OUR lifestyle determines liver health. Here are some key areas we should address.
Achieving the perfect Body Mass Index of 18 to 22.9kg/m2 may sound like a dream but losing as little as 5-7 per cent weight benefits the liver. Carbohydrates constitute 50% of calorie intake. Simple carbohydrates like sugar and refined flour should be avoided as they cause rapid changes in blood glucose level leading to insulin resistance and fatty liver. Complex carbohydrates like whole cereals and oats are rich in fibre that slows the absorption of glucose. Fats should not provide more than 30% of calories. The use of saturated fats like ghee, butter and coconut oil should be limited. It is recommended that oils like sunflower oil should be combined with the use of olive oil or mustard oil to provide all essentials. Foods rich in protein include egg white, chicken, fish, pulses, whole grams and pulses are good for the liver. Green vegetables and fresh fruits are recommended while it is better to avoid red meats.
Consumption of more than 21 small drinks a week in males and 14 small drinks in a week in females increases the chances of developing liver disease. For those who like to drink daily, it is good to have two days off in a week to allow the liver to regenerate. Once the liver disease has set in it would be advisable to avoid alcohol completely.
A minimum of 150 minutes a week i.e. 30 minutes a day, 5 days a week, of aerobic exercises like running, brisk walking or cycling is recommended with an aim to maintain 70% of the Target Heart Rate (220 minus age for males and 216 minus age for females). Interval training, involving short bursts of jogging in the midst of a brisk walk, leads to more efficient burning of fat. Strength training and exercises for the core muscles in the back, abdomen and pelvis completes the package. It is good to remember that any exercise is better than no exercise.
Avoiding harmful supplements
Herbal and dietary supplements for bodybuilding and weight loss are responsible for 20% of drug-induced liver injury. While protein supplements are safe it is important to check the label carefully for two common threats to the liver, viz., anabolic steroids in bodybuilding supplements and high doses of green tea extract in weight-loss supplements.
Health checks and immunization
Pamper your liver with annual checks that should include clinical examination, liver function blood test and ultrasound. Fibroscan, a non-invasive way to study the liver is useful when indicated. By directing shear waves through the liver with fibroscan probe, the liver stiffness and quantity of fat can be determined. Fibroscan is recommended for individuals who have raised liver enzymes and in those with obesity, fatty liver or suspected liver disease. The vaccine is available for Hepatitis A and B. Two doses of Hepatitis A vaccine, six months apart, are recommended for children above 1 year of age. Adults desirous of taking the vaccine may do so if negative for the antibody. For Hepatitis B, all infants are vaccinated at birth. In adults who are negative for HBsAg, three doses of vaccine are recommended at 0,1 and six months.
By Dr Avnish Seth, MD, DM
Principal Consultant, Gastroenterology, Hepatobiliary Sciences & Transplant Hepatology, Fortis Memorial Research Institute