Raising the bar on liver health with simple habits

Liver disease is rapidly on the rise in Ireland, and if left unchecked, it can lead to serious illness and even death. It’s not only linked to alcohol intake 

“Significant liver damage doesn’t happen after one weekend of bingeing, but takes place over many years of flogging the organ,” says Sarah Di Lorenzo, a clinical nutritionist based in Sydney and author of the Liver Repair Plan. 

As our largest internal organ, the liver is little short of a functional powerhouse, performing over 500 key functions in the body every day. 

It quietly goes about its responsibilities of filtering the blood of toxins, making bile so that we can digest meals, processing nutrients and regulating our metabolism.

The liver helps blood to clot, balances fluid levels, excretes cholesterol, hormones, drugs, and bilirubin from the body and helps to keep the immune system on an even keel.

I could go on, but to cut to the point, if your liver isn’t functioning well, then your health will eventually be impacted. 

And poor liver function is not solely linked to heavy drinking. Your risk might be higher than you think.

According to the Irish Liver Foundation, the burden of liver disease in Ireland is “significant”, and growing. 

Between 1971 and 2012, the World Health Organisation recorded a 452% increase in liver deaths in Ireland, and the foundation says that more than half the adult population are at risk of chronic liver disease. 

Shockingly, people admitted to the hospital with liver disease are two to three times more likely to die than those with heart attacks. 

But the good news is that many liver problems could be prevented if we take better care of our liver’s health.

Alcohol intake isn’t always the underlying cause. 

Among the most common conditions is metabolically dysfunctional-associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease, a chronic condition caused by a build-up of fat in the liver. 

It can affect people of all ages, although it is mid-lifers who are most likely to suffer. Poor diet, lack of exercise, being overweight and carrying too much fat around the middle can all raise the risk.

“Significant liver damage doesn’t happen after one weekend of bingeing, but takes place over many years of flogging the organ,” says Sarah Di Lorenzo, a clinical nutritionist based in Sydney and author of the Liver Repair Plan. 

“But our liver has a breaking point and the damage you may have caused in your 20s, 30s, and 40s may not become apparent until you are in 50s or 60s.”

Di Lorenzo says our liver is remarkably forgiving: “Its powers of self-repair are phenomenal. But its ability to regenerate diminishes with age, so we really need to start caring for our liver as soon as we can.”

Both binge-drinking and moderate drinking can, over time, lead to liver inflammation and ultimately scarring or cirrhosis.

Here’s how to care for your liver:

Cut down on alcohol

There is no such thing as a safe alcohol intake when it comes to liver health. 

The more you drink, the harder your liver has to work to process it. 

“Our liver has to use an enzyme called alcohol dehydrogenase to convert the ethanol in alcohol and break it down into acetaldehyde,” Di Lorenzo says. 

“Another enzyme — aldehyde dehydrogenase — then breaks down the acetaldehyde into acetates, which are metabolised before leaving the body with carbon dioxide, so it’s a long and very taxing process.”

Both binge-drinking and moderate drinking can, over time, lead to liver inflammation and ultimately scarring or cirrhosis.

Drinking black coffee — even instant or decaf — could place you at a lower risk of liver disease, according to researchers who tracked large numbers of coffee drinkers and those who didn’t drink the black stuff. 

Drink three to four cups of coffee daily

Drinking black coffee — even instant or decaf — could place you at a lower risk of liver disease, according to researchers who tracked large numbers of coffee drinkers and those who didn’t drink the black stuff. 

Over 10.7 years, participants were monitored for any type of liver disease and showed that coffee-drinkers had a 21% reduced risk of chronic liver disease and a 49% reduced risk of early death from the condition.

Their findings, published in BMC Public Health, showed that drinking three to four cups of coffee a day offered the most significant benefits.

“Coffee is one of the best drinks for liver health as it helps to prevent the build-up of fat in the liver and increase antioxidants such as glutathione that protect against liver damage,” Di Lorenzo says. 

“It helps to lower the risk of cirrhosis, inflammation and liver disease in general,” says Di Lorenzo.

Keep weight in check

Overeating builds up fat on the body but also in the liver, and there’s a proven link between weight and fatty liver disease, Di Lorenzo says. 

Researchers from Boston University School of Medicine found that losing 7 to 10% — 10-20lb (5-10kg) for someone weighing 14st (89kg) — of your body weight can reverse liver damage in some people who are overweight.

Don’t bother with liver detox supplements

There’s a huge market for ‘liver detox’ and ‘liver function’ supplements containing ingredients such as milk thistle extract, artichoke extract, N-acetyl-L-cysteine, turmeric extract and choline. 

While it is tempting to think you can heal your liver by popping a daily pill, they are not worth the expense.

Some supplements, herbal remedies or Chinese medicine, such as kava kava and skullcap, have been known to be toxic to the liver, says the Irish Liver Foundation, and it advises seeking advice from your pharmacist, doctor or dietician before taking any liver supplements or non-prescribed medication.

“People with chronic liver disease usually have vitamin D deficiency,” says Di Lorenzo. “It’s absolutely essential for liver and general health.”

Take a vitamin D supplement

A recent study of almost 4m people showed that those with low levels of vitamin D were at the highest risk of liver disease and scarring.

In Nature Communications another group of researchers showed that taking vitamin D supplements helped to reduce liver inflammation. 

“People with chronic liver disease usually have vitamin D deficiency,” says Di Lorenzo. “It’s absolutely essential for liver and general health.”

Increase your step count

A recent study of 91,000 people by researchers at the University of Oxford found that the more steps people take each day, the lower their risk of developing a fatty liver and MASLD. 

Every 1,000-step higher (representing 10 minutes of walking) was associated with a 12% lower risk of liver disease. 

Taking a walk after a meal is even better. “Liver disease is driven by inflammation, and inflammation can be increased by elevated blood glucose,” Di Lorenzo says. 

“Blood sugars spike after a meal, and walking helps to offset that.”

Even two to three minutes at a brisk pace is better for your liver than sitting down after a meal.

Avoid DIY liver function tests

DIY home tests cannot tell you if you have a liver condition, and you should speak to your GP if concerned. 

You might be referred for a transient elastography test, also called a FibroScan. 

This tells you how stiff your liver is — a healthy liver is soft and supple — but won’t diagnose a liver condition on its own. 

You can get a private scan at clinics such as The Liver Wellness chain, where it costs €250.

• The Liver Repair Plan by Sarah Di Lorenzo is published by Simon and Schuster.