When you think of all of your body’s glorious organs, which come to mind first? Your brain? Your Heart? Maybe even your skin? Do you every stop and wonder how your liver is doing? Probably not. And that’s a shame because, statistically speaking, you could be one of the 25%-30% of Americans who have poor liver health – and it’s got nothing to do with alcohol.
There’s a silent epidemic that is rising in numbers called Non Alcoholic Fatty Liver disease, or, NAFLD. The rise is so significant, and so scary, in fact, that experts predict that the more severe form of the disease, called Nonalcoholic steatohepatitis, or NASH could become the number one reason for liver transplantation in the next 10 – 20 years (it’s currently number 2 and some recent studies suggest that perhaps it has already reached the number 1 spot. It also happens to be the number 1 liver disease we are seeing in the pediatric population as well. Moreover, NAFLD is an independent risk factor of cardiovascular disease and patients with fatty liver are more likely to have a heart attack or stroke than the general population. Not a lot of people outside of the big liver organizations, or Heapatology departments have been talking about this, but now, due to the massive rise in both health care costs (estimated at $106 billion per year) and diagnosis of the disease (often through liver enzymes, ultrasound, or biopsy), the conversation is beginning to hit mainstream, and the word “epidemic” along with it.
Many of the most at risk individuals are either overweight or obese (although, it can occur in lean individuals as well), have at least one component of metabolic syndrome (elevated blood sugar, high blood pressure, high triglycerides, central obesity, or low HDL ), or have a poor diet. The risk of this disease is right in line with the rise of obesity and type 2 diabetes.
Two years ago, I started seeing this increase in incidence in my own patients at the Cleveland Clinic. They often would come to me, seeking advice on how to lose weight in a manner that best served this undervalued organ. They could find no guide on the internet, no game plan from their doctor, no pamphlet suggesting which foods to choose, and which to lose. So I decided to create one.
Although there are many aspects in treating and reversing this disease, these are the top 5 nutrition related tips for what you can do right now to help your liver thrive.
Ditch the sugar. Completely.
I get it, you already know how bad sugar is, but what you may not know is how VERY bad it is for the liver, or that the liver is the only organ that can actually metabolize one of the primary sugars found in soft drinks, candy, and baked goods – fructose. Professor Robert Lustig from UCSF once said that “fructose is alcohol without the buzz” and went on to describe how fructose mimics the same detrimental responses to the liver that alcohol does. Essentially, too much of anything is usually never good, but too much fructose puts the liver in overdrive and creates a higher probability of fat formation: the beginnings of NAFLD. Another recent study linked the development of NASH to fructose consumption among children. While many of the studies on fructose are in animals, as opposed to humans, there is still plenty of insight to determine that having too much of it is not so sweet after all. That doesn’t mean stop eating fruit, however, as its attachment to fiber means a less aggressive rise of both glucose and insulin, than, say, a piece of licorice. If you’re getting your fructose from a bag, box, or bottle, it’s best to keep it on the shelf.
Remove toxins from your food equation.
We live in a world of toxins. They are hard to avoid, as they are everywhere from the streets we drive and jog on, to our cleaning agents, to our food. The liver is the organ that gets to deal with all of them. It is THE detoxifying organ. Anything that enters the body as a foreigner or invader finds its way to our liver – and if your liver is sick, it can stick around a little too long and eventually will cause you to get sick. Perhaps the easiest toxins to avoid are the ones that come with our food. For starters, you might want to eat food as it exists in nature: wild. That means wild fish as well as poultry that has been spared from antibiotics. Avoid processed foods and go organic whenever you can. I suggest, at the very least, being aware of the Environmental Working Groups “dirty dozen” list. You’ll also want to steer clear of fast food, both because it’s not good for you, but especially due to new evidence which links fast food wrappers to high concentrations of fluorinated chemicals. It also means using more glass containers to store food, and less reliance on cans and packaging that contains BPA. These factors are just the tip of the toxin iceberg, but they are good place to start!
Embrace Omega 3’s.
Recent evidence suggests that staying away from unhealthy fats, and embracing healthier ones like omega 3 fatty acids, as well as monounsaturated fats, can help reduce fat content in the liver, and assist in the prevention, and treatment of NAFLD. When it comes to liver health and reversing NAFLD, omega 3 fats hold the golden ticket.
Chill out on the herbal supplements.
Many of my patients come to me with a laundry list of supplements. Some are very helpful, like vitamin D for example, or fish oil, as described above, but many others, like black cohash or kava kava actually harm the liver. The National Institute of Health has a comprehensive guide assessing the toxicity of certain supplements and medications on the liver, so if you have risk factors for NAFLD, or any progression to a more severe form, its worth checking your pill list to make sure you’re not doing more damage.
Drink up! (From a mug, not a glass)
Ah yes, I’ve left the best for last. You’re probably wondering if you can still enjoy alcohol, and the answer you don’t want to hear is this: it depends. It depends on the severity of your disease (has it progressed to the next stage), which alcohol is your drink of choice (studies show that red wine may be protective, while beer and hard liquor may harm) and what other obvious factors may preclude you from drinking responsibly (family history, pregnancy, etc.). One thing is certain, there is plenty of evidence that binge drinking may do much more damage, and that even just being a woman could increase your risk. Keeping to recommended “moderate” amounts is highly advisable, but for some, even daily drinking should stop. The upside to the drinking conundrum is that you can drink another liquid to the max and get major liver benefits. Coffee! Coffee rules the scientific arena when it comes to the list of top foods for liver health. That daily cup of joe has a lot of upside, including protection from NAFLD, promotion of general liver health, and even reduction of mortality risk from liver cirrhosis. The bean may be the key factor here, so even decaffeinated coffee can be beneficial.
While much more science is needed to understand the true mechanisms of reversing this disease and looming health crisis, these steps can put you on a path of healing and longevity now.