Our body’s second largest organ, the liver has more than 500 jobs to do, including helping the body get rid of unwanted toxins like alcohol and it’s by-products. What can we all do this festive season to show our livers a little more love?
The serious statistics
Liver disease incidence has more than trebled in the last 20 years and is now the only one of Ireland’s top 5 killers still on the increase. This time of year, the focus is generally on the effect of alcohol on our liver and how to survive the continuous round of seasonal parties.
However, it’s not all about drink. Non-alcoholic Fatty Liver disease is caused by build-up of fat tissue around the centre of the body and this can lead to the same damage as alcohol causes. 25 – 30% of the adult population are thought to have this. This fat build-up is caused in a number of ways, including excess saturated fat in the diet, excess sugar intake and carrying too much fat around your middle. If caught early, diet and lifestyle can reverse this and we are currently participating in a trial for diet to help patients with Non Alcoholic Fatty Liver Disease in St James Hospital in Dublin.
So how much should we be drinking?
Low risk alcohol guidelines were reduced in 2012 to a maximum of 17 standard drinks for a man, 11 for a woman and at least 2 – 3 alcohol-free days. A standard drink is
- Half a pint of beer
- Small 100ml glass of wine
- Measure of spirits
In UK, this has just been revised to 11 units per week for men and women. A unit of alcohol is a rough measure of the drink amount that will provide about 10g of alcohol and a bottle of wine can have 8 – 11 units, depending on strength.
The World Health Organisation defines binge drinking as more than 6 units in one session i.e. more than 3 pints. Ireland have the second highest levels of binge drinking of the 184 countries measured in a 2014 WHO report. The report also showed that 39% of all Irish people over the age of 15 had engaged in binge drinking over the previous month, 3 times the global average. Even a single night of excessive drinking can cause intestinal damage and bleeding and depress your immune system.
So, what happens when you drink?
The liver can usually cope with small amounts of alcohol. However, if you drink more than your liver can deal with, you will struggle to process it. When alcohol reaches the liver, it produces a toxic enzyme called acetaldehyde which can damage liver cells and cause permanent scarring, as well as harm to the brain and stomach lining.
Your liver also requires water to do its job properly. Alcohol acts as a diuretic and as such, it dehydrates you and forces the liver to find water from other sources. 250ml of alcohol can cause up to 1 L of water to be lost i.e. we lose 4 times as much as we consume. The severe dehydration is part of the reason why, after a big night of drinking, you can wake up nursing a whopping headache.
Alcohol irritates our stomach lining, causing an increase in stomach acid production, leading to nausea, acid and even vomiting.
The other down-side
Alcohol is high in empty calories. 3 glasses of wine = c. 500 calories. Some cocktails have much more. A pint of beer has around 200 calories. This can mount up!
You also tend to have lower resistance to foods you might normally try to avoid when you are drinking or hungover. That kebab might look pretty good after 5 pints, bringing your calorie intake for the night to around 2000.
When out on the town
- Try a pretox – a large glass of water with b vitamins, vitamin C and milk thistle before you have a drink.
B vitamins are needed by your liver to process and detoxify alcohol
The herb Milk thistle contains silymarin and silybin, antioxidants that are known to help protect the liver from toxins, including the effects of alcohol.
Vitamin C also helps to detoxify alcohol and levels are depleted by alcohol consumption
- Drink lots of water
Drink plenty throughout the day ahead of a night out. Alternate every alcoholic drink with a glass of water. Or at least a non-alcoholic drink.
- Slow down!
Your liver can only process about one standard drink per hour and some people can manage much less. Pace yourself. Not overdoing it is the best way to avoid a massive hangover.
Other drink options include non-alcoholic beer, sparking water and cordial, grapefruit juice or angostura bitters. If you drink white wine, dilute with sparkling water. This is helpful where you are at a party or dinner where your glass may be filled up regularly without you noticing
Stick with clear alcohol. Generally, clear drinks like vodka, gin and white white wine will contain fewer congeners (the additives that exacerbate hangovers) than darker varieties like brandy, whiskey and red wine.
4. Don’t drink on an empty stomach.
Having food in our stomach reduces how high your peak alcohol concentration gets by up to 30%. Less alcohol = less hangover
Ideally eat something an hour before going out. Try to include some slow releasing carbs with a little fat or protein. Ideas include wholegrain bread with peanut butter, wholegrain pasta with pesto or even cheese and wholegrain crackers
The morning after – don’ts
- Don’t overdo caffeine. One cup of coffee can help to reduce swelling in the blood vessels and reduce a headache. But too much will give your liver more work to do.
- Avoid a fry up or take away. Hydrogenated fats and the chemicals found in processed foods cause the liver to work harder, increasing the burden
- Avoid painkillers if you can. Paracetemol needs to be metabolised by your already overworked liver and while anti-inflammatory action of aspirin should help some symptoms, it can further irritate your stomach
And do’s to try
- Repeat your B vitamins, vitamin C and milk thistle to support your liver, ideally before you go to bed
- Drink a smoothie (high in vitamin C) mixed with some coconut water. Coconut water is full of natural electrolytes, to help restore hydration and mineral levels, especially potassium
- Adding some fresh ginger to a smoothie or drinking ginger tea can help reduce nausea
- Eat some food. The liver helps to manage blood sugar. Tiredness and nausea are often exacerbated by low blood sugar leading to a rebound effect from alcohol. Eggs are high in cysteine, an amino acid thought to help break down acetaldehyde. Try a wholegrain bagel with scrambled eggs and a piece of fruit for b vitamins, vitamin C and cysteine on one plate
- Try getting some exercise or even a walk in fresh air. This will help boost circulation and increase the elimination of alcohol
Enjoy the festive season!