Liver Disease: The Silent Epidemic
Liver disease is often dubbed a “silent killer,” and its prevalence is alarmingly rising in the UK. According to the British Liver Trust, death rates attributed to liver disease have quadrupled over the past 50 years, resulting in over 11,000 fatalities annually.
Professor Debbie Shawcross, a renowned expert in hepatology and chronic liver failure at the Institute of Liver Studies, King’s College London, emphasizes the critical role of the liver in overall health. “The liver is just as vital as the heart, yet many people overlook its importance,” she explains. Shawcross highlights an “evolving crisis” in chronic liver disease in the UK, with both prevalence and mortality rates increasing drastically.
“Liver cirrhosis is the third leading cause of death and loss of working life, following ischaemic heart disease and self-harm. Disturbingly, it is the only major cause of mortality that is on the rise in England. Over the past decade, deaths due to liver disease have increased by 40 percent,” she notes, adding that “individuals often succumb to liver disease at a younger age, with more than one in ten victims in their 40s.”
Understanding the Liver’s Role
The liver serves as the largest solid organ in the body, holding approximately 13 percent of the total blood supply at any moment. “It functions as a factory, performing over 500 different roles,” Shawcross elaborates. These functions include:
- Absorbing nutrients and detoxifying harmful substances from the bloodstream.
- Processing digested food from the intestine into energy.
- Regulating fat, protein, and sugar levels in the blood.
- Filtering blood and combating infections.
- Neutralizing and breaking down drugs and toxins.
- Storing essential chemicals, such as iron and vitamins.
- Producing bile and vital hormones.
- Manufacturing proteins crucial for blood clotting and tissue repair.
“You only have one liver, and while liver cells possess the ability to regenerate after damage, repeated injuries can lead to scarring, causing the liver to shrink and fail in performing its essential functions,” Shawcross adds.
The Asymptomatic Nature of Liver Disease
Similar to high blood pressure, liver disease often remains asymptomatic for many years. “It may take 10 to 20 years for advanced liver disease, known as liver cirrhosis, to manifest,” she explains. “As the liver becomes scarred, it shrinks and begins to fail. Remarkably, one in six patients with liver cirrhosis may also develop liver cancer.”
Cirrhosis, which marks the end stage of chronic liver disease, is a progressive condition resulting from ongoing liver injury due to factors like excessive alcohol consumption, viral hepatitis, or metabolic disorders. “With one third of the global population now classified as overweight or obese, steatotic liver disease—caused by fat accumulation in the liver—is becoming increasingly common,” Shawcross warns. “Overweight individuals and those who consume excessive alcohol are at a heightened risk of liver damage.”
Daily Habits for a Healthy Liver
Shawcross incorporates various daily habits to promote liver health while avoiding detrimental practices. Here’s her advice:
1. Enjoy an Apple a Day
“Eating an apple, or other stone fruits like plums, cherries, or nectarines, can genuinely promote health. Apples are rich in pectin, which encourages the growth of beneficial gut bacteria that produce short-chain fatty acids. These fatty acids are vital for maintaining a healthy gut and immune system, as well as keeping liver cells functioning optimally. I ensure my children have an apple in their lunchboxes and stock up on them during grocery trips.”
2. Drink Two to Three Cups of Coffee Daily
“Research indicates that individuals who consume three to four cups of coffee daily have a reduced risk of developing liver disease compared to non-coffee drinkers. Coffee has been shown to mitigate liver damage, including fibrosis, which can lead to cirrhosis. A UK Biobank study confirms that all types of coffee, including decaffeinated, instant, and ground, lower the risk of chronic liver disease and liver cancer.”
3. Consume Alcohol in Moderation
“While there’s no completely safe level of alcohol consumption, it’s unrealistic to expect complete abstinence. I enjoy a glass of wine with dinner on weekends and special occasions. However, it’s crucial to limit intake to no more than 14 units per week, and avoid consuming more than six units in a single day, which constitutes binge drinking—particularly harmful to liver health. Remember to take two to three alcohol-free days each week to give your liver a break.”
4. Pair Alcohol with Food
“About 25 percent of alcohol from a drink is absorbed directly from the stomach into the bloodstream; the remainder is absorbed from the small intestine. The rate of absorption depends on various factors including the alcohol concentration, carbonation, and whether your stomach is full. Consuming alcohol with food slows its absorption and lowers blood alcohol concentration.”
5. Opt for Stairs over Elevators
“With one third of the population now overweight or obese, fat deposition in the liver is a leading cause of liver disease. Regular exercise that elevates heart rate is as important—if not more so—than maintaining a balanced diet and healthy weight. Resistance training can prevent muscle wasting and reduce fat stored in the liver, thereby protecting against diabetes and reducing liver inflammation. Even modest exercise can enhance liver health by bettering how the liver processes fats and sugars. Simple actions, such as taking the stairs instead of the lift or getting off public transport one stop earlier, can make a difference.”
6. Replace Fizzy Drinks with Kombucha or Kefir
“Sugar-sweetened sodas are a major source of fructose, which the liver stores primarily as fat, increasing the risk of fatty liver disease and other serious conditions. Diet sodas, containing artificial sweeteners, can also lead to insulin resistance and liver inflammation. Some studies suggest that sugar can be as harmful to the liver as alcohol, regardless of weight. Kombucha, a lightly carbonated drink made from fermented tea, is rich in antioxidants, vitamins, and probiotics that can benefit digestion and gut health. I often replace sugary sodas with kombucha or unsweetened kefir for a healthier choice.”
7. Prioritize Sleep
“As a busy professor balancing clinical duties, research, teaching, and motherhood, I often struggle to get eight hours of sleep. Lack of sleep elevates stress hormones, which can lead to increased hunger and cravings for unhealthy foods, thereby promoting fat accumulation in the liver. Restorative sleep also reduces late-night snacking, which can contribute to weight gain and liver fat. When I can manage an early night, I notice a significant improvement in my overall well-being.”
8. Avoid Binge Drinking
“Binge drinking, defined as consuming six or more units in one sitting, inflicts more harm on the liver than consistent moderate drinking.”
9. Steer Clear of Liver Detox Remedies
“Many herbal and homeopathic supplements marketed as liver detoxifiers do not enhance liver health. In fact, certain herbal treatments can be toxic, leading to liver damage or failure.”
10. Never Skip Breakfast
“Omitting breakfast raises the risk of metabolic liver disease, diabetes, and cardiovascular issues. Consuming a larger portion of daily calories in the morning can also help reduce the risk of developing fatty liver.”
