it’s Love Your Liver month, but what are the best ways to do this? Joanna Lowy investigates.
It’s the UK’s fifth biggest killer and we are the only country in Europe where death rates are rising. That’s why January is Love Your Liver month.
“Every year there are over 8,600 deaths from alcohol-related liver disease alone – equivalent to a jumbo jet crashing every 17 days,” says Consultant Hepatologist Andrew Holt, a member of the newly-formed Birmingham Gut and Liver Clinic based at BMI Priory Hospital.
Run by the British Liver Trust, Love Your Liver month aims to reduce the rapidly growing cases of liver disease, focusing on the four main causes.
In conjunction with Love Your Liver month, various charities are doing their own things to help people cut down their alcohol intake.
Cancer Research UK is just one of these, running the ‘Dryathlon’ which encourages people to stop drinking for the whole month of January.
But not everyone is in favour of this.
“One of the problems of ‘detoxing’ from alcohol is that many people believe that if they stop drinking for a month, it cancels out any ill effects from drinking over the recommended limits for the other 11 months a year”, explains medical adviser to alcohol education charity Drinkaware, Dr Sarah Jarvis. “That’s simply not how it works. If you’re drinking within recommended limits, your liver is ‘detoxing’ all the time and you don’t need to stop for a month. However, the Medical Advisory Group at Drinkaware recommends that if you’re drinking around the daily alcohol limits you should have a couple of alcohol free days every week. This reduces your alcohol tolerance, making it less likely that your drinking will increase to harmful levels.”
“Whilst Sober Services applauds the ambitions of such a campaign, it’s a difficult notion for us to promote and support” adds Director Ian Young.
“Most of the clients Sober Services deals with are alcoholics and people who have a problem with drinking at some level. The very nature of our clients problems begin with their inability to stop drinking for a day, let alone a month.
“The type of people who will be able to abstain from alcohol for a month without too much of a challenge are precisely the types of people for whom the threat of liver damage is largely non existent”, he continues.
“Cutting out or drastically reducing your alcohol intake is certainly a good idea, and for long term benefits it needs to be a continual effort” says specialist in liver related problems, Dr Mark Wright.
“There is a public stereotype of binge drinkers being at risk from alcohol, but they are not the only ones to consider. People who have been drinking regularly throughout their lives, whether to excess or not, are still susceptible.”
As well as supporting the two to three alcohol-free days a week and drinking in moderation, the Love Your Liver campaign also suggests not saving up several days’ allowance and drinking it all at once.
“At the moment alcohol is the main cause of liver disease, but obesity is right behind it, and in the United States obesity is now the main cause of liver disease and alcohol is the second cause” says Chief Executive of the British Liver Trust, Andrew Langford. “So it’s a huge issue. If 25% of the population are obese then we know that 90% of those will be doing damage to their livers. With obesity alone we could have between 13-15 million people in the UK who are slowly damaging their livers, and that will just carry on.”
“Ask someone what they know about their liver diseases and they will tell you that nearly all are caused by alcohol”, Dr Holt adds. “However many liver diseases are also caused by diabetes, high blood pressure and obesity, and can be prevented by early intervention.”
“I just thought it could never happen to me and carried on stuffing myself with chips, pizzas and fizzy drinks,” says. Mohammed Ajmal, before discovering his liver was almost three times the size it should be.
“Basically, Dr Holt gave me just the shock I needed to change my lifestyle and, literally, save my life,” says the 44-year-old after visiting the Birmingham BMI Priory.
“I was just over 20st, and he said that if I didn’t lose 20% of my body weight I would die within 10 years – that was it, the pizzas, chips and fizzy drinks just had to go.”
The British Liver Trust has outlined several things you can do to maintain a healthy lifestyle and ward off the threat of liver disease including exercising, cutting down on sugar and fat and drinking more water. They also advise not panicking if you’re not losing weight as quickly as you’d like, as the best way to keep your liver healthy is to fight the pounds gradually.
“While weight loss is often the focus of lifestyle intervention, exercising under the current guidelines of at least 150 minutes per week can show significant improvements in liver enzymes and other metabolic parameters” says Research and Development Manager for Premier Training International, Kesh Patel. “The key message is that virtually any exercise is useful, but it may be best to start out with walking; as fitness improves, exercise intensity can be increased, and may include more vigorous forms of aerobic and strength training – both types of exercise improve liver function in a number of ways. The cardiovascular effects of aerobic training will result in improved blood flow to and from the liver and increased oxygen uptake to liver tissue; and the load-bearing effects of strength training can help to maintain bone strength and reduce body fat. Building lean muscle mass can also delay the muscle wasting that is associated during advanced stages of liver disease.”
The fourth and final main cause of liver disease is the virus which is estimated to affect over 500,000 people in the UK, approximately one in every 350 people.
There are a number of different causes. Hepatitis B and C, blood-borne viruses, can cause permanent liver damage and increase the risk of liver cancer. Hepatitis A and E are spread by faecal-oral transmission, and are passed out through bowel motions and re-enter the body through the mouth, usually via contaminated food or water. Hepatitis E is also thought to be passed on through eating pork that has not been cooked properly.
The best defence against the virus is through a vaccine, but the British Liver Trust also advises against sharing personal items such as razors, nail scissors, tweezers or toothbrushes and practicing safe sex.
“The liver filters toxins from the blood, makes important proteins, regulates your cholesterol levels and helps your body to fight infection and disease”, explains Dr Wright. “When a person drinks alcohol regularly over a sustained period of time the liver becomes damaged and cannot perform these essential functions in the same way.”
“Overeating fats and carbohydrates will start to be stored in your liver and if you’re not exercising those off as the liver tries to filter those will just get clogged up”, Andrew explains. “And the effects are the same as alcohol – the liver will slowly start to stiffen, which will lead to liver failure.”
Luckily for Mohammed, his symptoms were caught just in time.
“I told him straight that the bad news was that he could die prematurely but the good news was that the damage he had done was almost completely reversible if he could just make some positive life changes,” Dr Holt says.
“The liver is an amazing organ and will rejuvenate itself if you just give it a chance. The down side is that liver disease can creep up on you without any warning and you don’t even know you have it until it is too late to treat. It really can be the silent killer.”
Now down to 16 stones, Mohammed sticks strictly to a healthy diet as well as making sure he walks three miles a day and gets eight hours sleep every night – and is still looking to shed a few more pounds.
“I have good, fresh food and lots of liquid – I eat four large oranges a day as well as drinking a litre of bottled spring water and a litre of green tea. Not only is it better for my health it is actually tastier and more enjoyable to eat once you make the change,” he said.
And the good news is that following his last check-up Mohammed’s liver has almost completely recovered.
“I got the warning in time and did something about it. Now I just want to make other people aware of the dangers of liver disease and make them realise they can do something to prevent it,” he says.
Love Your Liver, organised by the British Liver Trust, will be taking a roadshow around the country. People will have the opportunity to receive a fibroscan liver check which measures the ‘stiffness’ or ‘elasticity’ of the liver, as well as receive advice from leading liver specialists such as Dr Holt.