Is Your Liver Cooked?


Kirsten Macnab |

Plus, seven ways to show your liver some love.

By Aimee Swartz | Illustration Sciepro

Millions of men have hidden liver trouble. Follow our advice to keep yours healthy

Maybe you’ve heard this line just before last call: “The liver can grow back!” Well, yes, but let’s not rationalise ourselves into the hos­pital. Your liver is incredible, but boozing is just one way to ruin this vital organ, which turns food into nutrients and filters toxins from blood. Another big threat is fat. As many as a third of adults have a build-up of extra fat cells, a condition with a lovely name: fatty liver disease.

Early medical literature described fatty liver as a problem afflicting heavy drinkers, but “that’s no longer the case,” says W. Ray Kim, a professor of medicine at Stanford University. Now it increasingly occurs in people who don’t drink in excess. In those people, it’s called nonalcoholic fatty liver disease, or NAFLD – the most prevalent chronic liver disease in Western countries.

It’s normal for a liver to contain fat cells, but things change once its fat content hits 10% or more. Inflammation can set in. The liver’s spongy texture can coarsen as its function declines. But this might sneak up on you. Your liver can still power on when only a fraction of its tissue is healthy, so most people with NAFLD go years without symptoms. It’s often detected by chance through unrelated blood work or imaging tests.

Up to 20% of the time, NAFLD may take on a more serious form: nonalcoholic steatohepatitis, or NASH. This, too, is often silent. Most people with NASH feel fine and only notice symptoms – like weight loss and fatigue – once the liver is badly damaged, a process that can take years. By then they may have cirrhosis, potentially fatal damage from scarring. “As scar tissue replaces healthy liver tissue, the liver will begin to fail,” says Dr Kim. “Once a person with NASH has cirrhosis, there is no reversing it.” Eventually the only option is a transplant. What’s more, NASH is emerging as a major cause of liver cancer, a disease that kills the majority of its victims. The good news is that unlike cir­rhosis, NAFLD and NASH can be reversed. Here’s how to show your liver some love.

1. Beware of Metabolic Syndrome

Fatty liver is a classic 21st-century disease; its rise coincides with our increasingly poor diet and lack of exercise. High blood pressure, high blood sugar, unhealthy cholesterol levels, and excess abdominal fat – that constellation known as metabolic syndrome – also threaten a man’s liver, says Sean Kelly, an assistant professor of medicine at Ohio State’s Wexner Medical Center. Having only one of these factors is a signal of poor health; two or more will multiply your risk of developing NAFLD (plus plenty of other problems, such as heart disease and diabetes). As metabolic syndrome compromises your body’s machinery, fat accumulates in your liver. Your doctor can detect blood sugar and cholesterol levels through a simple blood test.

2. Watch Your Enzymes
While you’re arranging for your blood work, ask for a comprehensive metabolic panel. This will indicate whether key liver enzymes are in the normal range. Men may be programmed to metabolise fats in a way that makes them more prone to fatty liver than women, according to research from the UK.

3. Nourish Your Liver
Excess calories and carbs promote the formation of fat deposits in your liver, but a smart diet can actually help your liver regenerate new cells. Eat plenty of fruits, vegetables and wholegrain carbs, and limit foods high in saturated fats and sugar. “Start small. Even simple modifications, like avoiding fried foods or giving up soda, can make a big difference,” says Dr Kelly. Hit the bulk aisle: In a recent study in the International Journal of Food Sciences and Nutrition, people with NAFLD who consumed just over 30 grams of brown milled flaxseed a day for 12 weeks improved their liver health.

4. Be Religious About Exercise

Recent studies have shown that regular exercise can reduce liver fat even without weight loss. That goes for aerobic exercise (such as running or swimming) as well as strength training. In one UK study, people who cycled and did resistance training three days a week for three months reduced their liver fat by an average of 16% compared with those who didn’t do the exercises. Whatever habit you establish, keep it up. If you quit working out, your liver fat levels will rebound within a year, suggests a new study in the International Journal of Obesity.

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5. Maintain a Healthy Weight
For every extra BMI point, your NAFLD risk rises 13%. “Often a 10% body-weight reduction translates into a big improvement,” says Dr Kelly. If you need to slim down, do it gradually; Dr Kim advises taking six months to a year, because
losing two or more kilos a week can bring on
or worsen fatty liver. Avoid weight-loss or bodybuilding supplements, some of which can hurt your liver. Twenty percent of people with substance-induced liver injury can blame it on a supplement, versus 7% a decade ago, the journal Hepatology reports.

6. Limit Your Alcohol Intake
Drinking can send your liver into overdrive as it tries to process the alcohol and detoxify your blood. There’s no hard and fast rule, but the Office of Disease Prevention and Health Promotion recommends that men limit alcohol to one or two drinks a day. If you already have NAFLD, it’s probably okay to have a drink from time to time, but not on the regular. NASH patients, however, should be totally off the sauce, say researchers in Germany.

7. Mind Your Medicines
Some medicines and supplements – even ones that tout liver benefits – can actually harm your liver. Case in point: the pain reliever acetaminophen can wreck your liver if you take too much (more than 4 000 milligrams in 24 hours). You probably know that acetaminophen is in Tylenol, but it’s also in hundreds of other drugs, especially cold and flu remedies and prescription pain relievers. Only take medicines that you need, follow dosing recommendations, and let your doctor or pharmacist know everything you
are taking, even if it’s sold over the counter.

8. Protect Yourself from Hepatitis

Viral hepatitis – A, B or C – can wreck a liver. Hepatitis A is primarily spread through food or water tainted with microscopic amounts of faeces, and is endemic in South Africa. You can immunise yourself against it with the help of a vaccine; doses six to 18 months apart will ensure long-lasting, life-long protection. Hep B and C, on the other hand, are spread via blood and other body fluids. There’s a shot for B; and to avoid B and C, use latex condoms and never share toothbrushes, razors or needles. Anyone being tested for HIV should consider hepatitis B and C testing as well.

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