11 Transformational Habits for a Healthy Liver

As the old saying goes, “You are what you eat.” A healthy diet is key to a healthy liver.

Consuming a diet that is rich in fruits, vegetables, protein, fiber, and healthy fats is the best way to protect against the development of non-alcoholic fatty liver disease, the leading cause of chronic liver disease (3).

Some foods that are particularly beneficial for liver health are:

• Spinach
• Kale
• Broccoli
• Salmon
• Tuna
• Almonds
• Blueberries
• Grapefruit

Your daily cup of coffee could also help protect your liver against NAFLD. A 2021 study found that drinking coffee regularly is associated with a lower risk of chronic liver disease and liver cancer (4).

Another study from 2021 associates coffee with lower liver stiffness (5). Regular, long-term coffee consumption may also have a protective effect on liver enzyme levels in people with and without liver disease and people with chronic alcohol consumption (6).

On the other hand, new research from the University of Missouri School of Medicine has established a link between diets high in fat and sugar and NAFLD (7).

By feeding mice foods high in fat and sugar, researchers discovered that the mice developed a gut bacteria called Blautia producta and a lipid that caused liver inflammation and fibrosis. That, in turn, caused the mice to develop NAFLD, with similar features to the human disease (8).

“Fatty liver disease is a global health epidemic,” says Kevin Staveley-O’Carroll, MD, PhD, one of the lead researchers and professor in the Department of Surgery at UCONN. “Not only is it becoming the leading cause of liver cancer and cirrhosis, but many patients I see with other cancers have fatty liver disease and don't even know it. Often, this makes it impossible for them to undergo potentially curative surgery for their other cancers.”

Since over half of our bodies are made up of water, it’s not shocking that we need to replenish it with water to maintain healthy bodily function. That goes double for your liver!

Unfortunately, roughly 75% of Americans are chronically dehydrated (9).

So, what does this mean for your liver? Well, when you become dehydrated, it's harder for your liver to filter waste from your body. It would be like trying to flush a toilet without running water.

Water also makes up most of your blood. When you are hydrated, it's easier for your blood to pass through the liver and thus be filtered. Basically, the less hydrated you are, the less efficient your liver is at filtering out toxins like chemicals or alcohol.

Speaking of alcohol…liver health and alcohol intake are closely linked.

Your body treats alcohol as a toxin, and it's the liver's job to get rid of it. But each time your liver filters alcohol, some of your liver cells die. And while the liver is incredible at developing new cells, excessive drinking can reduce its ability to regenerate (10).

Native Note: Heavy drinking is classified as four or more drinks per day for men and three or more drinks for women (11).

This can result in serious and permanent damage to your liver, such as:

• Alcoholic Fatty Liver Disease (AFLD): When the liver metabolizes alcohol, it can lead to the build-up of lipids, or fats, in the liver. These fats can impair liver function. At this stage of the disease, the liver may become enlarged.
• Alcoholic Hepatitis: This stage is characterized by inflammation or swelling of the liver as a result of alcohol consumption. This liver inflammation can result in the degeneration of liver cells, which impairs the liver’s ability to function.
• Cirrhosis: Cirrhosis occurs when the liver has become permanently damaged by alcohol to the point where scar tissue replaces healthy tissue. The liver will no longer function normally if scar tissue builds up beyond a certain point. This type of damage cannot be reversed.

How you react to the adverse effects of alcohol varies depending on age, gender, genetics, and other medical issues. Women tend to develop liver disease faster than men despite consuming the same amount of alcohol over the same length of time.

It should also be noted that beer and wine are not safer than spirits. Alcohol is alcohol, regardless of the type. One standard drink is equivalent to 12 ounces of beer, five ounces of wine, or 1.5 ounces of spirits. All have the same amount of alcohol.

Health isn’t just about what you eat—or don’t eat—it's also about how you move. Regular exercise, whether it be resistance training, walking, running, swimming, or biking, can have a huge impact on liver health.

Exercise has many well-known benefits for the liver (12, 13):

• Improve blood flow to the liver
• Change the composition of bacteria in your body
• Decrease liver inflammation
• Change how your blood vessels dilate
• Reduce fat in your liver
• Reduce overall body fat

It also turns out that exercise may also decrease your chances of developing liver cancer. Research shows that physically active patients who are at risk for liver cancer may be up to 60% less likely to develop hepatocellular carcinoma, the most common type of primary liver cancer (14).

Some liver diseases, like NAFLD, are linked to the build-up of fat in the liver. If fatty deposits build up over a long time, they can damage the liver and stop it from working properly. People are more likely to develop NAFLD if they are overweight or obese and eat a diet high in sugar and fat (15).

Obesity can also speed up the damage associated with other conditions, such as alcoholic liver disease, and can decrease the effectiveness of treatments for hepatitis C.

If you are overweight or obese, research shows that losing 3-5% of your body weight can improve liver health, and losing 7-10% can reduce inflammation and the risk of liver cell injury (16). It should be noted that you should aim for a gradual weight loss (1 to 2 pounds per week); very rapid weight loss may worsen inflammation and fibrosis.

As the most common drug ingredient in the United States, acetaminophen is found in more than 600 prescription and over-the-counter drugs. They range from Vicodin to Percocet, Midol to Tylenol, Sudafed, and Nyquil, not to mention their generic or store-brand equivalents.

Severe damage could occur if people take more than 4,000 mg of acetaminophen in 24 hours (17). While that seems like a lot, overshooting 4,000 mg isn’t hard. One Tylenol Extra Strength pill contains 500 mg of acetaminophen. If you take two pills up to four times a day, that’s 4,000 mg. Add a cold or cough medicine that includes acetaminophen, and you can easily exceed the recommended daily limit.

Acetaminophen overdose is more common than you think (18, 19, 20):

• Acetaminophen overdose is the leading cause of acute liver failure in the United States.
• About 1,600 U.S. cases of acute liver failure occur each year due to acetaminophen overuse.
• Around 500 people die each year from overdosing on the drug.
• It's the top reason people call poison control centers across the country.

Native Note: Interestingly, N-acetylcysteine (NAC) is also used intravenously in emergency medicine as an antidote for acetaminophen poisoning.

Practicing safe sex can help protect you from sexually transmitted diseases that can damage your liver, including hepatitis B and C, which can develop into chronic conditions that can eventually destroy your liver (21, 22).

Condoms are the only method of birth control that can reduce the spread of hepatitis C. Latex condoms are believed to be at least 99% effective (23). Some experts recommend using a plain condom and avoiding flavored or scented condoms, which may be more likely to fail. You should also avoid oil-based lubricants, which can degrade latex.

Basic hygiene protocols are simple but can prevent the risk of many dangerous infections and diseases, such as hepatitis A, B, and C (24).

Prevent the spread of infection by washing your hands for at least 20 seconds with soap. Don’t forget to scrub underneath your nails and between your fingers, too!

When toxins enter our bloodstream, the liver screens them out as a part of its regular blood-filtering process. Everyday cleaning products like drain cleaner can contain toxins that can cause liver damage, so always read the warning labels (25).

It's best to look for cleaners made from natural ingredients.

If you have to come into contact with these chemicals, wearing protective gear like goggles, gloves, and masks can help reduce your exposure.

I am no stranger to tattoos and piercings, which means I’m also no stranger to the health risks they impose. It only takes tiny traces of blood to transmit hepatitis B or C, and not everyone will know they have the virus.

In the US, there are no federal regulations for tattoos or piercings apart from age restrictions (26). This means that parlors may have different sanitation and sterilization standards in accordance with how strictly a state chooses to manage the industry. For example, Nevada does not regulate tattoo or piercing shops, but New Jersey requires each shop to meet certain equipment sterilization and sanitation standards.

What to look for in a tattoo or piercing studio:

• Gloves: Artists should be wearing disposable gloves to keep the risk of contamination and blood exposure as low as possible. They should also change their gloves every time they leave their work area or switch to a new client.
• Disinfectant: Does the artist wipe down their work area when they are done with a client? Make sure that any area where they have set a tool has been properly cleaned as well. The hepatitis B virus can survive on a surface for up to a week, so it is extremely important that any surface a tool comes into contact with has been sanitized.
• Clean Equipment: Many shops have reusable guns. These objects can come in contact with clients’ blood, so they should always be thoroughly cleaned before being used again. If you notice that an artist works on one client and does not disinfect or change their tool before accepting a new client, there is an extremely high risk for blood exchange.
• Certifications: Oftentimes, shops will have their certifications displayed on the wall to show they’ve been properly trained and required to meet certain standards by law.

Native Note: If you need help identifying safe establishments, the Association for Professional Piercers and Alliance for Professional Tattooists, Inc. are international non-profit organizations that allow you to search for shops in your area that meet certain health standards and answers any questions you may have. Both have been approved by the CDC.

We all experience stress at some point in our lives, but what is it exactly? Stress—whether physical or emotional—is your body’s reaction to a perceived threat. It triggers our "fight or flight" reaction, which releases a group of hormones like cortisol and adrenaline. These hormones prepare us to respond to the situation at hand. While this may be beneficial in short bursts, ongoing stress can harm your health.

The link between stress and liver health is not always obvious, but it is important. According to research, stress can damage liver function and cause symptoms of liver cirrhosis and other liver issues (27).

Chronic stress triggers inflammation all over the body, including the liver (28). This impacts the liver's capacity to remove toxins from the body and leads to tissue damage. As a result, the liver may struggle to process harmful substances, allowing toxins to build up. Overall, this can have detrimental effects on our health.

Cortisol triggers glucose production in the liver, providing a temporary source of extra energy during stressful encounters. However, if stress is prolonged, it can cause increased glucose levels in the liver, contributing to insulin resistance and even type 2 diabetes (29).

Chronic stress can also cause many people to turn to alcohol or unhealthy eating habits as coping mechanisms. These can also contribute to liver disease.

Finding healthy coping mechanisms can make a huge difference in managing your stress levels. Some examples include (30):

• Therapy
• Journaling
• Meditation
• Breathwork
• Walking

The best way to maintain a healthy liver is to get regular checkups with your healthcare provider. Chronic liver disease can be silent for years and go unrecognized, so it’s important to learn to recognize the signs of liver damage.

Symptoms of liver damage can include (31):

• Yellowing of skin or eyes
• Pain in abdomen
• Nausea and vomiting
• Loss of appetite
• Fatigue
• Excessive sweating
• Dark urine and pale stools
• Pale skin color
• Unusual bruising
• Unusual bleeding

NAC’s role in your liver health comes mainly from its ability to increase your levels of glutathione—your body’s master antioxidant. Glutathione plays a role in fighting oxidative stress, which can cause inflammation and damage your liver.

NAC can also boost blood flow and oxygen supply to the liver by escalating levels of nitric oxide (24). Nitric oxide is a powerful vasodilator, meaning it expands blood vessels to facilitate improved blood circulation.