liver for emergencies. Any blood glucose that remains after that goes back to the liver where it is converted into – you guessed it – more triglycerides.
It turns out that sugar and starchy carbohydrate foods are bad news for the liver. Be careful before switching to alternative sweeteners. Honey has a higher fructose content than table sugar, and agave syrup – so often advertised as a “healthier” alternative to sugar – has even more. In nature, fructose is relatively scarce. Honey, dates, raisins, molasses, and figs contain more than 10% fructose, but grapes, raw apples and blueberries, for example, have much less, between 5-10%. Fruit is not just made of sugar; it also contains a lot of fibre, giving the fruit bulk and making it filling. Strip away the fibre, and you get juice – so much easier to consume in large quantities. Fruit juices, including orange juice and apple juice, contain just as much sugar as soft drinks, and most of that in the form of fructose.
If you want to give your liver some TLC, we recommend reducing not just your alcohol intake, but also that of sugar (think soft drinks, juices, sweets, chocolate, biscuits, cakes etc.) and starchy carbohydrate foods (rice, pasta, potatoes, bread, croissants and other baked goods) because ultimately they are sugar, too.
If that seems like too big a step at a time and you can only do one thing, watch what you drink. Not consuming alcohol, soft drinks and fruit juices would make a great start on your path to a healthy liver.
Don’t want to stop there? There’s more that you can do!
Eat the colours of the rainbow
Antioxidants are vitamins, minerals, phytonutrients and chemicals, made in the body or ingested with food, that protect our cells from damage and thus us from disease. Phytonutrients – plant nutrients – are not just protective. They are also the pigments that give the plant its colour. Different nutrients have different colours. Carotenoids are yellow, orange or red – think sweet potatoes, squash, carrots, mango, tomato. Chlorophyll is green – spinach, lettuce, watercress, broccoli, parsley. Yellow flavonoids are in green tea, citrus fruit, berries, onions, dark chocolate and buckthorn. Anthocyanins are blue and found in blueberries, red wine, red cabbage, aubergines, cherries and blue grapes. Cover all the colours of the rainbow and benefit from all of the different antioxidants.
Sulphur – smelly but indispensable
Sulphur is a trace element and ingredient for the body’s most powerful antioxidant: glutathione. Glutathione is made in the body and required for liver detoxification. It is thought to be protective cancer, heart disease, dementia, Alzheimer’s and more, and necessary for healthy ageing. As it has a pungent aroma, so do many of the foods that contain it, such as onions, garlic, mustard, fish, and eggs. But, surprisingly, sulphur is also found in grains, such as pear barley and oats, pulses, nuts, seeds, seafood and red meat. It is sulphur that gives cabbage, too, it’s famous strong smell. But there is even more cabbage can do for your liver.
Cruciferous vegetables – powerhouses for your health
The go-to vegetables to support the liver are the cruciferous veg or brassica family: cabbage, cauliflower, kale, Brussels sprouts and broccoli are some of the most popular cruciferous veg, but there are many more. The brassica family get their bitter taste from chemical compounds called glucosinolates. In animal studies, glucosinolates were able to slow down the growth and spread of cancer cells. In addition to their potentially cancer-preventive effects, cruciferous plants – especially broccoli – help liver enzymes to process toxins more effectively and reduce their negative effects on the body. Pop a portion of cruciferous vegetables on your plate as often as you can, at least 2-3 times each week. If you lack inspiration as to what to do with that much cabbage, check out this specialist cookbook: Brassica by Laura B. Russell.
Bitter is better
Plants use bitter compounds to protect themselves from predators. In humans, such bitter substances soothe the cardiovascular system and digestion, strengthen the immune system and stimulate fat metabolism in the liver and bile. If you want to pamper your liver and promote bile flow, consume bitter compounds several times a week. Foods that are particularly rich in them are artichokes, dandelion leaves and stems, bitter leaves (radicchio, chicory, rocket), coffee and chocolate with a very high cocoa content.
If you are looking for an interesting and slightly different webinar to offer your employees, why not consider our new seminar Loving your Liver . Email us now at info@vitalhealthnutrition.co.uk for more details