Byron J. Richards,
Board Certified Clinical Nutritionist
Your liver plays a central role in the metabolism of any type of calorie. During weight gain your liver is being punched in the nose by inflammatory metabolic flu signals1 coming from your white adipose tissue (stored fat) and your digestive tract (bacterial imbalance, LPS, Candida, etc.). At the same time, your white adipose tissue is unable to store fat fast enough, turning to the primary backup location for fat storage – your liver. Now your liver gets clogged with excess fat, metabolism becomes even more strained2, your waistline expands, and you are at risk for developing far more serious health problems.
This liver problem is not a simple nutrient deficiency issue, although many nutrients can help unclog the situation. This is a problem of stuck and stagnant fat congesting your liver. The problem spills over into your gallbladder, which is the primary reason 600,000 gallbladders are yanked out of Americans every year. As the problem persists over time, the inflammatory metabolic flu signals literally cook the fat, making your liver look progressively more like a crispy slice of bacon than a functioning body organ. The more bacon-like your liver becomes the more difficult it is to lose weight. It is not a pretty picture.
If your liver cannot handle the excess fat and sugar coming at it, then fat and sugar will pile up in all the wrong places all over your body – hardening your arteries, your brain, and generally accelerating aging across the board. Thus, it is appropriate to think of your liver not only as a backup system trying to cope with excess, but also as an organ of last resort, a type of a last stand, before more difficult health issues take hold.
Unfortunately, your liver is expected to deal with this problem with both hands tied behind its back. For example, the excess leptin production from white adipose tissue causes a depression in its companion hormone, adiponectin. Low adiponectin in turn causes insulin resistance in your liver, which raises your blood sugar and simultaneously converts sugar to fat in your liver. Now your liver cannot process carbohydrates properly, resulting in easy weight gain or weight regain from eating carbohydrates. Having a fatty liver elevates the risk for type 2 diabetes by 500 percent3.
Fluctuating blood sugar levels or elevated blood sugar in association with excess body weight are predictive of a clogged liver. Conversely, when you are able to eat a normal amount of carbohydrates and not gain weight from them, your liver is functioning better. This is one reason why Rule #5 of the Leptin Diet, Reduce the Amount of Carbohydrates You Eat, is so important to help get your metabolism back on track when you are overweight.
When your liver is clogged with fat, it has difficulty breaking down fat to use as fuel. Your liver and white adipose tissue are constantly breaking down and restoring fat (triglycerides). The problem is that once the liver is clogged then the process becomes imbalanced and tilts more toward fat storage than fat break down. This is reflected by elevated triglycerides in your blood. In fact, as your triglycerides begin to elevate from weight gain, they actually turn off gene function4 in your liver that causes fat to pile up in your liver.
Your fasting triglycerides should never be more than twice as high as your HDL cholesterol number. The best chance you have of clearing triglycerides from your blood is by not snacking between meals (Rule #2) and not eating after dinner at night (Rule #1). Of course, if you eat meals that are too large (violating Rule #3) you simply overwhelm your liver with too much to do. When your triglyceride number comes down you have created an environment wherein your liver now has the potential to dump clogged fat. Conversely, when your triglyceride number stays elevated—even if you are eating better—it is reflective of a liver clogged with fat.
If you are consistently exercising, then your muscles need fuel and your liver will help send fuel in their direction. If you are too inactive then your liver is confronted by a huge problem of what to do with all the excess fat and sugar. Your white adipose tissue is bursting at the seams, your liver itself is drowning in surplus, and no place in your body needs all that is available. To cope with this situation your liver turns on a last ditch backup mechanism by dumping the excess calories back into your digestive tract. This process is incredibly inefficient and is the antithesis of what your body is designed to do, which is to efficiently extract calories from food and get them into your body. Never in your body’s wildest genetic dreams, did it think it would need to cope with being poisoned by too much food.
To perform this magical feat, your body now synthesizes extra cholesterol and bile as a mechanism to export the fat into your digestive tract. This has the side effects of elevating your LDL cholesterol and causing indigestion and heartburn. This much bile, which often includes excessive bilirubin, is highly caustic to the lining5 of your small intestine and can readily move backwards into your stomach as the primary cause of what doctors call acid indigestion. In addition to the explanations for digestive problems given in previous articles in this series, this is a primary reason why people take various types of antacid medications – not even addressing the source of the problem! Elevated LDL cholesterol in conjunction with an expanded waistline is highly predictive of a clogged liver. Your liver requires protein to get itself into metabolic action. This is why I recommend higher protein at breakfast (Rule #4). It is one reason whey protein has been shown to lower cholesterol and triglycerides in overweight humans.
Friendly flora helps protect your GI tract from bile-related irritation, but the lack of friendly flora causes digestive imbalance that is yet another metabolic stressor directly leading to fatty buildup in your liver.
Stress can add insult to injury. Higher stress levels induce more cortisol release to buffer the inflammatory effects of stress. It has now been discovered that as cortisol levels rise, a protein (HES1) in your liver elevates, which turns off your liver’s ability to break down fat. This also contributes to fatty liver and abdominal weight gain.
All Five Rules of the Leptin Diet are basic strategies to unclog your liver. Following them consistently does just that. Extra fiber is important to help absorb the excess fat, cholesterol, and toxins that are being dumped out. Friendly flora is important to help protect against the caustic effects of bile, and so are higher amounts of DHA6 – a natural degreasing compound for your liver that lowers your triglycerides.
In articles #2 through #5 of the Leptin Diet Weight Loss Challenge, I describe various additional problems that are common in stubborn weight loss. Each one of these problems stresses out your liver and contributes to the accumulation of fat in your liver. Therefore, improvement in any of these areas—especially to the point of engaging consistent weight loss—helps gradually unclog your liver over time. This is reflected not only by weight loss, but also in trend improvements in your waistline, blood sugar, triglycerides, and LDL cholesterol.
The rest of this article is devoted to strategies that speed up the process of unclogging your liver and improving your metabolism. These strategies are especially relevant to someone who isn’t making progress, even when implementing solutions given in earlier articles. These strategies can be employed by anyone to help speed up the process. The basic solutions I gave in previous Leptin Diet Weight Loss Challenge articles, along with consistent exercise, provide the foundation for getting your liver to work better. If you are engaging the weight loss process while employing them, then your liver is improving.
In terms of your minimum daily requirement for additional nutrient support, your goal is functional and practical. Do enough to engage the process of weight loss and consistently maintain the trend.
Consistent exercise is vitally important to resolving the issue of a fatty liver. This is because exercise creates a demand for calories to flow to muscles, helping your liver have preferred options regarding where to send calories.
If you are fit enough and get a good response to intense exercise, it will produce the best results. However, a number of studies are showing that moderate consistent exercise can definitely improve this problem.
Obese individuals who walked on a treadmill7 for one hour per day improved insulin resistance, boosted adiponectin levels, lowered free radical damage, and improved fatty liver problems. Another study showed that placing sedentary obese adults on a four week aerobic cycling8 and stretching program cleared out 21 percent of their liver fat, clearly helping to unclog their livers.
An animal study seeking to document molecular mechanisms showed that three aerobic sessions per week were adequate to reduce weight gain, shrink belly fat, and clear out liver fat. In humans who lost weight and then exercised 40 minutes twice a week, even if they regained a slight amount of weight, they did not regain “dangerous fat” that is associated with fatty liver. I would always suggest more exercise than this study. However, the study shows that keeping up even a moderate exercise program can prevent sliding back into the fatty liver problem.
I recently pointed out that strength training is likely to help fatty liver. This is because fatty liver disturbs growth hormone signaling that also contributes to fatty liver. On the other hand, strength training along with reducing inflammation helps condition growth hormone signaling to be normal.
Consistent exercise needs to be part of any weight loss strategy. It needs to be maintained following weight loss to ensure that your body stabilizes while you make new and more metabolically fit fat cells over time (and your old unfit ones die off). Exercise turns on genes that enhance metabolic function that simply will not turn on if you aren’t active. It is more important to be consistent than intense. No matter what your current level of fitness, find activities you can do consistently, and gradually increase your intensity. Sooner or later you will get to a level of fitness that tilts fat burning in your favor, not to mention improving liver and cardiovascular health.
A lipotropic nutrient is one that helps fat flow out of your liver. Such nutrients are involved in fat metabolism in one way or another, and often support natural liver detoxification processes as well. Fat soluble antioxidants such as tocotrienols, vitamin D, lipoic acid, and silymarin protect your liver, which is under more duress when it is fatty. The antioxidant N-acetyl-cysteine (NAC) has also been shown to protect your liver against fatty liver damage. While you need to engage and sustain the process of weight loss to solve fatty liver problems over time, various nutrients can play a supportive role either by helping the fat flow or by protecting your liver. In addition to fiber, DHA and friendly flora that were mentioned earlier, additional nutrients can also be of support.
Some individuals may benefit from guggulsterones9 if their LDL cholesterol is elevated and especially if they also have indigestion. This nutrient can help your liver dispose of cholesterol and fat into your digestive tract without making extra bile that burns the lining of your digestive tract. This function is synergistic with increased fiber intake and friendly flora, and possibly the use of digestive enzymes. The obvious result is that you do not need to take any type of antacid because you have finally addressed the source of the problem.
B vitamins play an important role in this regard. Two nutrients in the B vitamin family, choline and inositol, are well documented as lipotropic nutrients. The amino acid methionine can be converted to choline as well as being vital to your liver’s clearance of toxins. Proper methionine metabolism requires B6, B12, and folic acid. In other words, a good multiple vitamin is needed for basic liver-related fat and toxin-processing metabolism.
My two favorite lipotropic booster nutrients are acetyl-l-carnitine (ALC) and pantethine. ALC has the unique ability to metabolize damaged fat fragments out of your liver as well as your brain. ALC helps the process of beta oxidation, which enables your cells to use fat as a fuel for energy production. Animal studies show that ALC can even restore age related malfunction of cellular fat metabolism11. ALC has been shown to improve liver health in those with highly compromised liver function. Pantethine is to fat what a freight train engine is to box cars – providing the metabolic energy to haul fat around and take it where it needs to go. Taking 600 mg of pantethine per day12 for six months was shown to help individuals clear out fatty liver and lower triglycerides. These nutrients also do double duty as they are two of the best to help with stress, which can also help cause fatty liver.
Many other nutrients have been shown to help fatty liver problems, including green tea13, curcumin14, quercetin15, theanine16, grape seed extract17, hawthorn18, and resveratrol19. I’m sure there are many others. The important point is that many dietary supplements, both basic and more advanced, have a beneficial impact on liver health and fatty liver in particular. This highlights once again the extreme importance of good nutrition to optimal health. It is not that you need to do all of these things; I am simply illustrating how many potential options you have to help solve this problem. Your goal is providing enough support to consistently engage the process of weight loss.
Those surfing the Internet for ways to help their liver are likely to come upon various programs proclaiming a liver flush, liver detox, or some type of extended fasting. Liver detoxification is something that goes on every day of your life. There is no such thing as doing a liver detox program so that your liver is somehow magically squeaky clean. Any nutrients—including various herbs not mentioned here—that support lipotropic function, toxin clearance, or liver protection may be of value as part of a program. They are not a magical remedy.
Fasting for longer than a few days can be extremely hard on your liver. The rationale behind it is that because your liver has been overloaded by eating too much, then not eating much of anything for an extended period of time will give it a break and help dump the stagnant fat and toxins. There is an element of truth to this notion, but it is not without rather significant risk. When you don’t eat protein your liver actually slows down and you can seriously impair your metabolism and detoxification function. When scientists want to study animals with defunct liver function they simply take the protein out of their diets until their livers quit working. Even upon protein re-feeding it can take six months for their livers to recover. It is far better to follow the Five Rules of the Leptin Diet and provide related support as I have suggested. This will gradually undo the problem over time without running the risk of fast-induced liver trauma.
The gallbladder/liver flush is mostly a sick joke. It typically involves fasting on apple juice for several days and then consuming large mounts of olive oil, citrus juice, and Epsom salts. The substances seen in the stool following this effort are not gall stones, but rather the oil itself forming soft complexes. I never recommend this for anyone.
Being overweight and consuming a diet high in carbohydrates both help cause fatty liver. This has been confirmed in human studies1 and the details of the chemistry have been explored in animal studies2. Too many high glycemic refined flour products, too much white rice, and refined sugar are clear paths to fatty liver because the excess insulin stimulates the formation of fat in the liver. Furthermore, a detailed human study shows that lowering dietary carbohydrates3 stimulates the breakdown of fat in the liver and helps clear out the problem. It was found that such individuals naturally gravitate to higher protein intake to make up for the reduced carbohydrates, most likely to protect against muscle breakdown as a potential fuel source (compared to the preferred fat breakdown.) It has been confirmed that higher protein intake20 activates fat burning following a meal. Furthermore, it has been confirmed that whey protein is the best known form of protein for this effect.
Utilizing a higher level of whey protein intake can have multiple benefits on metabolism. A recently published study with obese nondiabetic women21 had them take 20 grams of whey protein three times a day for four weeks. At the end of the study they had a 20 percent reduction in unhealthy liver fat, a 15 percent reduction in triglycerides, and a 7 percent reduction in total cholesterol. Another 12-week study22 showed that whey protein, compared to other proteins or sugar, reduced triglycerides, cholesterol, and improved insulin function. Whey protein specifically helps prevent muscle loss during weight loss while enhancing insulin signaling. It also helps reduce your appetite4 while enhancing your exercise response5 and improving strength6. The multiple benefits of whey make it an ideal source of protein calories in support of weight management.
It is nice to see so much science supporting a strategy I have used for many years to help individuals jump start their weight management efforts. The program is fairly simple. Your meals will center on three protein drinks per day. Use 1 – 1 ½ scoops of whey protein and mix in 1 heaping tablespoon of supplemental fiber. This can be mixed in 2% milk, though you can use rice milk, almond milk, or 50 percent fruit juice and 50 percent water (stay away from soy milk as it slows down metabolism). The extra fiber is really important otherwise bowels will slow down and toxins can back up. Have a serving of fruit with each meal, including at least one banana a day, to support potassium intake. The fruit can be blended into the protein drink or eaten after. Take all your regular supplements, and I would suggest some extra chlorella for your greens as well as detox support. Coffee or tea in moderation is acceptable, if desired. Cream or half and half may be used in moderation, but no sweeteners of any type may be added to anything.
The first day is the hardest, as the leptin urges to eat are still in full swing. Cravings tend to disappear by day two, or day three at the latest. This program can be done for three days, a week or two, or a month. In such a case, every three or four days have a regular meal of 500 – 600 calories with no dessert and minimal carbohydrates.
This program helps get you going, helps get you back on track, and can help get you out of a sluggish rut so you can get yourself pointed in the right direction. It tends to “shrink” your stomach so you feel full on less food and is one of the fastest ways to re-balance leptin that is just too out-of-whack. It also helps change your taste system so that fruit and other carbohydrates are now plenty sweet.
This program is not a long-term strategy, it is more of a corrective strategy that also helps unclog your liver and rebalance your leptin system. Ensure you get adequate sleep while doing this program. Do not attempt it if you know your sleep time is being cut short. Likewise, stress should be as minimal as possible during this program.
Individuals with weak liver or kidney function should not do this program as the weakened organs may not be able to keep up with the increase of protein-driven metabolic activity. Some people cannot handle this much whey protein due to digestive gas/bloating, which is caused by underlying bacterial imbalance that should be addressed instead. A very few people, unfortunately, just don’t do well on whey protein. The goal is not to push yourself through feeling miserable because you somehow think you are doing yourself good. It really doesn’t take more than a day or two to get on track if things are going as they should. At some point you will need to eat more carbohydrates to sustain muscle function and electrolyte balance – so you can’t keep doing this indefinitely. These suggestions are given for informational purposes. If you have any questions about your specific health issues or ability to do this program then consult with your doctor for advice.
Your liver is the brain of your body and it must work right for your metabolic and fat burning ability to be normal and healthy. Getting your liver to work better takes time and requires that you engage weight loss as a trend. Your basic tools for doing this are following the Leptin Diet, exercising consistently, and taking basic dietary supplements that support weight management as explained in the first article in this series.
Other issues relating to digestion, toxins, metabolic flu, and germ gangs, as explained in articles #2 through #5 in this series are also important to consider. If you have problems with any of these topics, which is typical when weight is not readily responding to better diet and exercise, then these issues should be addressed to help engage the process of weight loss. Any of these issues also cause liver stress and contribute to fatty liver.
Sometimes it is helpful to specifically address the issue of liver health as a liver clogged with fat is a weak link in the metabolic chain. This can be done by increasing lipotropic nutrients and nutrients that protect your liver. It generally means restricting carbohydrates somewhat (not completely), so as to induce fat burning. This can be enhanced with a higher protein intake, especially whey protein. A one to four week program, utilizing whey protein at each meal, may help get you on track or help you break through a weight loss plateau.
Over the long haul, your ability to be consistent with your program and keep the weight loss process engaged is vitally important. Diversions from the successful path need to be corrected sooner rather than later. There is no short cut but there is a clear path. Learn to enjoy the path and you will have gone a long way toward making major improvements in your quality of health. You are really winning when the improved feeling of health in your body outweighs the urges to eat too much of the wrong kinds of food.
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