In collaboration with Canadian dietitian Audrey Cyr
Diet has an important role to play in liver health. Although some food habits may keep your liver healthy, others might be harmful. After advising you on some healthy foods, My Liver Exam discusses those you may avoid.
Avoid radical diets
The majority of people with non-alcoholic fatty liver disease are overweight or obese. Obesity involves an enlarged liver, due to the accumulation of fat.
Note that progressive weight loss can reverse the condition. Indeed, several studies have shown that a 500 kcal reduction in the daily caloric intake can result in a significant decrease of fat in the liver.1
The recommended weight loss for overweight or obese people should not exceed 1 kg (2.2 lb) per week. Very low calorie diets should absolutely be avoided because they can aggravate the disease and increase the inflammation of the liver.2
Focus on alcohol
The liver is the organ that metabolizes alcohol. However, only a certain amount can be metabolized over a period of time.
When the amount of alcohol in the blood is too high, this liver function may be interrupted, resulting in chemical imbalance. If the liver is forced to neutralize alcohol continuously, liver cells can be destroyed or altered resulting in fatty deposits (fatty liver), and more serious problems, such as inflammation (alcoholic hepatitis) and / or formation of permanent scar tissue (cirrhosis) .3
Alcohol consumption can lead to the development of severe liver disease. Women are more likely to develop alcoholic disease. The consumption of 20 to 40g of alcohol per day for 10 years is the threshold value in the development of the first stage of liver disease.4
For men, the threshold represents 40 to 80 g per day for 10 years.
It should be noted that the amount of alcohol consumed is about 12g. Consumption is equivalent to :
- 1 beer of 341 ml (11.05 oz) with 5% of alcohol,
- a wine cup from 148 ml (5oz) to 12% of alcohol,
- a glass of spirits from 44 ml (1.5 oz) to 40% of alcohol.
In conclusion, for a woman, the threshold is 1.5 to 3.5 drinks a day for 10 years and for a man, 3.5 to 6.5 drinks a day for 10 years.
Consumption of 6.5 to 13.5 drinks a day for 10 to 20 years can lead to hepatitis or cirrhosis. The recommendation is therefore to moderate its alcohol intake to maximum one consumption per day for women, and two for men. Ideally, do not drink every day.
You can read our article about alcohol effects on the liver.
Concentrated sources of fructose, especially high fructose corn syrup and concentrated sources of glucose stimulate hepatic lipogenesis.5-7
The main sources are:
- Soft drinks,
- Sweet fruit drinks,
- Some flavored yogurts,
- Sweet breakfast cereals,
- Canned fruits,
- Bakery products (pastries, pastries, cakes, pies),
- Prepared or frozen meals,
- Condiments: sweet sauces, ketchup, jams, fruit jellies.
It is recommended to read the ingredient list carefully to check for glucose-fructose or high-fructose corn syrup and avoid products containing it.
A recent study in 2018 found that there was a variable response from one individual to another regarding fructose consumption. This response could thus determine whether hepatic steatosis can develop or not following excessive consumption of fructose.8
Another study showed that not all sources of fructose were harmful to the liver, therefore it is important not to rule fruits out of your diet, for example.9
In addition to being aware of fructose intake, this study also suggested a high consumption of animal proteins was more closely linked to non-alcoholic fatty liver disease than fructose.
Saturated and trans fat
Regarding saturated and trans fats, although no human studies have directly linked the consumption of saturated fat to non-alcoholic fatty liver disease, some animal studies have shown a relation between this type of fat and the deterioration of liver health.10
The main sources of saturated fat are cold cuts, red meats, butter, and high fat dairy products such as cheese, cream, and ice cream. For trans fats, they are found mainly in pastry and bakery products and commercial fried foods made with vegetable fat, such as French fries and donuts. They are also found in hard / solid margarine. The words “partially hydrogenated oils” in the ingredient list means that it contains trans fat.
It is therefore recommended to focus on fish and seafood, poultry / eggs as main sources of protein or to learn about vegetable proteins such as soy products (tofu / tempeh / edamames) or vegetables (dried peas, lentils, beans, chickpeas, etc.) as well as nuts and seeds. Vegetable oils such as olive or canola oil should be preferred to butter for cooking as well. Avoid what is processed with a long list of ingredients and cook more at home.
Some studies suggest that high consumption of pesticides could also affect your liver health.11 The less you consume of pesticides, chemicals, antibiotics or hormones, the less your liver must work to filter these substances. For the year 2018, the foods that contain the most pesticide residues are, in descending order: strawberries, spinach, nectarines, apples, grapes, peaches, cherries, pears, tomatoes, celery, potatoes and peppers.
Ideally, choose these foods in organic version. It is also recommended to wash fruits and vegetables before consumption.
Finally, too high sodium intake may also negatively impact your liver health. Although these are preliminary animal studies, the results have shown that too much sodium causes a number of changes in the liver including deformed cells, a higher rate of cell death and a lower rate of cell division.13
Since high sodium intake can have many health implications, it is recommended to reduce it.
Tips and tricks:
- Buy unsalted or low sodium foods. Look for the words “no sodium,” “low sodium,” or “no added salt” on the package.
- Compare labels and choose products that contain the least sodium (target less than 360 mg per serving).
- Buy fresh or frozen vegetables without added salt.
- Prefer low sodium vegetable and tomato juice.
- Prefer unseasoned meats, poultry, fish, seafood and tofu.
- Opt for unsalted nuts.
- Obtain low sodium canned dry beans.
- Avoid salt shaker at the table. Restrict salt and salty spices when cooking (eg onion salt, sea salt, vegetable salt, steak spice, soy sauce or tamari, monosodium glutamate).
- Avoid frozen meals and fast food meals.
Suggested condiments to add flavor without the addition of sodium include: dry mustard, pepper, onion or garlic powder, fresh ginger, balsamic vinegar, herbs (basil, oregano, etc.), salt-free spices, and lemon juice.
- Adams LA, Angulo P. Treatment of non-alcoholic fatty liver disease. Postgrad Med J. 2006;82(967):315-322.
- Shah K, Stufflebam A, Hilton TN, Sinacore DR, Klein S, Villareal DT. Diet and exercise interventions reduce intra-hepatic fat content and improve insulin sensitivity in obese older adults. Obesity (Silver Spring). 2009;17(12):2162-2168.
- Fondation canadienne du foie: complications liées à l’alcool. Page consultée en ligne le 18 juillet 2018 : https://www.liver.ca/fr/patients-caregivers/liver-diseases/alcohol-related-complications/
- Harrison, Principes de médecine interne, Flammarion.
- Asrih M, Jornayvaz FR. Diets and nonalcoholic fatty liver disease: the good and the bad. Clin Nutr. 2014 Apr;33(2):186-90.
- Zivkovic AM, German JB, Sanyal AJ. Comparative review of diets for the metabolic syndrome: implications for nonalcoholic fatty liver disease. Am J Clin Nutr. 2007 Aug;86(2):285-300.
- Basaranoglu M, Basaranoglu G, Sabuncu T, Senturk H. Fructose as a key player in the development of fatty liver disease. World J Gastroenterol. 2013;19(8):1166-1172.
- Beysen C, Ruddy M, Stoch A, et al. Dose-dependent quantitative effects of acute fructose administration on hepatic de novo lipogenesis in healthy humans. Am J Physiol Endocrinol Metab. 2018 Jul 1;315(1):E126-E132.
- Alferink L, Kiefte-deJong JC, Veldt B, et al. Animal protein is the most important macronutrient associated with non-alcoholic fatty liver disease in overweight participants: The Rotterdam Study. J Hepatol. 2017;66(1 Suppl):S50.
- Wang D, Wei Y, Pagliassotti MJ. Saturated fatty acids promote endoplasmic reticulum stress and liver injury in rats with hepatic steatosis. Endocrinology. 2006;147(2):943-951.
- Banrida Wahlang, Juliane I. Beier, Heather B. Clair, Heather J. Bellis-Jones, K. Cameron Falkner, Craig J. McClain, and Matt C. Cave. Toxicant-associated Steatohepatitis. Toxicol Pathol. 2013 Feb; 41(2): 343–360.
- Environmental working group : EWG’s 2018 Shopper’s Guide to Pesticides in Produce. Page consultée en ligne: https://www.ewg.org/foodnews/summary.php#highlights
- Wang G, Yeung CK, Wong WY, Zhang N, Wei YF, Zhang JL, Yan Y, Wong CY, Tang JJ, Chuai M, Lee KK, Wang LJ, Yang X. Liver Fibrosis Can Be Induced by High Salt Intake through Excess Reactive Oxygen Species (ROS) Production. J Agric Food Chem. 2016 Feb 24;64(7):1610-7.