The liver is one of the most vital organs of the body, performing hundreds of necessary functions that help the body maintain overall well-being. Despite its importance, liver health often goes unnoticed until it worsens. Each year, on April 19, World Liver Day is observed to raise awareness about this essential organ, its importance, better health, diseases, and more. 

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Marking the day, we had an insightful conversation with Dr. Arvinder Soin, Chairman and Chief Surgeon at Medanta Institute of Liver Transplantation and Regenerative Medicine, Gurugram, Haryana. During the chat, Dr Soin shared expert guidance on how small changes in the daily lifestyle can protect and revitalise liver function, myths about liver health and early warning signs.

Read the edited experts from the chat below:

Q: Which daily lifestyle factors are the most important for your liver health, and how do you safely and sustainably make some simple changes to care for the liver even if you are feeling completely well?

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Dr Soin: Overall, liver health is about what you do every day - diet, movement, alcohol, and stress management. The most important factors are:

• Your Diet: If you eat the typical American diet (processed food, sugar-sweetened beverages, unhealthy fats, etc), then it will cause you to store fat in your liver. Whole grains, whole fresh vegetables, lean protein, and healthy fats support optimal liver function.

• Alcohol: Regular excessive use of alcohol is a huge contributor to liver damage. Not just drinking excessively but drinking moderately for several years can also lead to liver damage. 

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•Exercise: Regular exercise will allow you to maintain a healthy body weight, healthy muscle mass, and healthy metabolism which are all important for a healthy and fat-free liver. 

• Sleep and Stress: Interrupted sleep and chronic stress can lead to inflammation, disrupted hormonal cycle, and changes in liver enzymes and liver function.

Changes in the diet to avoid sugary drinks and replace them with water or herbal tea, eating more fibre foods like oats, lentils, and greens; not drinking alcohol; exercising for 45 minutes regularly; and having a way to manage your stress through mindfulness, mindfulness or relaxation techniques.

2. What dietary and lifestyle choices can we make to develop a healthy gut-liver connection that supports long-term health?

Dr Soin: The gut and liver are highly interconnected. Gut microbiome health influences liver function. If the gut balance of bacteria is compromised (due to diet, antibiotic use, too much-processed food, alcohol consumption, ongoing stress etc.), the gut permeability can increase and things like toxins or bacteria meant to be eliminated from the gut can transfer through the gut barrier into the blood, and liver, which can lead to inflammation and damage to tissues and organs past the gut.

To support the connection between gut health and liver health:

•    Eat Food that Supports Good Bacteria: Prebiotics (i.e. garlic, onions, bananas) promote the good bacteria. Probiotics (i.e. yoghurt, kefir, fermented foods) are types of good/gut bacteria that support a balanced gut microbiome.
•    Limit Processed Foods and Added Sugar: Both can upset the balance of bacteria in the gut.
•    Evaluate Antibiotic Use: Antibiotics can deplete both good and bad bacteria and should be used cautiously.
•    Eat Plenty of Fibre: Fibre from whole plant foods keeps digestion moving, in addition to toxin elimination.
•    Hydrate: When you drink 2.5-3 litres of water daily, you will support the detoxification function of your liver.

Q: Early Warning Signs: What are the signs, often missed, that might be an indication of early liver trouble, and why is it important to recognise these early signs before serious problems develop?

Dr Soin: Liver disease is frequently called "silent" as it may be developing without any obvious signs and symptoms at early stages. Often, the signs are subtle and may be related to other health problems. Some indicators that may suggest a problem include- feeling tired or fatigued; abdominal discomfort or bloating; sudden unexplained weight gain or loss; darkened urine or pale stools; persistent itchiness of the skin; noticeable yellowish skin or eyes (jaundice); and impairment to one's ability to concentrate.
Recognising and knowing these symptoms is important as the sooner liver disease is discovered and treated, the less likely it is to cause serious complications or impact long-term health.

Q: What are some myths about liver health, and what evidence-based strategies can we utilise to be informed about our diet, lifestyle, and risks of liver disease? 

Dr Soin: A common myth is that liver disease only affects people who drink in excess. While getting liver disease from alcohol is a serious risk factor, the number of people suffering from Non-alcoholic fatty liver disease (NAFLD), which is caused by obesity, diabetes, high cholesterol, and poor diet and health practices, is now greater than that of individuals with alcoholic liver disease. Another common myth is that liver damage is inevitably irreversible. In many of those cases, lifestyle changes and early treatment can slow, halt, and in some cases, reverse fatty liver and fibrotic inflammation.