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How to prevent a fatty liver

Many people know our liver primarily as a detoxification centre, but the organ has numerous other functions. A weakened or overtaxed liver therefore has a negative impact on health. Exhaustion, depression, loss of appetite, pain in the right upper abdomen or itching can indicate liver damage. Anyone who thinks that liver damage is only caused by excessive alcohol abuse is very much mistaken. Pesticides, medication, stress and an unhealthy diet and lifestyle also put a strain on our liver. The big problem is that a damaged liver doesn't hurt and is often only recognised (too) late.

Table of contents
  • Our liver: function and tasks
  • Civilisation disease fatty liver
  • How do I recognise liver damage
  • ? What damages our liver
  • Protection for the liver: what helps against fatty liver
  • What does milk thistle do to the liver?

Our liver: function and tasks

The liver is the central organ of our metabolism. Nutrients that we absorb after digestion in the intestine first reach the liver via the portal vein. Depending on requirements, it then releases the nutrients into the blood or filters excess nutrients out again. It therefore regulates our protein, fat and carbohydrate metabolism and is also an important storage site, e.g. for glycogen and vitamins. The liver also filters harmful substances and waste from the blood. The liver is also the largest gland in the body and produces bile acid, which is important for digestion. To do this, it needs cholesterol, which - like many proteins (e.g. coagulation factors or transport proteins) - is produced in the liver.

Civilisation disease fatty liver

Fatty liver (steatosis hepatis) is the most common chronic liver disease in Germany. It can be triggered by alcohol abuse and is then referred to as alcoholic fatty liver (= AFL). However, other - non-alcoholic - causes are increasingly the basis of fatty liver disease. According to a joint position paper by leading German health organisations, almost one in three Germans suffers from non-alcoholic fatty liver disease. In recent years, it has also become increasingly common in children and adolescents.

A distinction is made between different forms of the disease. For example, it can lead to increased fat storage in the liver (non-alcoholic fatty liver disease = NAFL) or to non-alcoholic fatty liver inflammation (non-alcoholic steatohepatitis = NASH). As these diseases are accompanied by unspecific symptoms, they are often not recognised. This can have fatal consequences. A fatty liver can develop into liver cirrhosis and, in the worst case, liver cancer. To prevent these long-term consequences, it is therefore important to recognise liver damage at an early stage.

How do I recognise liver damage?

The cries for help from a damaged liver are very unspecific and are usually only recognised when the damage is already very extensive. General symptoms such as fatigue, exhaustion, tiredness, nausea, itching, loss of appetite or a slight feeling of pressure or fullness in the right upper abdomen are among them. If the disease is already advanced, more specific symptoms such as yellowing of the skin and eyes may also appear. Permanently elevated liver values in blood tests are also an indication of liver damage. A change in the structure of the liver can be examined using ultrasound.

What damages our liver?

Toxic substances such as environmental toxins, medication or alcohol damage our body and in particular our detoxification organ, the liver. But our lifestyle also has a negative impact on the organ. Lack of exercise and being overweight are the liver's biggest enemies. An excessive intake of carbohydrates and fat leads to fatty degeneration of the liver. If we consume too much energy, our body stores it in the form of fat, first in the subcutaneous fatty tissue and then in the abdominal cavity and liver. Liver values should be checked regularly, especially if you are very overweight, have diabetes and high blood lipid levels. However, depending on genetic predisposition, even a few kilos too much can cause a fatty liver.

Increased risk of liver damage

If several risk factors are combined - e.g. if you are overweight and abuse alcohol at the same time - the risk of liver damage is particularly high.

Diseases such as diabetes or heart failure also contribute to the formation of a fatty liver. However, it is not only an alcoholic or non-alcoholic fatty liver that can lead to serious liver disease. Hepatitis viruses are also an increasing risk. Hepatitis C is the second most common cause of liver cirrhosis and hepatocellular cancer in Germany.

How does alcohol damage the liver?

Alcohol (ethanol) and its degradation products acetaldehyde and acetate have a damaging effect on liver tissue. Liver cells are destroyed or altered. The more alcohol you drink, the greater the damage. Alcohol abuse can initially lead to an alcoholic fatty liver, which can then develop into liver inflammation (alcoholic hepatitis) and, in the worst case, into life-threatening liver cirrhosis. However, it is not only the amount of alcohol consumed that plays a role, but also the time period. For the sake of the liver, healthy women should not consume more than 10 g / healthy men should not consume more than 20 g of alcohol per day. It is also recommended not to drink alcoholic beverages every day.

Which medications damage the liver?

Many medications are broken down by the liver. As long as you stick to the recommended dosage and duration, most medicines are harmless. Caution is advised with overdoses. For example, paracetamol overdoses are the most common cause of acute liver failure in the western world. Antibiotics, non-steroidal anti-inflammatory drugs or over-the-counter painkillers are just a few examples of drugs that are harmful to the liver. Paracetamol in particular is considered to be especially harmful to the liver. The painkiller should not be taken for more than three days and the maximum daily dose should not be exceeded under any circumstances. Alcohol should also be avoided while taking the medicine.

Is fruit sugar (fructose) harmful to the liver?

Fruit sugar (fructose) can favour fat deposits in the liver. However, it is not the naturally occurring fructose in fruit that is problematic here, but the fructose used in processed foods. Fructose is not only twice as sweet as household sugar, it is also cheaper and easier to produce. This is why the food industry uses it extensively in its products under names such as high fructose corn syrup (HFCS), corn syrup, fructose-glucose syrup or isoglucose. The problem: unlike glucose, which is used by many cells in our body to generate energy, fructose is not essential for life. Fructose therefore remains in the liver and is stored there as fat. Please note: household sugar (sucrose) also consists of half fructose. In general, you should therefore avoid consuming too much sugar.

You can read more about fructose in the blog post Fructose: friend or foe? Fructose: friend or foe? To the blog post

A recent study investigated how the consumption of different sugary drinks over a period of seven weeks affected the liver's fat metabolism. The result: fat production in the liver was twice as high after consuming fructose-containing drinks than after consuming glucose-containing drinks.

Consuming large amounts of isolated fructose can therefore damage the liver. Especially if too many calories are generally consumed at the same time. Therefore, when buying ready-made products, check whether sugar has been added and avoid soft drinks and fruit juices as far as possible. Fresh fruit, on the other hand, poses no danger. On the contrary, as part of a balanced diet, it provides many vitamins, minerals and other health-promoting ingredients.

Can stress affect the liver?

Stress damages our body, including the liver. The stress hormone cortisol has a negative effect on liver metabolism by reducing the activity of enzymes that break down fat. Permanently elevated cortisol levels therefore favour fat deposits in the liver.

Protection for the liver: what helps against fatty liver?

The most important measure to prevent liver disease is to avoid liver-damaging substances and behaviours. This includes, for example, reducing excess weight, eating a balanced diet, getting enough exercise and avoiding sugary drinks, alcohol and convenience foods. There are also some plants and foods that can strengthen liver function. For example, bitter herbs and vegetables can be used more often to strengthen the liver. Dandelion and artichoke are particularly well-known in this context. Both plants promote bile flow, improve fat metabolism and support the liver's detoxification function.

The most important medicinal plant when it comes to liver health is milk thistle (Silybum marianum). Its positive effect on the liver and gall bladder has been proven in numerous studies. The fruits or seeds of the plant are used. These contain the active ingredient complex silymarin, which is known for its liver-protecting and regenerating effect. Silymarin includes the flavonoids silibinin, silychristin and silydianin. Silibinin has the highest biological activity and also accounts for the largest proportion in terms of quantity.

What does milk thistle do in the liver?

Flavonoids have an antioxidant effect and protect the cells from free radicals. At the same time, silymarin protects the liver from toxic substances and stimulates regeneration through the formation of new liver cells. Milk thistle therefore helps the liver to recover more quickly after damage.

You can read more about milk thistle in the blog post "Medicinal plant milk thistle: ideal for the liver and gall bladder "Medicinal plant milk thistle: ideal for the liver and gall bladder

To the blog post

Nutri-Plus milk thistle with artichoke and dandelion

Our high-dose milk thistle capsules contain 200 mg silymarin per daily portion. Production is subject to the strictest quality standards and the product is regularly tested by an independent laboratory. Like all our products, the capsules are free from animal ingredients.

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www.dgvs.de/wp-content/uploads/2021/07/NAFLD-Positionspapier-_Runder-Tisch_25.07.2021_final.pdf www.deutsche-leberstiftung.de/presse/pressemappe/lebererkrankungen/fettleber/nicht-alkoholische-fettleber/ www.dge.de/wissenschaft/referenzwerte/alkohol/?L=0 www.leberhilfe.org/lebererkrankungen/alkohol_und_leber/ B. Geidl-Flueck et al. Fructose- and sucrose- but not glucose-sweetened beverages promote hepatic de novo lipogenesis: A randomised controlled trial. Journal of Hepatology 2021; 75:46-54. L. Abenavoli et al. Milk thistle in liver diseases: past, present, future. Phytother Res. 2010; 24(10):1423-32. U. Lemke et al. The Glucocorticoid Receptor Controls Hepatic Dyslipidemia through Hes1. Cell Metabol 2008; 8:212-23.