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Liver Disease, What Diet Works, and Why Olive Oil

A bit of perspective. There is a difference in the standards of care between the US and some in Europe. My approach leans to the European. We start with the fact that the fundamental problem is the biochemical flow between the liver and fat cells. When diet is poorly balanced, over time fat accumulates in the liver and by itself is rather benign but when other chemistries like insulin management begin to degrade you get inflammation which leads to fibrosis and if not stopped, can progress to cirrhosis. Since there is no treatment your tool is diet and the challenge is to avoid anything that stresses the liver and loads up on anything that is protective. Easy peasy right. Well let's take a look

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  • eliminate all alcohol
  • eliminate saturated fat and no red meat
  • eliminate all non-skim dairy products
  • eliminate trans-fat and all hydrogenated oils
  • eliminate all high fructose corn syrup
  • eliminate most salt -- the goal 1500 mg/day
  • eliminate all added dietary sugar
  • eliminate processed grains, no white flour or white rice
  • Avoid most products hustled by the supplement industry
  • Make sure that any medications you take are not harming your liver


Oh my god. That is a terrible list. Not possible to live that way. OK, take a breath. The goal is to take as much pressure off the liver as possible, provide molecules from your diet that are protective and don't stimulate the stellate cells to initiate scaring, but still provide proper nutrition. So what do you do?


For oil get 60 ml, that's 1/4 cup, a day of extra virgin olive oil
Don't buy prepared foods without reading the label, there isn't actually much that you can buy
Eat lots of fruits and vegetables but remember the salt limit
Learn to like kale, lima beans, Brussel sprouts, etc.
Look for fiber like whole wheat bread, no white bread. Use brown rice
Eat fatty fish like salmon at least a few times a week
East skinless chicken or turkey and lean pork, fresh pork not processed like ham
Explore new foods like quinoa as a grain
Eat plenty of vegetable protein like beans.
Take 400mg to 800 mg of vitamin E
Take fish oil supplements daily
Drink 3 to 4 cups of paper filtered coffee daily
Be aware that eating out is tough as very little of it is good for you

You get the idea. You might call this a type of Mediterranean diet but the excess olive oil is specifically a medicine.

The rest is mostly nutrition. The salt limitation is good for you and lowers your blood pressure. So why should you think this might work for you? Without getting too technical your energy systems are built around triglycerides. Any oil can be used by the body to make them but if made with unsaturated oil they are better for the body. More importantly, olive oil is mostly an omega 9 fatty acid. Good olive oil is a complex mixture of around 30 oils and phytochemicals which support liver function and soothe activated stellate cells which cools inflammation. Good olive oil causes a burning feeling at the back of your throat. Those are the phytochemicals and more is better if you ever go to an oil tasting bar.

A couple of other things to understand. Olive oil does contain some omega 6 and you eat fatty fish to balance that with omega 3 because between them they help modulate fibrosis and the omega 6 / omega 3 ratio is important. You eliminate fructose because it is not usable by the body without processing by the liver so you lower demand on the liver. The thing no one tells you is that normal table sugar is 50% fructose so sweet treats go away except as fruit.

As a practical matter, you can't get that much olive oil in cooking. Personally, I just view it as cough syrup and take 4 tablespoons daily plus whatever I get with food. Be sure to pay attention to the source of the oil. UC Davis found that 69% of supermarket oil wasn't really extra virgin. A little factoid, Italian law allows any oil that comes through the country to be labeled as Italian no matter its source. Bertolli, the biggest Italian distributor in the US doesn't own a single olive tree. Until recently most olive oil sold here was vegetable oil doctored to look like olive oil. Here are a couple of links to info.

http://olivecenter.ucdavis.edu/research/reports
http://olivecenter.ucdavis.edu/research/files/oliveoilfinal071410updated.pd f

A cautionary tale. Bulk oil is shipped in large plastic bags called whales. A US packer once received a shipment which the staff thought smelled funny. When it was tested it had 390,000 times the allowed concentration of an insecticide banned in the US. It turns out that every port sprays the shipments to prevent insect invasion and that particular chemical penetrated the plastic. An extreme case but how many whales are actually contaminated. The only safe way to buy oil is from organic farms who manage their own product. I buy only oil marked with the COOC label. That is the certification sponsored by UC Davis to assure quality.

Also, a word about exercise. Everyone tells you to exercise but no one tells you why with regard to your liver. Remember all of the blood in your body goes through the liver on its way back to the heart. You will see a lot of material about liver cleanses and people sell all manner of odd schemes. Most of that is just hucksters after your money. Remember that nothing gets to the liver without going through the cauldron of hydrochloric acid in the stomach and the bile and enzyme stew of the intestines and can only reach the liver as some chemical that can be absorbed by the bowel. There may be some things that change the blood chemistry enough to benefit the liver but I personally have seen no persuasive proof.

 

The role of exercise has to do with fluid flow. The organ is flexible and the fluid paths through the liver expand if greater demand is made of them to transport blood. In such an intricate system gunk can accumulate in low flow areas. The defense is to get your heart rate up, demand that all of those passages expand and stretch. It is rather like an internal massage for the organ. That gives you a chance to open the passages, move things along that might become a problem if you stay sedentary. Keeping the tissue flexing isn't a cure but can help delay the ongoing damage.

OK, this is probably more than you wanted, but life and death decisions are made multiple times every day. For me, I take my liver's threat personally. My goal is to shackle the beast in my belly and die one day from something else. That may sound extreme but in the end, we all choose the many small steps which ultimately determine the general flow of our health. Whether we make those choices deliberately or from habit is the question.

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