Influencing Liver Disease with Diet

Everything we eat, breathe and otherwise absorb is processed by the liver. By purifying and transforming our food into substances fueling our body, the liver is dependant on what we feed ourselves. In the face of liver disease, where liver function is impaired, proper nutrition takes on increasing importance. A balanced diet containing sufficient calories and an appropriate ratio of carbohydrates, proteins and fats can assist a damaged or struggling liver to regenerate new, healthy liver cells.The common liver disease, cirrhosis, refers to the replacement of damaged liver cells by fibrous scar tissue. Fibrous scar tissue inhibits the liver from performing its many varied, critical functions. Individuals with cirrhosis typically experience weight loss, which is associated with either a decreased intake of food, or a decreased ability to process food.

Protein and the Liver

Protein in our diet comes from foods such as meat, fish, eggs, cheese, nuts and dairy. Proteins typically provide the building blocks for the body to repair damaged tissue. However, in the case of a severely damaged liver, ingested proteins may not be properly processed, leaving excessive toxic waste circulating in the body. With any type of liver disease, it is paramount to work closely with a healthcare physician to design a customized nutritional plan.

According to the American Liver Foundation, adults with cirrhosis require a balanced diet rich in protein, allowing liver cells to regenerate. However, too much protein can have the opposite effect. According to Melissa Palmer, MD, author of Dr. Melissa Palmer’s Guide to Hepatitis and Liver Disease, “If too much protein is consumed and not enough carbohydrates, the liver will be forced to use protein as an energy source. This is an unwise and inefficient use of protein, as protein will be diverted from its primary job of building cells and tissues. Furthermore, this will put undo stress on the liver, as it is more taxing for the liver to convert protein into energy than it is to convert carbohydrates into energy.” The Atkins diet is a popular weight-loss plan encouraging consumption of very high amounts of protein and very low amounts of carbohydrates. Critics of the Atkins diet emphasize the danger that a diet centered on protein can have on the body. High protein intake can change the pH of the blood, making it very acidic. When the blood is too acidic, the body goes into a state of ketosis, a life-threatening metabolic condition that can seriously damage the liver. Because of the possible repercussions, a knowledgeable physician must determine the amount of protein consumed by someone with impaired liver function. Whether concerned with helping the liver regenerate healthy cells, or preventing the dangerous condition of ketosis, those with liver disease should not leave their protein consumption to chance.

Carbohydrates and the Liver

Carbohydrates come from starch and sugar and are found in food such as bread, potatoes, rice, pasta, cereals, fruit and sweets.The body breaks down carbohydrates into glucose, and stores it in the liver as glycogen. Glycogen is essential for a steady supply of energy, as it is released between meals when blood sugar levels drop. Therefore, glycogen is the link connecting the liver with blood sugar regulation.According to Palmer, “People with liver disease should strive for a diet consisting of approximately 60 to 70 percent carbohydrates, with complex carbohydrates predominating. For such people, a well-balanced diet will include at least 400 grams of carbohydrates.” Most experts agree that for optimal nutritional value, carbohydrates should be the main source of calories for individuals with liver disease.

Fats and the Liver

Fats in our diet come from many sources including butter, lard, cream, cooking oils, cheese, animal fats and many prepared foods.According to Palmer, “Ideally, a person should aim for something in the neighborhood of 10 to 20 percent. People who are overweight should aim for 10 percent. While it is important to eat as little fat as possible, eating a small amount of the more healthy fats does have some benefit … essential fatty acids, perform (as the name suggests) a variety of duties that are essential to the proper functioning of the body.”Some people with liver disease have problems digesting and absorbing fat. Individuals with this issue likely need to decrease their fat intake and will be instructed by their physician to consume a certain type of fat more easily absorbed by the body.

Conclusion

Although liver disease is so prevalent in today’s society, most people are unaware of how influential food can be to our liver’s health. While most authorities agree that carbohydrates should be the most predominant part of a liver supportive diet, balanced amounts of protein and fat are also crucial. Choosing the right balance of foods with your physician will take your specific metabolism needs and liver health status into consideration. When individuals with liver disease follow their advised nutritional program, the support offered to their liver is unmatched by any modern medical intervention.

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Cholestatic Liver Disease

The term “cholestasis” literally means “standing still of bile.” When the flow of bile in your body is disrupted, anicteric cholestasis levels in the body will rise. Middle-aged women over the age of 40 are the ones who usually suffer from the chronic type of cholestatic liver disease. This type of disease is called “primary biliary cirrhosis.”

Diagnosis

About 90 percent of patients diagnosed with primary biliary cirrhosis are women over the age of 40. Women living in northern Europe tend to be more susceptible to this disease compared to women in other parts of the world. Women in Japan have the lowest rate of diagnosed cases of this disease.

The diagnosis of cholestatic liver disease is based on a combination of many findings and tests. Some of these factors include findings of cholestatic liver enzymes, a positive anti-mitochondrial antibody, and characteristic liver biopsy. The most common laboratory finding is the detection of elevated serum alkaline phosphates of liver origin. The presence of anti-mitochondrial antibody is the most characteristic laboratory finding in cholestatic liver disease. Over 95 percent of all who suffer from this disease will test positive for anti-mitochondrial antibody.

Signs and Symptoms

Fatigue is the most common symptom of this disorder. Seventy to eighty percent of all the patients suffering from this disease experience this symptom. However, fatigue is generally not an indication of the severity of this disorder. As the disorder progresses, other symptoms may arise, such as hypertension. As the disorder progresses even more, the ability to absorb fat-soluble vitamins will continue to decrease. As the disorder progresses further, autoimmune disorders will begin to develop. For example, a patient with this disease may begin to develop an autoimmune thyroid disease, as well as an inflammatory bowel disease once this disorder is left to progress.

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Symptoms of Liver Problems

Liver problems can range from mild liver congestion to a serious liver disease. Depending on the problem, many people are unaware they have a liver problem and may only have vague symptoms. One of the most common symptoms is chronic tiredness. These people generally feel lethargic and sluggish during the day, especially in the morning.

Due to the fact that the liver is one of the hardest working organs in the body and has many roles, there are a number of problems that can occur with the liver. The three main categories these problems fall into are:

1. Disease of the liver cells

2. Problems producing or secreting bile

3. Problems with detoxification

How do you know if you have a liver problem?

Tests are available through standard pathology labs that measure liver enzymes, total protein, albumin and bilirubin. Although these tests are called liver ‘function’ tests, they indicate whether the liver is damaged rather than how it is functioning. In other words, they are used to detect liver diseases, such as hepatitis and cirrhosis as well as liver cells being damaged from viruses, bacteria, alcohol, drugs and so on. These tests are not useful in detecting mild problems with liver congestion and sluggish detoxification. This is best done by observing your symptoms. However, it is important to consult your practitioner and have the tests performed anyway, just to rule out the possibility of liver disease.

An ultrasound can detect if there is a blockage in the bile duct. This is most commonly caused by the presence of gallstones in the biliary duct. It is estimated that around 10-20% of people over 40 years of age have gallstones and their presence is linked to a high fat, low fibre diet. The presence of gallstones in the bile duct typically causes nausea and pain. Bile flow can also be impaired through the liver, however this can be difficult to detect with standard testing.

General symptoms that can indicate a liver problem

  • Feel tired and unrefreshed when you wake up
  • Energy levels fluctuate throughout the day, with your tiredness becoming worse around mid-morning and/or mid-afternoon
  • Difficulty losing weight
  • Frequent headaches
  • Bad breath, digestive problems, bloating, gas, indigestion
  • Allergies and intolerances to foods that are worsening as time goes on
  • Reactions to many chemicals including cleaning products, petrol, paint, perfumes, bleaches, etc.
  • Problems digesting fatty/creamy/oily foods. They can make you feel unwell, nauseous or cause heart burn and reflux
  • A yellowish tinge to the skin, eyes and palms of the hands
  • Reactions to drugs, in particular headache tablets, antibiotics and anti-histamines
  • An intolerance to alcohol. Either you get drunk very quickly or you have bad hangovers that are out of proportion to the amount of alcohol you have drunk
  • Caffeine gives you a strong buzz and can keep you awake for hours
  • When you eat asparagus, you have a funny smell in your urine
  • Skin problems such as acne, eczema, psoriasis, general rashes, itchy skin
  • Hot flushes that feel as if they rise up from the torso towards the head
  • You frequently wake up around 1-3am in the morning
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