How To Unfatty A Fatty Liver
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How To Unfatty A Fatty Liver
In Greek mythology, Prometheus suffered the punishment of being chained to a rock, where he would have his liver eaten by an eagle, whereupon each day his liver would grow back, only to be eaten again the next day.
We mere humans who are not Greek gods might not be able to endure quite such punishment to our liver, but it is an incredibly resilient and self-regenerative organ.
In fact, provided at least 51% of the liver is still present and correct, the other 49% will regrow. Similarly, damage done (such as by trying to store too much fat there due to metabolic problems, as in alcoholic or non-alcoholic fatty liver disease) will reverse itself in time, given the chance.
The difference between us and Prometheus
In the myth, Prometheus had his liver regrow overnight every night. Ours don’t recover quite so quickly.
Indeed, the science has good and bad news for us:
❝Liver recolonization models have demonstrated that hepatocytes have an unlimited regenerative capacity. However, in normal liver, cell turnover is very slow.❞
~ Michalopoulos and Bhusan (2020)
Read more: Liver regeneration: biological and pathological mechanisms and implications
If it regenerates, why do people need transplants, and/or die of liver disease?
There are some diseases of the liver that inhibit its regenerative abilities, or (as in the case of cancer) abuse them to our detriment. However, in the case of fatty liver disease, the reason is usually simple:
If the lifestyle factors that caused the liver to become fatty are still there, then its regenerative abilities won’t be able to keep up with the damage that is still being done.
Can we speed it up at all?
Yes! The first and most important thing is to minimize how much ongoing harm you are still doing to it, though.
- If you drink alcohol, stop. According to the WHO, the only amount of alcohol that is safe for you is zero.
- You might like our previous article: How To Reduce Or Quit Alcohol
- Consider your medications, and find out which place a strain on the liver. Many medications are not optional; you’re taking them for an important reason, so don’t quit things without checking with your doctor. Medications that strain the liver include, but are by no means limited to:
- Many painkillers, including acetaminophen/paracetamol (e.g. Tylenol), and ibuprofen
- Some immunosuppresent drugs, including azathioprine
- Some epilepsy drugs, including phenytoin
- Some antibiotics, including amoxicillin
- Statins in general
Note: we are not pharmacists, nor doctors, let alone your doctors.
Check with yours about what is important for you to take, and what alternatives might be safe for you to consider.
Dietary considerations
While there are still things we don’t know about the cause(s) of non-alcoholic fatty liver disease, there is a very strong association with a diet that is:
- high in salt
- high in refined carbohydrates
- e.g. white flour and white flour products such as white bread and white pasta; also the other main refined carbohydrate: sugar
- high in red meat
- high in non-fermented dairy
- high in fried foods.
So, consider minimizing those, and instead getting plenty of fiber, and plenty of lean protein (not from red meat, but poultry and fish are fine iff not fried; beans and legumes are top-tier, though).
Also, hydrate. Most people are dehydrated most of the time, and that’s bad for all parts of the body, and the liver is no exception. It can’t regenerate if it’s running on empty!
Read more: Foods To Include (And Avoid) In A Healthy Liver Diet
How long will it take to heal?
In the case of alcoholic fatty liver disease, it should start healing a few days after stopping drinking. Then, how long it takes to fully recover depends on the extent of the damage; it could be weeks or months. In extreme cases, years, but that is rare. Usually if the damage is that severe, a transplant is needed.
In the case of non-alcoholic fatty liver disease, again it depends on the extent of the damage, but it is usually a quicker recovery than the alcoholic kind—especially if eating a Mediterranean diet.
Read more: How Long Does It Take For Your Liver To Repair Itself?
Take good care of yourself!
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Feel Great, Lose Weight – by Dr. Rangan Chatterjee
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We all know that losing weight sustainably tends to be harder than simply losing weight. We know that weight loss needs to come with lifestyle change. But how to get there?
One of the biggest problems that we might face while trying to lose weight is that our “metabolic thermostat” has got stuck at the wrong place. Trying to move it just makes our bodies think we are starving, and everything gets even worse. We can’t even “mind over matter” our way through it with willpower, because our bodies will do impressive things on a cellular level in an attempt to save us… Things that are as extraordinary as they are extraordinarily unhelpful.
Dr. Rangan Chatterjee is here to help us cut through that.
In this book, he covers how our metabolic thermostat got stuck in the wrong place, and how to gently tease it back into a better position.
Some advices won’t be big surprises—go for a whole foods diet, avoiding processed food, for example. Probably not a shocker.
Others are counterintuitive, but he explains how they work—exercising less while moving more, for instance. Sounds crazy, but we assure you there’s a metabolic explanation for it that’s beyond the scope of this review. And there’s plenty more where that came from, too.
Bottom line: if your weight has been either slowly rising, or else very stable but at a higher point than you’d like, Dr. Chatterjee can help you move the bar back to where you want it—and keep it there.
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What Are Nootropics, Really?
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What are nootropics, really?
A nootropic is anything that functions as a cognitive enhancer—in other words, improves our brainpower.
These can be sensationalized as “smart drugs”, misrepresented excitingly in science fiction, meme-ified in the mundane (“but first, coffee”), and reframed entirely, (“exercise is the best nootropic”).
So, clearly, “nootropics” can mean a lot of different things. Let’s look at some of the main categories…
The neurochemical modulators
These are what often get called “smart drugs”. They are literally drugs (have a chemical effect on the body that isn’t found in our diet), and they affect the levels of certain neurotransmitters in the brain, such as by:
- Adding more of that neurotransmitter (simple enough)
- Decreasing the rate at which we lose that neurotransmitter (re-uptake inhibitors)
- Antagonizing an unhelpful neurotransmitter (doing the opposite thing to it)
- Blocking an unhelpful neurotransmitter (stopping the receptors from receiving it)
“Unhelpful” here is relative and subjective, of course. We need all the neurotransmitters that are in our brain, after all, we just don’t need all of them all the time.
Examples: modafinil, a dopamine re-uptake inhibitor (mostly prescribed for sleep disorders), reduces the rate at which our brains scrub dopamine, resulting in a gradual build-up of dopamine that we naturally produced, so we get to enjoy that dopamine for longer. This will tend to promote wakefulness, and may also help with problem-solving and language faculties—as well as giving a mood boost. In other words, all things that dopamine is used for. Mirtazaрine, an adrenoreceptor agonist (mostly prescribed as an antidepressant), increases noradrenergic neurotransmission, thus giving many other brain functions a boost.
Why it works: our brains need healthy levels of neurotransmitters, in order to function well. Those levels are normally self-regulating, but can become depleted in times of stress or fatigue, for example.
The metabolic brain boosters
These are the kind of things that get included in nootropic stacks (stack = a collection of supplements and/or drugs that complement each other and are taken together—for example, a multivitamin tablet could be described as a vitamin stack) even though they have nothing specifically relating them to brain function. Why are they included?
The brain needs so much fuel. Metabolically speaking, it’s a gas-guzzler. It’s the single most resource-intensive organ of our body, by far. So, metabolic brain boosters tend to:
- Increase blood flow
- Increase blood oxygenation
- Increase blood general health
- Improve blood pressure (this is relative and subjective, since very obviously there’s a sweet spot)
Examples: B-vitamins. Yep, it can be that simple. A less obvious example might be Co-enzyme Q10, which supports energy production on a cellular level, and good cardiovascular health.
Why it works: you can’t have a healthy brain without a healthy heart!
We are such stuff as brains are made of
Our brains are made of mostly fat, water, and protein. But, not just any old fat and protein—we’re at least a little bit special! So, brain-food foods tend to:
- Give the brain the fats and proteins it’s made of
- Give the brain the stuff to make the fats and proteins it’s made of (simpler fats, and amino acids)
- Give the brain hydration! Just having water, and electrolytes as appropriate, does this
Examples: healthy fats from nuts, seeds, and seafood; also, a lot of phytonutrients from greens and certain fruits. Long-time subscribers may remember our article “Brain Food: The Eyes Have It!” on the importance of dietary lutein in reducing Alzheimer’s risk, for example
Why it works: this is matter of structural upkeep and maintenance—our brains don’t work fabulously if deprived of the very stuff they’re made of! Especially hydration is seriously underrated as a nootropic factor, by the way. Most people are dehydrated most of the time, and the brain dehydrates quickly. Fortunately, it rehydrates quickly as well when we take hydrating liquids.
Weird things that sound like ingredients in a witch’s potion
These are too numerous and too varied in how they work to cover here, but they do appear a lot in nootropic stacks and in popular literature on the subject.
Often they work by one of the mechanisms described above; sometimes we’re not entirely sure how they work, and have only measured their effects sufficiently to know that, somehow, they do work.
Examples: panax ginseng is one of the best-studied examples that still remains quite mysterious in many aspects of its mechanism. Lion’s Mane (the mushroom, not the jellyfish or the big cat hairstyle), meanwhile, is known to contain specific compounds that stimulate healthy brain cell growth.
Why it works: as we say, it varies so much from on ingredient to another in this category, so… Watch out for our Research Review Monday features, as we’ll be covering some of these in the coming weeks!
(PS, if there’s any you’d like us to focus on, let us know! We always love to hear from you. You can hit reply to any of our emails, or use the handy feedback widget at the bottom)
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Superfood Baked Apples
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Superfoods, and super-tasty. This is a healthy twist on a classic; your blood sugars will thank you for choosing this tasty sweet delight. It’s also packed with nutrients!
You will need
- 2 large firm baking apples, cored but not peeled
- 1/2 cup chopped walnuts
- 3 tbsp goji berries, rehydrated (soak them in warm water for 10–15minutes and drain)
- 1 tbsp honey, or maple syrup, per your preference (this writer is also a fan of aged balsamic vinegar for its strong flavor and much milder sweetness. If you don’t like things to be too sweet, this is the option for you)
- 2 tsp ground sweet cinnamon
- 1 tsp ground ginger
Method
(we suggest you read everything at least once before doing anything)
1) Preheat the oven to 180℃ / 350℉ / gas mark 4
2) Mix the chopped walnuts with the goji berries and the honey (or whatever you used instead of the honey) as well as the sweet cinnamon and the ginger.
3) Place the apples in shallow baking dish, and use the mixture you just made to stuff their holes.
4) Add 1/2 cup water to the dish, around the apples. Cover gently with foil, and bake until soft.
Tip: check them every 20 minutes; they may be done in 40 or it may take 60; in honesty it depends on your oven. If unsure, cook them for longer at a lower temperature.
5) Serve warm.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- From Apples to Bees, and High-Fructose C’s
- Why You Should Diversify Your Nuts!
- Goji Berries: Which Benefits Do They Really Have?
- The Sugary Food That Lowers Blood Sugars
- Honey vs Maple Syrup – Which is Healthier?
- A Tale Of Two Cinnamons ← this is important, about why we chose the sweet cinnamon
- Ginger Does A Lot More Than You Think
Take care!
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What To Eat, Take, And Do Before A Workout
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What to eat, take, and do before a workout
We’ve previously written about how to recover quickly after a workout:
Overdone It? How To Speed Up Recovery After Exercise
Today we’ll look at the flipside: how to prepare for exercise.
Pre-workout nutrition
As per what we wrote (and referenced) above, a good dictum is “protein whenever; carbs after”. See also:
Pre- versus post-exercise protein intake has similar effects on muscular adaptations
It’s recommended to have a light, balanced meal a few hours before exercising, though there are nuances:
International society of sports nutrition position stand: nutrient timing
Hydration
You will not perform well unless you are well-hydrated:
Influence of Dehydration on Intermittent Sprint Performance
However, you also don’t want to just be sloshing around when exercising because you took care to get in your two litres before hitting the gym.
For this reason, quality can be more important than quantity, and sodium and other electrolytes can be important and useful, but will not be so for everyone in all circumstances.
Here’s what we wrote previously about that:
Are Electrolyte Supplements Worth It?
Pre-workout supplements
We previously wrote about the use of creatine specifically:
Creatine: Very Different For Young & Old People
Caffeine is also a surprisingly effective pre-workout supplement:
International society of sports nutrition position stand: caffeine and exercise performance
Depending on the rate at which you metabolize caffeine (there are genes for this), the effects will come/go earlier/later, but as a general rule of thumb, caffeine should work within about 20 minutes, and will peak in effect 1–2 hours after consumption:
Nutrition Supplements to Stimulate Lipolysis: A Review in Relation to Endurance Exercise Capacity
Branched Chain Amino Acids, or BCAAs, are commonly enjoyed as pre-workout supplement to help reduce creatine kinase and muscle soreness, but won’t accelerate recovery:
…but will help boost muscle-growth (or maintenance, depending on your exercise and diet) in the long run:
Where can I get those?
We don’t sell them, but here’s an example product on Amazon, for your convenience
There are also many multi-nutrient pre-workout supplements on the market (like the secondary product offered with the BCAA above). We’d need a lot more room to go into all of those (maybe we’ll include some in our Monday Research Review editions), but meanwhile, here’s some further reading:
The 11 Best Pre-Workout Supplements According to a Dietitian
(it’s more of a “we ranked these commercial products” article than a science article, but it’s a good starting place for understanding about what’s on offer)
Enjoy!
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Policosanol: A Rival To Statins, Without The Side Effects?
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Policosanol (which can be extracted from various sources, but is mostly made from sugar cane extract) is marketed as lipid-lowering agent for improving cholesterol levels, but its research history has not been without controversy:
2001: it works!
After a lot of research in the 1990s, it came out of the gate strong in 2001, with:
❝Policosanol (5 and 10 mg/day) significantly decreased LDL-cholesterol (17.3% and 26.7%, respectively), total cholesterol (12.9% and 19.5%), as well as the ratios of LDL-cholesterol to high-density lipoprotein (HDL)-cholesterol (17.2% and 26.5%) and total cholesterol to HDL-cholesterol (16.3% and 21.0%) compared with baseline and placebo❞
This, by the way, is comparable in efficacy to the most powerful statins, but without the adverse side effects.
Source: Efficacy and tolerability of policosanol in hypercholesterolemic postmenopausal women
Furthermore, its effects were not limited to postmenopausal women, and additionally, it was found that 20mg/day was sufficient for optimal effects; 40mg worked exactly the same as 20mg:
2006–2010: we do not trust the Cubans!
After it had been marketed and used in much of the world for some years, extra scrutiny was brought upon it, because the initial studies had been performed by the same lab in Cuba, a commercial lab that had tested them for a private interest (i.e., a company selling the supplement):
Heart Beat: Policosanol: A sweet nothing for high cholesterol
And furthermore, US-based labs were unable to replicate the results:
Policosanols as Nutraceuticals: Fact or Fiction
The Cuban researchers countered that the composition of policosanol as produced in their lab was different than the composition of the policosanol as produced in the US labs, because of the purity of the ingredients used in the Cuban lab.
Which, on the face of it, could be true or could just be the claim of a commercial lab with an association with a company selling a product.
Of course, importing Cuban ingredients to test them in the US was not a reasonably accessible option for the US-based labs, because of the US’s embargo of Cuba. In principle it could be done, but unless there is already a huge clear profit incentive, research scientists are usually on their hands and knees begging for grants already, so getting extra funding for specially-important Cuban ingredients was not going to be likely.
2012: never mind, it does work after all!
An American meta-analysis of 4596 patients from 52 eligible studies (from around the world, so many of them not affected by the US’s embargo; some were from within the US using non-Cuban ingredients, though), found:
❝policosanol is more effective than plant sterols and stanols for LDL level reduction and more favorably alters the lipid profile, approaching antilipemic drug efficacy❞
Those last words there, to be clear, mean “yes, the original claim of being on a par with statins is at least more or less true”.
Source: Meta-Analysis of Natural Therapies for Hyperlipidemia: Plant Sterols and Stanols versus Policosanol
2018: also yes, the Cuban kind does get those extra-effective results, even when tested outside of Cuba
A Korean research team verified this; it’s quite straightforward so for brevity we’ll just drop links:
- Consumption of Cuban Policosanol Improves Blood Pressure and Lipid Profile via Enhancement of HDL Functionality in Healthy Women Subjects: Randomized, Double-Blinded, and Placebo-Controlled Study
- Long-Term Consumption of Cuban Policosanol Lowers Central and Brachial Blood Pressure and Improves Lipid Profile With Enhancement of Lipoprotein Properties in Healthy Korean Participants
Mystery resolved!
Want to try some?
We don’t sell it, but here for your convenience is an example product on Amazon—it’s not the Cuban kind, because the US’s trade embargo makes it difficult for the US to import even things that are theoretically now exempt from the embargo such as food and medicines. In principle they can now be imported, but in practice, the extra regulations added to Cuban imports make it nearly impossible, especially for small sellers.
Still, it’s 40mg/tablet policosanol from sugar cane extract, and 3rd party lab tested, so it’s the next best thing 😎
Enjoy!
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Ras El-Hanout
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This is a spice blend, and its name (رأس الحانوت) means “head of the shop”. It’s popular throughout Morocco, Algeria, and Tunisia, but can often be found elsewhere. The exact blend will vary a little from place to place and even from maker to maker, but the general idea is the same. The one we provide here today is very representative (and for an example of its use, see our Marrakesh Sorghum Salad recipe!).
Note: we’re giving all the quantities in whole tsp today, to make multiplying/dividing easier if you want to make more/less ras el-hanout.
You will need
- 6 tsp ground ginger
- 6 tsp ground coriander seeds
- 4 tsp ground turmeric
- 4 tsp ground sweet cinnamon
- 4 tsp ground cumin
- 2 tsp ground allspice ← not a spice mix! This is the name of a spice!
- 2 tsp ground cardamom
- 2 tsp ground anise
- 2 tsp ground black pepper
- 1 tsp ground cayenne pepper
- 1 tsp ground cloves
Note: you may notice that garlic and salt are conspicuous by their absence. The reason for this is that they are usually added separately per dish, if desired.
Method
1) Mix them thoroughly
That’s it! Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Our Top 5 Spices: How Much Is Enough For Benefits?
- A Tale Of Two Cinnamons ← this is important, to understand why it’s critical to use sweet cinnamon specifically
- Sweet Cinnamon vs Regular Cinnamon – Which is Healthier? ← not even exaggerating; one is health-giving and the other contains a compound that is toxic at 01.mg/kg; guess which one is easier to find in the US and Canada?
Take care!
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