Christmas is a time where we might eat or drink a little more than usual. For many of us it’s part of celebrating with loved ones, though it can have an impact on our liver.
Your liver is about the size of a rugby ball, and the largest solid organ in the body. It weighs around 1.8 kg in men and 1.3 kg in women. Despite its size, a healthy liver contains a very small amount of fat, or no fat at all.
‘The liver is usually very resilient, but it can be damaged by prolonged exposure to excess alcohol and fatty foods,’ explains Dr McClymont.
‘Having an unhealthy or fatty liver may go unnoticed at first as there are typically no symptoms in the early stages, but fortunately there are lots of ways we can make better choices to look after the liver all year round.’
Why do we need a healthy liver?
We might not realise it, but the liver is one of our most vital and complex organs. It carries out loads of jobs – from getting rid of toxins in our blood, producing bile to help break down fats in our food, regulating our blood sugar, producing proteins and playing a role in our immune system.
Because the liver acts as our body’s factory for so many functions, having a healthy liver can have a huge amount of health benefits – from better digestion to improved brain function and even a higher level of energy.
What are the risks of an unhealthy liver?
Non-alcoholic fatty liver disease
The most common conditions associated with an unhealthy or fatty liver are described as non-alcoholic fatty liver disease (NAFLD). This wide range of conditions are mostly seen in people who are overweight or obese.
Up to a third of people in the UK have early stages of NAFLD, where there are small amounts of fat in their liver. Usually this early stage of a fatty liver is relatively harmless and can be easily improved with lifestyle changes.
More serious damage to your liver – which often takes several years – can lead to a more advanced stage of fatty liver disease called cirrhosis, which is not reversible.
Alcohol-related fatty liver disease
The other main type of fatty liver disease is caused by drinking too much alcohol or alcohol addiction. This is known as alcohol-related fatty liver disease (ARLD) or sometimes referred to as an alcoholic fatty liver.
‘Our liver is not able to process too much alcohol and too much causes damage to the liver’s cells, creating fatty deposits. Although in the early stages a fatty liver can regenerate, excessive amounts of alcohol over many years can reduce the liver’s ability to develop new cells – and this can lead to cirrhosis that causes permanent scarring and damage to the liver’s function’, explains Dr McClymont.
ARLD is very common in the UK, and is affecting many more people over the last few decades due to problems with alcohol misuse.
How can I protect myself from problems like fatty liver disease?
‘Most types of liver damage including fatty liver disease have no symptoms in the early stages. And lots of people will only know they have a liver problem once there’s already long-term damage or scarring,’ says Dr McClymont.
The good news is that 9 in 10 cases of liver disease can be prevented with simple lifestyle choices around your health. These involve maintaining a healthy weight through diet and exercise, and not drinking too much alcohol.
A healthy diet to protect your liver
- Eat lots of fruits and leafy greens like spinach
- Choose high-fibre and whole-grain foods instead of white bread, pasta and rice
- Cut out foods high in added sugar, salt, refined carbohydrates and saturated fat like chocolate, crisps and processed cheese
- Avoid red meats (stick to traditional Turkey this year!).
It’s a good idea to speak to a GP or a dietician for more specific nutritional advice, but here are a few recommended foods to kickstart your healthy liver diet.
Keep up the coffee
Good news for coffee lovers – having a daily cup of coffee can help protect your liver against non-alcoholic fatty liver disease (NAFLD) and reduce your chances of developing further complications, like liver fibrosis, if you’ve been diagnosed with NAFLD.
Swap sausages for salmon
‘Tis the season where it’s tricky to escape unsaturated fat like butter, sausages and cured meats. Swapping these fatty foods for avocados, nut butter, and fatty fish like salmon and sardines, rich in omega-3, can help prevent a fatty liver.
As well as lots of other protein-rich food like oats, beans, lentils and chickpeas, a diet rich in nuts (and especially walnuts) has been shown to reduce liver inflammation.
Tips to balance alcohol
Especially during the festive season, it’s not easy to cut out alcohol completely. With a quarter of us drinking at levels that could put our health at risk, it’s important to remind ourselves of the health benefits of drinking less.
Here are some tips to help look after your liver, particularly over Christmas and the new year.
Know what your healthy limits are
Keep in mind current UK guidelines advise not to drink more than 14 units a week (for men and women), spread over 3 days. A unit of alcohol is equal to roughly half a pint of normal lager or a pub measure (25ml) of spirits. A small glass of wine is more like 1.5 units.
Give your liver days off each week
Plan ahead to give your liver a regular break with at least 2 or 3 alcohol-free days every week – even better if these are all in a row. This may be trickier over Christmas, but with a bit of preparation, you can make sure there are lots of tempting soft drinks available for you and your guests.
Try a dry month after Christmas
And if you want to go a step further to prevent fatty liver disease, having an alcohol-free month (like the popular ‘dry January’) can kickstart liver regeneration, allowing your liver fat levels to start falling by around 15%.
‘Even if you have had an indulgent couple of weeks or been a heavy drinker for a while, drinking less alcohol or stopping altogether has lots of short and long-term benefits for your health,’ says Dr McClymont.
How can I know if I have a fatty liver?
‘In the early stages of fatty liver disease there are often no symptoms. You may even not be aware you have the condition unless you’ve had a blood test or abdominal ultrasound for another medical reason,’ says Dr McClymont.
Those with more advanced stages of NAFLD may experience some of the following symptoms.
- Dull or aching pain in the tummy (top right)
- Weakness or extreme tiredness
- Unexplained weight loss
When fatty liver disease progresses and cirrhosis develops, you can get more severe symptoms. These include:
- Jaundice (yellowing of the skin and eyes)
- Itchy skin
- Swelling in the legs, feet, ankles or tummy
How can a fatty liver impact your health?
People with high levels of fat in their liver are at much greater risk of developing other serious health problems, like diabetes, high blood pressure and kidney disease. And if you already have diabetes, NAFLD increases your risk of developing heart disease and other heart problems.
More advanced stages of fatty liver disease, which usually happens after several years of inflammation, causes your liver to become scarred, lumpy and shrink in size. This damage is permanent and can cause liver cancer or liver failure (where your liver stops working).
If fatty liver disease is picked up early, it's much easier to stop fatty liver symptoms getting worse or other health problems occuring.
But rest assured that over time, reducing the amount of fat in your liver can lead to significant improvements in your health.
When to see a GP and what to expect
‘If you’ve been diagnosed with a type of fatty liver disease, a GP can help you manage the condition and reduce the chance of it progressing’ reassures Dr McClymont.
‘Most people with NAFLD will not develop serious liver problems or damage – so will not need medication or a referral. The most important way to manage the condition is by making healthier and more informed lifestyle choices,’ she says.
‘A GP can give you lots of advice and information on this. And they can recommend treatment for any associated conditions like high blood pressure, diabetes or high cholesterol.’
A GP can also refer you for treatment if you have problems with alcohol addiction.