Respect Your Liver

Heart disease, diabetes, cancer; we’re constantly hearing about these obesity-related diseases. However, the obesity epidemic is fuelling another dangerous condition that we rarely hear about. It’s called nonalcoholic fatty liver disease (NAFLD), and it affects an estimated 10 per cent of Australians —too many to ignore.

Liver disease used to be associated with alcoholism, but a wide range of liver disorders affect teetotallers too.

Poor eating habits

The fatty liver that occurs in nondrinkers often starts with the overconsumption of fats and sugars. Prolonged poor eating habits may eventually lead to insulin resistance, a pre-diabetic state, which may also trigger a breakdown of the fat surrounding the liver so that it infiltrates the organ.

Insulin resistance also causes the liver to produce more fat in the form of triglycerides, which it then must store. When the fat content of the liver exceeds 5 to 10 per cent of the liver’s weight, it is officially called NAFLD.

The stages of NAFLD

Steatosis

The initial stage of NAFLD is termed steatosis, in which fat simply builds up in the liver but doesn’t do much harm. If a high fat and sugar intake or exposure to other toxic substances continues to push the limits of the liver’s ability to function properly, obesity will start to manifest itself both externally and internally. The waistline expands while fat continues to accumulate in the liver.

Nonalcoholic steatohepatitis (NASH)

Eventually, the excess fat and toxins trigger inflammation in the liver, a condition known as nonalcoholic steatohepatitis (NASH). An inflamed fatty liver is considered a red flag, as 20 per cent of people with NASH develop cirrhosis of the liver.

Cirrhosis

The most serious progression of NAFLD, cirrhosis is characterised by the formation of scar tissue (fibrosis). Unfortunately, this is irreversible, permanently compromising liver function.

What does the liver do?

The liver is a stalwart workhorse. It will continue to process everything we put in our mouths or on our skin even if many of its cells are damaged. It is also the only internal organ that can regenerate itself if it is partly severed.

In addition to dealing with all the toxins that enter our bloodstream, the liver is also our “director of metabolism”, regulating more than 500 hormonal reactions involved in the storage and breakdown of fats, protein and carbohydrates. Herein lies the complex connection between common metabolic disorders such as diabetes and liver health.

A liver’s efforts to properly regulate blood levels of fat (triglycerides), blood sugar (glucose) and certain amino acids are thwarted by fat and toxic build-up, like a car spinning its wheels in a muddy ditch. And if NAFLD progresses to NASH then cirrhosis, scar tissue will block blood flow in the liver, further slowing important detoxification processes as well as fat and carbohydrate metabolism.

It’s no coincidence that people with high cholesterol, high triglycerides or type 2 diabetes often have fatty livers. Indeed, a new study has concluded that fatty liver may be an independent risk factor for type 2 diabetes.

Researchers have also found a strong association between NAFLD and heart disease. Like some heart disease risk factors, it is often a silent condition with no obvious symptoms.

Diagnosis

NAFLD is diagnosed by performing

• a blood test to identify elevated liver enzymes,
• an ultrasound examination or
• a liver biopsy.

Respect your liver

As you may have guessed, a lifestyle that prevents development of a fatty liver is very similar to one that prevents heart disease and diabetes.

Make these basic lifestyle choices for a healthy liver:

• Eat vegetables and fruits that provide fibre, antioxidants, vitamins and minerals.
• Limit saturated fats and avoid trans fats in processed foods.
• Avoid refined carbohydrates such as sugar and processed “white” foods.
• Drink alcohol moderately (one to two drinks per day at most), if at all.
• Exercise regularly.
• Maintain a healthy weight.

Even people who aren’t overweight may develop a fatty liver from poor diet, making this one of the most important preventive strategies. Feed your liver the nutrients it needs without burdening it with excess fat and sugar.

(In the popular 2004 docudrama Super Size Me, Morgan Spurlock’s prolonged excessive intake of fat and refined carbs from fast food resulted in the preliminary stages of NAFLD even though clinically he was still considered a healthy weight.)

Despite the benefits provided by some substances, use medications and supplements judiciously. Natural or not, everything has to be processed by your liver, so take medications and supplements under the supervision of a health care practitioner.

Supplement your liver

In addition to a healthy diet, you can also care for your liver with the following supplements.

Milk thistle

The active component of this Mediterranean weed, silymarin, is thought to help liver cells repair themselves after exposure to toxins. In animal studies milk thistle was found to reduce liver damage from acetaminophen use, iron overload and alcohol consumption. Available as a capsule or tincture, milk thistle should be taken under professional supervision to avoid adverse effects.

Dandelion

Another weed traditionally used to treat the liver and kidneys, dandelion root has been used for thousands of years in Chinese medicine as a detoxifying agent and diuretic. Modern studies suggest that dandelion reverses hepatitis-induced symptoms by reducing inflammation so that the liver can heal itself.

Resveratrol

Get the benefits of red wine without the toxic effects of alcohol. Promising animal studies show that this potent antioxidant can decrease the inflammatory response and reduce fat deposits in the liver.

Beetroots or beetroot juice Beetroots are among the most detoxifying foods you can eat, so reduce the load on your liver by enjoying them regularly. There’s evidence that the betaine compounds in beetroots can protect the liver when it is under duress.