Alice Whitehead asks the experts how we can boost our health and avoid the rise in liver disease
The liver is our largest internal organ, and carries out over 500 essential jobs from filtering and fat burning to fighting infection. But this hard-working hero is under attack. “In less than 50 years, deaths from liver disease in people aged 64 and under have risen by 450 per cent,” says Vanessa Hebditch at the British Liver Trust.
While excessive consumption of alcohol continues to play a part in the liver disease statistics, the big wake-up call is that our love of processed foods and sedentary lifestyles could be to blame.
“The fact that a third of adults in the UK are now overweight means that non-alcohol related fatty liver disease (NAFLD) is likely to overtake alcohol-related liver issues as the leading cause of liver disease in the UK in the next few years,” adds Hebditch.
In fact, a study published in April suggests one in eight UK middle-aged adults could be damaging their liver function purely because they are overweight. More worryingly, NAFLD – where fat builds up in the liver cells – is virtually undetectable in its early stages. “It’s been dubbed the ‘silent killer’ because fatty change alone rarely causes any symptoms,” says Dr Patricia Macnair, at the Primary Care Society for Gastroenterology (pcsg.org.uk). “Up to 30 per cent of the UK population have NAFLD and most know nothing about it.” If left untreated, NAFLD can lead to more advanced liver disease such as nonalcoholic steatohepatitis (NASH) as the liver becomes inflamed and scarred. “At the moment three-quarters of people are diagnosed in an emergency setting, but by this time for many patients it is too late and the options for treatment and lifestyle intervention are limited. It is absolutely vital that we are all aware of the risk factors,” says Hebditch.
A healthy diet and plenty of exercise could boost liver health and reduce your chances of developing NAFLD. Cutting down on alcohol should be your first priority. “Alcohol is a poison which damages the cells in many organs in the body, especially the liver and the brain/nervous system,” says Dr Macnair. “If you drink, spread your units evenly and avoid bingeing – your body can deal with it slowly but cannot manage a high dose.”
The recommended units per week are 14 for men and women, spread over at least three days with several alcohol-free days per week. “That is probably less than most people think because the percentage of alcohol in your drink is the number of units in a litre of that fluid,” says Dr Dawn Harper, TV doctor and consultant GP at healthspan.co.uk. “So if you are drinking 12 per cent wine, this means there are 12 units in a litre – and a 250ml glass at home could easily equal three units, not one.”
Other foods which are hard on the liver include energy-dense foods. “Deep-fried foods, cakes, biscuits, and those high in sugar and heavily processed should be eaten in moderation,” affirms William Alazawi, consultant hepatologist at the Royal London Hospital (liverlondon.org). “The liver and the pancreas have to work harder to deal with these foods, resulting in high levels of sugar in the bloodstream which can be harmful to the body.”
Eating a diet high in low-glycaemic foods such as fruit, veg and wholegrains, and including a good amount of quality protein, is best for liver health. And research suggests that certain foods could help support liver function. A British Liver Trust report found regularly drinking moderate amounts of coffee might prevent liver cancer, lower the risk of fibrosis and cirrhosis and slow the progression of liver disease in some patients. Early studies by researchers at the U.S. National Cancer Institute suggest this might be related to an intrinsic element in coffee, so decaffeinated coffee may offer the same benefit.
Fish is also under the microscope for liver health. It’s thought the potassium and protein in cod, salmon and sardines is linked to improved liver function. “A Mediterranean diet that includes fish oils may help the liver due to the way the oils are metabolised. You have to remember that everything we put in our mouths goes through the liver,” says Alazawi. “Omega 3 improves the profile of lipids (fatty acids) in the liver, but it won’t reverse scarring.”
Research on mice in Austria and the US has suggested curcumin from fermented turmeric powder might aid the fight against liver damage, and possibly delay the onset of cirrhosis – but human studies have yet to be conducted. And artichoke extract may also decrease the fat and cholesterol level in the liver and could prevent liver damage.
“Globe artichoke has been shown to lower cholesterol and triglyceride levels in people with non-alcoholic fatty liver disease, and in tests their elevated levels of liver enzymes almost halved compared with a placebo,” adds Dr Harper.
Other studies have explored how vitamin E and selenium in nuts might boost the liver and the way carotenoids in carrots stimulate bile flow and waste removal. An American Journal of Clinical Nutrition study showed that selenium deficiency was linked to a marked increase in liver cancer risk. “Fatty liver comes about when we have too much energy for our body to deal with,” explains Alazawi. “When we exercise, the hormone profile in the muscles is ‘switched on’, which means they signal to the liver that they need energy, in particular glucose, and the liver then has to break down the fat in order to feed the muscles.”
While there’s no quick fix for liver disease, a few simple changes to our diets and lifestyle could benefit our long-term liver health. “The idea of liver cleansing or detoxing can be misleading as usually any damage is done over a long period of time,” says Vanessa Hebditch. “But the liver is remarkable because as long as it does not get too damaged it can regenerate – and that’s why it’s crucial to find out if you have a problem at an early stage.” Find out if you are at risk of NAFLD by doing the British Liver Trust’s free online quiz at britishlivertrust.org.uk/screener
Dr Dawn Harper is a leading TV doctor and consultant GP at healthspan.co.uk. She works for the NHS and privately
Dr Patricia Macnair is a spokesperson for the Primary Care Society for Gastroenterology (pcsg.org.uk)
Vanessa Hebditch is Director of Communications and Policy at the British Liver Trust. britishlivertrust.org
William Alazawi is a consultant hepatologist at the Royal London Hospital (liverlondon.org)