Slimming Your Liver

Adopting a healthy lifestyle can help reduce fat accumulations in this vital organ.

by Claire Sykes

October 2011

Like your heart, your liver is always working hard for you 24 hours a day. Unlike the heart, though, the liver does its job with little fanfare. The largest organ in your body, the liver helps digest food and turn it into energy, along with filtering toxins from the blood and dozens of other essential functions.

But there’s only so much this critical organ can take. Over time, obesity and other factors, such as some medications and pollutants, can stress or seriously damage your liver. The first stop on the road toward increasingly worse liver problems is nonalcoholic fatty liver disease (NAFLD).

Defined as the accumulation of liver fat in people who drink little or no alcohol, NAFLD often shows no signs or symptoms. Left untreated, NAFLD can lead to liver inflammation and scarring (nonalcoholic steatohepatitis, or NASH) that can become progressively worse (cirrhosis). In its worst stages, NAFLD may even necessitate a liver transplant. Fatty liver is linked to a constellation of conditions, known collectively as metabolic syndrome, which includes high “bad” cholesterol (LDL) and triglycerides (blood fat), low “good” cholesterol (HDL), high blood pressure and insulin resistance.

As serious as NAFLD’s potential consequences are, the good news is that it can be prevented—and if caught early, reversed—through lifestyle changes, especially dietary modifications.

Body Fat, Liver Fat

The American College of Gastro­enterology reports that about 20% of adults and 5% of children have NAFLD. Why so many? Because it’s closely associated with something that weighs down 30% of the US population—obesity.

“Obese people are most at risk since they’re always breaking down fat, which the liver stores because it’s overwhelmed. With NAFLD, fat can be created by and stored in the liver,” explains Lyn Patrick, ND, of Durango, Colorado. “Especially if you’re obese, get evaluated by a physician to see if you’ve got NAFLD or a more serious form of liver disease.”

With any liver condition, a blood test will reveal higher levels of the liver enzymes ALT (alanine aminotransferase) and AST (aspartate transaminase). An ultrasound may confirm a diagnosis of NAFLD, but only a liver biopsy can determine the extent of liver damage, if any.

You needn’t be overweight to have NAFLD. But if you are, you’re probably also insulin resistant, a condition in which insulin can’t efficiently do its job of moving glucose, the body’s main energy source, into cells. (Only a small percentage of people who are insulin resistant develop NAFLD.)

“A sedentary lifestyle, and a diet rich in sugars and fat, may lead to insulin resistance. When your body resists the release of the insulin, you start storing foods as fatty deposits in the liver,” says Melissa Palmer, MD, director of hepatology at New York University and author of Dr. Melissa Palmer’s Guide to Hepatitis & Liver Disease (Avery).

Liver Liberation

The best way to deal with NAFLD is by reaching and maintaining a healthy body weight at a slow, steady pace. “Lose no more than one to two pounds a week. Then liver enzymes will begin to normalize, unless the liver is too damaged,” says Palmer.

“Probably your number one step is to avoid high-fructose corn syrup,” urges Patrick. “It’s clear that it contributes to NAFLD because the body metabolizes it as a fat, not a sugar. It’s directly related to how much fat is stored in the liver.”

Cut down (or out) on sugar, which is highest in alcoholic drinks, soda, fruit juice, dried fruit, agave syrup and some sports drinks. “Eat low-sugar fruits, such as cherries, berries, apples and pears,” advises David Graves, ND, of Spokane, Washington.

Low-sugar foods tend to have low glycemic index (GI) ratings. The higher the GI, the faster a food causes your blood sugar and insulin levels to rise. Low-GI foods also increase your blood sugar and insulin, but do so at a gradual, manageable rate, which reduces your risk of obesity and NAFLD, as well as heart disease and type 2 diabetes.

Low-GI foods include 100% stone-ground whole wheat bread, converted long-grain rice, grains such as quinoa and millet and non-starchy vegetables. Steer clear of white bread, corn flakes, crackers and pineapple (natural, true, but very sweet).

Your goal is to follow a diet that balances “complex carbohydrates, especially from fruits and vegetables, protein, fiber, essential fatty acids and high-quality animal products,” says Graves. Palmer adds, “No fatty, greasy or white-flour foods. Eat white-meat skinless poultry, fruits and vegetables, freshwater fishes such as salmon and herring and antioxidant-rich foods, such as blueberries, grapefruit and even coffee.”

Supplementation for NAFLD is best undertaken under a practitioner’s watchful eye. In general, though, Palmer recommends 800 IU of vitamin E, 1,000 mg of vitamin C, 20 grams of betaine (a precursor to the antioxidant SAMe) and 1,000 to 4,000 mg of vitamin D (depending on your levels). Graves suggests 1,000 mg of L-carnitine, an amino acid that has helped heal NASH in studies; 1,000 mg of lecithin, which helps protect fatty acids within the cell; 500 mg of choline, which helps the liver package fat for transport through the bloodstream; and 1,000 mg of high-quality fish oil. Graves also supports the use of dandelion root to improve the liver’s ability to process fat. Other liver-supportive botanicals include milk thistle, licorice, green tea and artichoke.

Don’t forget to move your body at least 30 minutes five times a week “to help metabolize fat and sugar in the liver,” says Graves. He suggests “shorter, more intense anaerobic exercise, with higher weights and fewer repetitions; and ‘peak aerobic’ exercise—30-second maximum-output intervals separated by 60-second low-intensity intervals.”

NAFLD may come on slowly, but don’t take your time getting on it. “The sooner you do,” says Graves, “the more quickly you can turn it around.” So love your liver—and enjoy a healthier life.

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