Sugar & the liver

Less loved or glamorous than other organs in the body, we feel the liver is due more attention and respect!

The liver undertakes numerous physiological processes (over 500 vital functions!) to keep the body healthy, including storing glucose to be later used for energy; producing bile for fat breakdown and utilising fat-soluble vitamins; forming proteins for use in the body, and much more.

Importantly, it is one of our primary detoxifiers, filtering blood to transform and clear out compounds our bodies make, such as hormones, as well as compounds from outside the body, such as alcohol, toxins, and even chemicals we breathe, ingest, and paste on our skin. Big job!

Like most things, the liver has a limit. Collectively, external and internal factors can place an excessive burden on the liver, impacting its ability to do its job effectively. Factors include too much alcohol, poor diet, chronic stress, and certain viral infections, as well as exposure to too many synthetic chemicals found in pesticides, cleaning, and personal care products, and excessive, incorrectly administered, or adverse reactions to medications, supplements, and herbal therapies.

The loaded liver

When the liver is struggling to function properly, it manifests in myriad ways throughout the body. Think poor metabolism, fat accumulation, reproductive hormone imbalance and premenstrual syndrome, sluggish digestion, high cholesterol levels, and sugar cravings, among other things.

While not exclusive or conclusive, other generalised signs and symptoms of a struggling liver include yellow eyes or skin, nausea with no other known cause (usually in the morning), lethargy, and gallbladder issues, including stones or pain.

It is pretty common knowledge that too much alcohol hurts the liver. But did you know a significant concern for liver health is excess added and free sugar consumption? 

Sugar and the liver

“Too much [free] fructose can damage your liver…When we consume large amounts of fructose in added sugar, particularly in liquid form on an empty stomach, it slams the liver with more than it can handle.”

– SugarScience, UCSF

The simple sugar fructose is almost entirely metabolised in the liver, unlike glucose which is used by cells throughout the body for energy.

When consumed in excess – especially in free or liquid form – the liver is burdened, its function is compromised, and fat can build up on the organ. This is known as non-alcoholic fatty liver disease (NAFLD) or fatty liver.

“NAFLD (Non-alcoholic Fatty Liver Disease): this is when the liver becomes full of fat. In my case, it resulted from all the sugar (fructose) I was eating. It now affects 5.5 million Australians.”

– Damon Gameau, That Sugar Book

Fatty liver can lead to an inflamed liver, progressing to scarring, cirrhosis, and in some, cancer. 

For most people, fatty liver is preventable (excepting those with certain conditions). According to recent stats, about one in three Australians have fatty liver, mostly from factors other than alcohol. This number is predicted to rise. 

Not-so-fun fact: NAFLD didn’t exist a few decades ago. Fatty liver was referred to as Alcoholic Fatty Liver Disease, caused by excessive alcohol consumption, not by food. 

Supporting the liver

Keeping the liver healthy means being mindful about everything consumed; what you avoid or limit is as important as what you do and include. Here are steps to show your liver you care.

Step one: Quit liquid sugars and limit alcohol
One of the best ways to start improving liver health? Quit sugary drinks. Soft drinks, sports drinks, iced teas, flavoured milk, juices, and juice drinks – all of them. Stick with water, first and foremost. You can enjoy water infused with slices of fruit, herbal tea, and plain unsweetened milk or milk alternatives. 

Watch your alcohol intake, and limit caffeine – each of these make work for the liver, too. 

Step two: Swap out ultra-processed foods for whole foods
Being super cheap and easy to overconsume, ultra-processed foods (UPF) – such as junk food, packaged snacks, and ready-to-eat meals and products – are dominating food choices and shaping our dietary patterns for the worse. 

Packed with added free sugars, unhealthy fats, and excessive salt, along with other highly processed and artificial ingredients, UPF not only contributes to ill health, it takes the place of real, whole foods that supply our bodies with the nutrition required to be well. The result? A broad range of health issues across the population. 

This is partly because of the excessive burden on the liver to process so much stuff. 

Swap UPF for nutrient-dense, whole, and minimally processed foods whenever you can, one ingredient or meal at a time. As your plate fills with more whole foods, there is less room for the harmful stuff.

Step 3: Manage toxin exposure
Compounds leached from plastic containers, synthetic chemicals found in body and hair care products, and the use of pesticides are a few examples of substances the liver has to contend with. Not to mention the additional load from smoking and illicit drug use.

While you won’t be able to avoid toxin exposure altogether, you can gradually reduce overall exposure to the extent that the liver can better cope.

Simply replacing a plastic bottle – whether reusable or single-use – with a stainless steel or glass bottle is an excellent step toward relieving the load on the liver (and better for the environment, too!).

Step 4: Enjoy liver-loving foods
Many real, whole foods contain nutrients required for optimal liver function, providing anti-oxidant, anti-inflammatory, and detoxification pathway support. Consider enjoying the following: 

• Leafy greens such as rocket, mustard, and dandelion; herbs such as coriander and parsley; and cruciferous (brassica) vegetables, including broccoli, broccoli sprouts, cauliflower, and kale. These can support the detoxification processes while also providing beneficial fibre.
• Fibre from a variety of sources, including vegetables, legumes, nuts, seeds, and whole oats, to encourage regular and frequent (aiming for 1-2x daily) bowel movements, taking waste products out of the body and lessening the load on the liver.
• Healthy fats from foods typical of the Mediterranean diet, such as extra virgin olive oil, nuts and seeds, avocado, and oily fish, such as sardines, offer liver-protective properties. They are also less of a burden than unhealthy sources of fats and trans fats from deep-fried foods and highly-processed oils. 
• Garlic and spices such as ginger and turmeric. These offer many beneficial compounds, some of which may support the liver’s health. We encourage these to be enjoyed as food rather than supplements. If you wish to supplement, please discuss this with your healthcare practitioner.

Step 5: Get moving, get quality sleep, and manage stress
In addition to what you eat, other lifestyle factors influence liver health, including exercise, sleep, and stress.

• Moving the body every day is essential for the entire body’s health, including the liver. Additionally, exercise has been found to be used as a therapeutic strategy to improve fatty liver disease.
• Get quality sleep, around 7-8 hours, for proper rest and restoration. This can reduce the inclination to reach for the stuff contributing to the liver burden, such as morning caffeine, mid-afternoon added sugar, and evening alcohol!
• Find ways to manage your stress in the day-to-day and longer term. Persistent stress hormone production* adds burden to the liver. Each day is filled with stressors, so find ways to reduce the triggers and inputs or practice healthier ways to manage your reactions, whether the stressor is real or perceived. A quick and accessible way to access the part of your nervous system associated with turning downs the stress response is taking deep, diaphragmatic (abdominal) breaths. See here for more.
  

Love your liver

Don’t be overwhelmed if you feel supporting your liver must entail all of the above. Go easy – even the smallest of changes can make a difference! Replace sweetened soft drinks with sparkling water infused with berries and mint; swap your plastic bottle with one made from stainless steel or glass; use all-natural cleaning, cosmetic, and body care products; and gradually exchange UPF products with real and whole foods, one meal at a time.

By Angela Johnson (BHSc Nut Med.)

*Note: Stress hormone production also ties into eating and sleeping well. When lacking nutrition and sleep, more stress hormones are produced to keep you keeping on, so take note of what you can do to support your liver in these ways, too.