Liver Disease and Nutrition

What is liver disease?

Liver disease refers to conditions that can affect the proper functioning of your liver and over time can lead to further damage and health complications. The liver is a complex organ and it has various roles in the body, such as filtering toxins from the blood, regulating sugar and cholesterol levels, aiding in digestion, and helping to fight infection. The different conditions stated below are referred to as liver diseases.^1,2

Hepatitis 

Hepatitis causes inflammation of the liver. It is often caused by a virus (viral hepatitis) or liver damage due to alcohol overconsumption. There are different types of hepatitis and most of them are contagious. Vaccinations are available for Hepatitis A and B.³ 

Hepatitis A- Found in contaminated food or drinks. It usually clears up after some time, although it can be life-threatening. 

Hepatitis B- Usually spread through fluids such as blood or semen. Infected pregnant women can pass it to their babies and it can also be spread through the use of infected drug needles and unprotected sex. Individuals can develop a long-term infection leading to liver cancer or cirrhosis, or it can clear up over time. There is no specific cure for hepatitis B. 

Hepatitis C- It can spread through sharing needles or through an infected individual's blood. In the later stages, it can lead to liver damage. There is no vaccination available for protection against the virus. 

Hepatitis D- This can only develop and survive in individuals with hepatitis B. It is usually spread through blood or sexual intercourse and can be either acute or chronic. 

Hepatitis E- Usually caused by drinking contaminated water or consuming raw pork, wild boar, shellfish, and venison. 

Fatty liver disease

Fatty liver disease results from a build-up of fat in the liver due to various factors, and there are two main types. 

Alcoholic fatty liver disease is caused by the overconsumption of alcohol and can have life-threatening complications if not managed.⁴

Non-alcoholic fatty liver disease is usually present in obese or overweight individuals, and  can lead to liver damage if it becomes worse, with links to further health problems such as high blood pressure and kidney damage.⁵

Primary biliary cirrhosis

This disease occurs when the body attacks the bile ducts in the liver, preventing bile from leaving the liver. This leads to a build-up of bile and eventually may lead to scarring of the liver and even liver failure. 

Haemochromatosis

This is a hereditary condition where iron is stored in the body over time and eventually leads to a build-up of iron in the liver alongside other organs. If not managed, it can lead to future liver damage. 

What are the symptoms of liver disease?

The majority of liver diseases can be managed if they are diagnosed in their earlier stages. The problem is, most of them do not cause any symptoms at an early stage and are usually spotted when undergoing other tests. If you consume alcohol in excess, it is important to let your doctor know so that the necessary tests are conducted. 

Once your liver is damaged or scarred, you may experience the following common symptoms.⁶

• Tiredness and weakness 
• Nausea
• Loss of appetite 
• Yellowing of skin or sclera 

What foods can help you maintain a healthy liver?

Cruciferous vegetables

Glucosinolates are compounds found in cruciferous vegetables such as brussel sprouts, broccoli, cabbage, kale, swede, and turnips. There is evidence to suggest that they help to protect the liver cells, play a role in liver detoxification reactions, and aid in reducing inflammation.⁷ They are also a great source of dietary fibre which is beneficial for liver health.⁸ 

Nuts

Nuts contain omega-6 and omega-3 fatty acids which aid in the reduction of fatty liver disease. Antioxidants found in nuts help with inflammation and oxidative stress endured by the liver.⁹  

Fatty fish

Similarly to nuts, oily fish such as salmon, sardines, trout, and mackerel contain omega-3 fatty acids which help with reducing inflammation and the build of fat in the liver. It is advised to eat 1-2 portions of oily fish a week.¹⁰

Berries

Berries are high in antioxidants. Berries can be consumed as part of a balanced diet by adding them to breakfast oats or cereals, putting them into smoothies or pancakes and even adding them to salads.¹¹

Coffee

Multiple studies have shown an association between coffee and the reduction of chronic liver diseases and scarring (cirrhosis) due to its antioxidant capacity.^12,13 Although there is not enough evidence to suggest ‘treatment’ using coffee, it may be beneficial to include moderate consumption of unsweetened coffee as part of the diet. 

What foods to avoid to keep your liver healthy?

Excess salt

A diet high in sodium and salt can lead to water retention, high blood pressure, swelling, and inflammation. A high salt intake has been associated with non-alcoholic fatty liver disease and has a negative impact on the liver.¹⁴ The majority of processed, on-the-go foods such as crisps, ready meals, and noodles are quite high in salt, so it is advised to reduce and limit consumption of these foods. 

Fried foods

Fried foods are generally high in saturated fat and sodium. Over time, increased levels of saturated fat can lead to inflammation and scarring of the liver. It is advised to limit and reduce the quantities of fried foods and opt for alternative cooking methods such as baking, steaming, boiling, or shallow frying. 

Red meat

The consumption of red meat has been associated with an increased risk of the development of fatty liver disease.^15,16 It is advised to consume white meats such as chicken and turkey that are lower in saturated fat. For individuals with haemochromatosis, where iron is accumulated in the body over time and eventually can lead to liver damage, it is advised to consume iron-rich food in moderation alongside foods that reduce the absorption of iron.

Summary

Conditions affecting the efficient functioning of the liver are referred to as liver disease. Symptoms of liver disease usually arise once the liver is already scarred or damaged, so it is important to have check-ups if you are taking medications that may affect the liver. Dietary modifications can help to reduce the effects of these conditions on the liver.