World Liver Day 2020: 5 ways to keep your liver healthy

There has been a steady rise in the rate of liver diseases over the years. Globally, alcohol, NASH and viral hepatitis are the most common causative factors of liver diseases.
Over consumption of alcohol is bad for the liver.(Unsplash)
Over consumption of alcohol is bad for the liver.(Unsplash)
Updated on Apr 19, 2020 09:58 AM IST
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Hindustan Times | ByDr Veena Aggarwal

There has been a steady rise in the rate of liver diseases over the years. Globally, alcohol, NASH and viral hepatitis are the most common causative factors of liver diseases. As per the World Health Organisation’s estimates published in 2017, liver disease deaths in India reached 259, 749 or 2.9% of total deaths. Liver disease may affect one in every 5 Indians.

Malnutrition in children and adults with advanced liver disease poses a big challenge. Multifactorial issues are associated with nutrition related issues including anorexia, hypermetabolism, increased energy loss, and increased energy needs. Hence, it is important to invest your time and efforts in keeping a healthy liver. Let’s look at five ways in which a healthy liver can be maintained.

Healthy liver and sugar

Many studies have suggested that sugar-sweetened beverages play a role in the epidemics of obesity, metabolic syndrome and fatty liver disease. It has been known that fructose component in sugar directly causes abnormalities in the metabolism of sugar and lipids. Indirectly, sugar promotes positive energy balance leading to increase of body weight and the fat content which in turn causes a dysregulation of lipid and carbohydrate metabolism. Based on clinical studies, it is suggested that reducing sugary beverages and total fructose intake, especially from added sugars may help reduce NAFLD and other complications of cirrhosis and chronic liver diseases.

Alcohol consumption

Alcohol consumption of more than four drinks (48 g) daily is associated with an increased risk of cirrhosis, liver cancer, and premature death. Alcohol related liver injury includes acute alcoholic hepatitis, fatty infiltration and cirrhosis. There is a combined effect of hepatitis C and alcohol on the development of symptomatic cirrhosis. As a clinician, I find it prudent to advise abstinence from alcohol since safe level of alcohol consumption is not known.

Immunization

If there is no prior vaccination, then the hepatitis A and hepatitis B vaccine should be administered in a full course It is also recommended that all patients with cirrhosis should receive yearly influenza vaccine.

Vitamins

Vitamin A is considered toxic to the liver. Excessive Iron from supplements often present in over-the-counter multivitamin preparations can cause iron to accumulate in the liver cells. Iron overload is detrimental to those with chronic liver diseases.

Vitamin C in doses more than 1 gm of should be avoided in patients with increased iron levels to reduce iron absorption. Antioxidants are helpful in managing liver health.

Dietary fat

Fatty infiltration results from alcoholic liver disease, non-alcoholic steatohepatitis (NASH), hepatitis C, drug reaction, Wilson’s disease, and other genetic diseases. The predisposing factors towards the infiltration of fats are diabetes mellitus, obesity, and increased level of serum triglycerides. In some cases, fat accumulation in the liver is also accompanied with inflammatory reaction causing fibrosis and cirrhosis. Hence, it is important to consider gradual weight reduction in patients with chronic liver disease and obesity. It is recommended that patients with compromised liver functions consume an iso-caloric diet of moderate total fat intake and low in saturated fatty acid to reduce the risk of NAFLD development.

Resources:

1. Asrani SK, Devarbhavi H, Eaton J, Kamath PS. J Hepatol 2019; 70: 151-71.

2. Stanhope KL. Crit. Rev Clin Lab Sci. 2016; 53: 52-67.

3. Riley TR, Smith JP. J Gen Intern Med 1999; 14: 699-704.

4. Jensen T, et al. J Hepatol. 2018; 68:1063-75.

5. Green CJ, Hodson L. The influence of dietary fat on liver fat accumulation. Nutrients2014; 6: 5018-33.

Dr Veena Aggarwal is Medical Advisor, Medtalks

(This story has been published from a wire agency without modifications to the text)

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Thursday, December 02, 2021