Is Red Wine Good for You? What the Evidence Really Says

Few questions divide opinion quite like this one! For years we have been told that a glass of red wine a day was good for the heart. More recently, the headlines have swung the other way, with warnings that there is no safe level of drinking at all. It is no wonder so many of my clients feel confused, or quietly hope the first story was the right one…

In my last blog I looked at what alcohol does to sleep, appetite and energy. This time I want to take a look at the evidence about red wine and health in a little more depth. My aim is not to tell you whether or not to drink. It is to help you understand where the "red wine is healthy" idea came from, why it has changed, and what the research actually supports.

Where Did the Idea Come From?
The story really took off in the early 1990s with the so-called "French paradox". Rates of heart disease in France appeared lower than you might expect given a diet relatively high in saturated fat, and red wine was put forward as one possible explanation.

At around the same time, a large number of observational studies began to show what became known as the "J-shaped curve". When researchers plotted alcohol intake against risk of death or heart disease, light to moderate drinkers often appeared to do slightly better than people who did not drink at all, with risk rising again at higher intakes. This curve was widely reported and shaped public messaging for many years.

The Problem With Observational Studies
Observational studies are incredibly useful, but they can only show an association. They cannot prove that one thing causes another, and in the case of alcohol there were some important problems with the comparison group.

The first is what researchers call the "sick quitter" effect. In many older studies, the non-drinking group included people who had stopped drinking because they were already unwell, or because of a previous problem with alcohol. Comparing moderate drinkers with this group made the drinkers look healthier than they really were.

The second is confounding. In many countries, people who drink moderately, and wine drinkers in particular, tend to have higher incomes, more education, healthier diets and more active lives. All of these protect the heart in their own right, and it is very difficult to fully separate them from the effect of the wine itself.

What Happens When We Correct for These Problems?
A 2023 systematic review and meta-analysis published in JAMA Network Open pulled together 107 cohort studies involving more than 4.8 million people. Crucially, the researchers looked at how well each study dealt with these biases, including whether former drinkers were separated from lifelong non-drinkers. Once study quality was taken into account, low-volume drinking was not associated with a lower risk of death from any cause compared with never drinking. Risk rose at higher intakes, and for women it began to rise at lower levels than for men.

Research also shows that in some East Asian populations, common gene variants make alcohol very unpleasant to drink, so people carrying them naturally drink less. Because these genes are allocated at random at conception, they act a little like a natural trial. A 2019 study in The Lancet, using data from around 160,000 adults in the China Kadoorie Biobank, used exactly this approach. It found no protective effect of moderate drinking on stroke. Instead, stroke risk rose steadily as alcohol intake went up.

This shift is reflected in UK guidance. When the UK Chief Medical Officers reviewed the evidence in 2016, they concluded that any protective effect on the heart was smaller than previously thought and applied to a much narrower group of people. The guidance does not recommend that anyone starts drinking for their health.

But Isn't It the Polyphenols That Matter?
This is a fair question, and it is where some of the confusion comes from. Red wine does contain polyphenols, plant compounds that research shows can have health benefits. The best known is resveratrol, which has shown interesting effects in laboratory and animal studies.

The issue is quantity. A 2007 review of red wines found an average of just 1.9mg of resveratrol per litre, with many wines containing very little at all. Human studies of resveratrol supplements have commonly used doses of 150mg a day or more. To match that from wine, you would need to drink dozens of litres a day, which is clearly not a sensible proposition. And of course, the alcohol (ethanol) comes with every glass, regardless of the polyphenol content.

The good news is that you do not need wine to get polyphenols. Red grapes, berries, cherries, dark chocolate, cocoa, tea, coffee, extra virgin olive oil, herbs and spices all provide them, along with fibre and other nutrients. A colourful, plant-rich diet is a far more reliable way to get them, and it fits beautifully with the Mediterranean-style eating that has strong evidence for heart health. I shared some ideas for this in Top Tips for Everyday Anti Inflammatory Swaps.

So, Should You Drink Red Wine for Your Health?
The honest answer is no, and I would not suggest that anyone who does not drink should start for the sake of their heart. If you want to protect your heart, the strongest evidence points to not smoking, regular movement, good sleep, managing blood pressure and cholesterol, and a diet rich in vegetables, fruit, pulses, wholegrains, nuts, seeds and oily fish. I covered this in more detail in Why Inflammation Matters for Heart Health.

That does not mean you have to give it up. Many people enjoy a glass of wine with a meal or with friends, and enjoyment, connection and celebration are a real part of life. The key is to see it for what it is: something you choose because you enjoy it, rather than something you drink because you think it is good for you. If you do drink, the UK guidance is to keep to no more than 14 units a week on a regular basis, spread over three or more days, with several drink-free days. A standard 175ml glass of 12% wine is 2.1 units, according to the NHS.

Need Some Support?
If you are worried about your heart health, your drinking or your risk of a particular condition, please speak to your GP first. They can check your blood pressure, cholesterol and other markers, and talk through your personal risk. If you would like to talk to someone about your drinking, Drinkline is free on 0300 123 1110.

If you would like personalised support with heart health, energy or building a way of eating that genuinely supports you, why not book in a free call?

Dark Chocolate, Orange and Cranberry Bites (Gluten Free)

Chocolate orange is one of those flavours that simply tastes of Christmas, so I wanted this month's recipe to be a little festive treat you can make in a few minutes and keep in the fridge for when friends drop by.

These bites are made with dates, ground almonds and cocoa, brightened with fresh orange zest and a few dried cranberries, then half-dipped in dark chocolate. Nuts bring protein, fibre and unsaturated fats, which make them more satisfying than many shop-bought sweets, and the orange and spice keep the flavour fresh rather than overly sweet.

They are still a treat, of course. Dates and dried fruit contain natural sugars, so these are something to enjoy and savour, not something to eat by the handful because they sound virtuous! That fits nicely with this month's theme of enjoying Christmas without all-or-nothing rules.

They are naturally gluten free and make a lovely homemade gift in a small jar or box. If you need to avoid gluten strictly, for example because you have coeliac disease, check the labels on your chocolate, cocoa and dried cranberries for any "may contain" warnings.

If you enjoyed my Magnesium-Rich Dark Chocolate and Walnut Bites, I think you will love this festive version.

Dark Chocolate, Orange and Cranberry Bites

Makes: 16 bites

Ingredients

• 150g soft pitted dates (Medjool work best)
• 100g ground almonds
• 40g pecans or walnuts
• 2 tbsp cocoa powder or raw cacao powder
• ½ tsp ground cinnamon
• A pinch of sea salt
• Finely grated zest of 1 orange, plus 1 to 2 tbsp of the juice
• 40g dried cranberries, roughly chopped
• 80g dark chocolate (70% cocoa solids or higher)
• 1 tbsp shelled pistachios, finely chopped, to decorate (optional)

Method

1. If your dates are firm, cover them with just-boiled water for 10 minutes to soften, then drain well.
2. Put the pecans or walnuts in a food processor and pulse until finely chopped.
3. Add the ground almonds, cocoa, cinnamon, salt and most of the orange zest (keep a little back for decorating), and pulse to combine.
4. Add the dates and 1 tbsp of orange juice and blend until the mixture clumps together when pressed between your fingers. Add a little more juice if it is too dry.
5. Add the cranberries and pulse briefly so they stay in small pieces.
6. Roll the mixture into 16 balls, about 20g each, and place on a tray lined with baking paper. Chill for 20 minutes to firm up.
7. Melt the chocolate gently in a heatproof bowl set over a pan of barely simmering water, making sure the bowl does not touch the water.
8. Dip each bite halfway into the chocolate, then return it to the tray. Sprinkle with the reserved orange zest and chopped pistachios while the chocolate is still soft.
9. Chill for 15 to 20 minutes until set.
10. Enjoy!

Make It Your Own
Store the bites in an airtight container in the fridge for up to a week or freeze them for up to three months. Let them sit at room temperature for 10 minutes before eating if they have been frozen.

For a nut-free version, swap the ground almonds and pecans for sunflower seeds and certified gluten-free oats, blended until fine. Most people with coeliac disease can eat gluten-free oats, but a small number react to them, so leave them out if you are unsure.

If you would prefer a dairy-free treat, many dark chocolates are made without milk, but do check the label. You can also swap the cranberries for chopped dried cherries or apricots, or roll the bites in desiccated coconut instead of dipping them in chocolate.

Top Tips: Enjoying Christmas Without The All-or-Nothing Vibes

At this time of year the messages around food and drink tend to fall into two camps. Either it is Christmas so anything goes until January, or it is all about "damage limitation", saving calories for the party and "burning off" the mince pies. Neither tends to leave people feeling particularly festive…

I would love you to try a different approach this year. Instead of strict rules, keep a few simple anchors in place so that you can enjoy the food, the drinks and the company - and still feel like yourself. Here are my top tips, based on the evidence and on what I see work for clients year after year.

1. Keep Your Everyday Anchors
The most helpful thing you can do over the festive season is keep some of your normal routine going. Regular meals, a breakfast that includes protein, and plenty of vegetables on most days give your body a sense of rhythm when everything else is busier than usual.

This is not about being "good". It is simply that steady, balanced meals help to keep energy and appetite more even, which makes it easier to enjoy the treats without feeling out of control. If you would like a reminder of how to build a balanced plate, take a look at Balance Your Plate Balance Your Energy.

2. Don't Arrive at the Party Hungry
Skipping meals to "save up" for an evening out often backfires. Research shows that alcohol tends to increase how much we eat rather than replacing food and arriving ravenous makes that effect more noticeable.

A proper meal or a satisfying snack before you go, ideally with some protein, fibre and healthy fat, can help. Think a bowl of soup with beans, eggs on wholegrain toast, or Greek yoghurt with nuts and berries. Having food in your stomach also slows down how quickly alcohol is absorbed, which the NHS recommends if you are drinking.

3. Know Your Pour
It is very easy to underestimate how much you are drinking at Christmas. Glasses are often large and get topped up before they are empty.

According to the NHS, a standard 175ml glass of 12% wine is 2.1 units, while a large 250ml glass is 3 units. A 125ml glass of 12% prosecco is around 1.5 units, and a pint of 5.2% lager is 3 units. Many red wines are 13.5% or more, so the numbers can be higher still. Asking for a small glass and letting it empty before it is refilled are simple ways to keep track without needing to count every sip.

4. Alternate and Explore Alcohol-Free Options
Alternating each alcoholic drink with water or a soft drink is one of the easiest habits to adopt, and it helps with thirst and pacing. The range of alcohol-free and low-alcohol drinks has also improved enormously, from alcohol-free wines and beers to botanical spirits and kombucha.

At home, sparkling water with fresh orange slices, a cinnamon stick and a few cranberries feels just as festive in a nice glass. Having something you genuinely enjoy in your hand makes it much easier to skip a drink you did not really want.

5. Keep Some Drink-Free Days
The UK Chief Medical Officers advise not regularly drinking more than 14 units a week, spread over three or more days, with several drink-free days each week. Over Christmas, it can help to look at your diary and decide in advance which evenings will be drink-free.

It is also worth knowing that "saving up" units for one big night is not the answer. The guidance specifically advises against heavy drinking in a single session, because the short-term risks rise quickly. And as I explained in my blog on alcohol and sleep, drink-free nights are often the ones when you sleep best.

6. Add Before You Subtract
Rather than focusing on what to cut out, think about what you can add. Christmas is a wonderful time for seasonal vegetables: Brussels sprouts, red cabbage, parsnips, carrots, kale and chestnuts, not to mention clementines and pomegranates.

Filling half your plate with vegetables at the big meals adds fibre, colour and plant compounds, and naturally leaves a little less room for the heavier foods without any sense of restriction. Most of us fall short of the NHS recommendation of 30g of fibre a day, so this is a gift to your gut too. If festive bloating is an issue for you, my blog How to beat the festive bloat has some practical ideas.

7. Move for Enjoyment, Not to "Burn It Off"
I would love us to retire the idea of exercising to cancel out food. Movement has so many benefits for mood, sleep, blood sugar and heart health that it deserves better than being used as a punishment.

A walk after Christmas lunch is a lovely tradition, and research suggests that even short bouts of walking after a meal can help to moderate the rise in blood sugar that follows it. A family walk, a dance in the kitchen or a game in the garden all count.

8. Enjoy It, Then Move On
Choose the festive foods you really love and savour them properly, sitting down and without distraction. If there is something you only eat because it is there, it is fine to leave it. I couldn’t go through Christmas without having a proper mince pie!

Then, if you have a bigger meal or a later night than planned, simply return to your usual way of eating at the next meal. There is no need to skip breakfast, start a detox or "be good" until January. As I explained in Why Detox Diets Don't Work and What to Do Instead, your liver and kidneys do that job very well on their own.

Start With One Thing
You do not need to do all of these. Pick the one or two that feel most realistic for you this December and let the rest go. Small anchors, kept consistently, are far more powerful than a perfect plan you abandon by the 20th.

Need Some Support?
If you are concerned about your drinking, or find it hard to cut down, please speak to your GP. You can also call Drinkline free on 0300 123 1110.

If you would like help building a way of eating that feels balanced all year round, not just at Christmas, why not book in a free call?

Alcohol, Sleep and Appetite: Why a Few Drinks Leave You Tired, Hungry and Bloated

December is the month when many of us drink perhaps a little more than we might do usually... There’s the work Christmas party, drinks with your mates, a glass of something while wrapping presents, and the long, sociable meals over Christmas and Boxing Day. None of that is a problem in itself, and I promise you this isn’t a blog about giving everything up!

But what I do hear in clinic at this time of year, though, is a very similar set of complaints. 

• "I fall asleep fine but I'm wide awake at 3am." 
• "I'm starving the next day and I can't stop picking." 
• "I feel bloated and sluggish for a day or two afterwards." 

If any of that sounds familiar, it might help to understand what alcohol is actually doing in your body. Knowing the why makes it much easier to decide what you want to do about it.

What Happens to Your Sleep?
Alcohol is a sedative, which is why a drink or two can make you feel drowsy and why so many people use a nightcap to help them drop off. The trouble is that falling asleep and sleeping well are not the same thing.

A 2025 systematic review and meta-analysis in Sleep Medicine Reviews pooled 27 studies looking at how alcohol affects the sleep that follows it in healthy adults. The researchers found that alcohol delayed the onset of REM sleep and reduced the total amount of it, and that this happened even at the lower doses studied, getting worse as the dose went up. Interestingly, the faster drop-off that people notice was only clearly seen at the higher doses, around five drinks or more.

REM sleep matters. It is the stage most closely linked with emotional processing, memory and that feeling of having had a genuinely restorative night. Losing some of it is one reason you can sleep for seven or eight hours after a night out and still wake up feeling as though you have barely slept.

There is also a timing effect. Your liver works through alcohol over the course of the night, and as levels fall, sleep in the second half of the night tends to become lighter and more broken. This is the classic pattern of sleeping heavily for a few hours and then waking in the early hours, often feeling hot, restless or wired.

A few other factors add to this as well. Alcohol suppresses vasopressin, the hormone that helps your kidneys hold on to water, so you are more likely to wake up needing the loo. It relaxes the muscles of the upper airway, which can make snoring worse, and has been linked with a higher risk of obstructive sleep apnoea. And for women in perimenopause or menopause, alcohol is a commonly reported trigger for hot flushes and night sweats.

Why Am I So Hungry After Drinking?
If you have ever found yourself at the kitchen counter at midnight eating cold roast potatoes, you are not lacking willpower! There is good evidence that alcohol changes how we respond to food.

A 2019 systematic review and meta-analysis in the British Journal of Nutrition looked at studies where people were given alcohol before or with a meal. On average, they went on to eat more food, around 340kJ (about 80kcal) more than when they had a non-alcoholic drink, and their bodies did not compensate for the energy in the alcohol itself. Total intake rose by around 1,070kJ (about 250kcal) per occasion.

Why might this happen? One interesting study published in the journal Obesity in 2015 gave 35 women either alcohol or a saline placebo through a drip, so the alcohol bypassed the gut entirely. After alcohol, a part of the brain called the hypothalamus, which helps regulate appetite, responded more strongly to the smell of food, and on average the women ate more at lunch. Researchers sometimes call this the "apéritif effect". Alcohol also lowers inhibition, so the plan to have a light supper can quietly become something else entirely.

The effect often carries into the next day. Poor sleep is strongly linked with increased hunger and a pull towards quick, sugary and salty foods, which is why the morning after can feel like one long craving.

Why Do I Feel So Tired and Bloated the Next Day?
Most people put next-day fatigue down to dehydration. Alcohol does make you pass more urine, and staying hydrated is sensible, but research into hangovers suggests dehydration is only part of the picture. Studies have not found a strong link between markers of dehydration and how bad a hangover feels. Broken sleep, the build-up of acetaldehyde (a toxic by-product as your liver breaks alcohol down) and an inflammatory response all seem to play a bigger role. In other words, a pint of water before bed is a good idea, but it will not fully undo a short night of fragmented sleep.

Bloating is a very common complaint too, and there are several reasons for it. Alcohol can irritate the lining of the stomach and relax the valve at the top of it, which is why the NHS lists it as a trigger for indigestion and heartburn. Fizzy drinks such as beer, prosecco and mixers add gas. Drinks are often paired with rich, salty or large meals, and a disrupted night can leave your digestion feeling sluggish. Over time, regular heavier drinking can also affect the gut lining and the balance of the gut microbiome, which is something I look at closely with clients who have ongoing digestive symptoms. If bloating is a regular issue for you, you might find The Fibre Mistake That's Making Your Bloating Worse helpful too.

How Much Is Too Much?
The UK Chief Medical Officers' guidelines, which the NHS follows, advise that men and women do not regularly drink more than 14 units a week. If you do drink as much as 14 units, it is best spread over three or more days, with several drink-free days each week.

It is worth knowing what that looks like in a glass. According to the NHS, a standard 175ml glass of 12% wine is 2.1 units, and a large 250ml glass is 3 units. A bottle of 13.5% wine is 10 units. Many Christmas wines are stronger than 12%, and glasses at parties are often generously filled, so units can add up more quickly than you think.

It is also important to be clear that "low risk" does not mean "risk free". The 14-unit guideline is a level at which the risk of harm is kept low, not a target or a level at which alcohol becomes good for you. I looked at what alcohol does to the liver in Sugar, Alcohol and your Liver, and I will explore the "healthy drinking" idea in more detail in my next blog on red wine.

So, What Can You Do?
None of this means you cannot enjoy a drink this Christmas! It simply means you can make choices with your eyes open. 

Having your last drink earlier in the evening gives your body more time to process it before sleep. Eating a proper meal with protein and fibre before or while you drink can help with the late-night hunger that follows. Alternating alcoholic drinks with water or a good alcohol-free option, and keeping a few drink-free evenings in your week, can make a real difference to how you sleep and feel. I will share more practical ideas in my Top Tips blog later this month [LINK TO TOP TIPS BLOG ONCE LIVE]. And if sleep is a wider struggle for you, Top Tips: 8 Evidence-Based Habits for Better Sleep and Can What You Eat Really Affect Your Sleep? are good places to start.

Need Some Support?
If you find that alcohol is regularly affecting your sleep, mood or digestion, or if you are finding it hard to cut down, please speak to your GP first. They can check for anything else that might be going on. You can also call Drinkline, the free national alcohol helpline, on 0300 123 1110.

If you would like personalised support with sleep, energy, digestion or finding a way of eating and drinking that works for your life, why not book in a free call?

Autumn Leek, Sprout & Barley Risotto with Soft-Boiled Eggs

This is a warming one-pan supper for a dark November evening: nutty pearl barley cooked slowly with leeks, onion and garlic, finished with shredded Brussels sprouts and cabbage, and topped with soft-boiled eggs and toasted hazelnuts. It rounds off this month's liver health series by bringing together several of the habits from my Top Tips: lots of plants, fibre from barley, beans and vegetables, and olive oil as the main added fat.

Leeks, sprouts, cabbage, kale and onions are all in season in the UK in November, so this is a good time to make the most of them. Each portion provides a whopping 15g of fibre, which is about half the 30g a day the NHS recommends.

Leeks, onions and garlic belong to the allium family, while sprouts, cabbage and mustard are all brassicas. Both families are known for their sulphur-containing plant compounds, which give them their distinctive flavour (and their cooking smells!). Researchers are interested in how these compounds interact with the body's own enzyme systems, including those in the liver. 

Finally, the eggs. Eggs are a good source of choline, a nutrient that contributes to the maintenance of normal liver function and to normal lipid metabolism. One egg provides around 147mg.

Serves: 4

Ingredients

• 2 tbsp extra virgin olive oil
• 2 medium leeks (about 300g), trimmed, washed and finely sliced
• 1 medium onion, finely chopped
• 3 garlic cloves, finely chopped
• 1 tsp fresh thyme leaves, or ½ tsp dried
• 200g pearl barley, rinsed
• 1 litre hot low-salt vegetable or chicken stock
• 1 x 400g tin butter beans, drained and rinsed
• 250g Brussels sprouts, trimmed and finely shredded
• 200g savoy cabbage or kale, tough stalks removed and finely shredded
• 1 tbsp wholegrain mustard
• Zest and juice of ½ lemon
• 30g Parmesan or vegetarian hard cheese, finely grated (optional)
• 8 eggs
• 40g hazelnuts, roughly chopped
• Small handful of flat-leaf parsley, chopped
• Black pepper

Method

1. Heat the olive oil in a large, deep pan over a medium-low heat. Add the leeks and onion and cook gently for 8 to 10 minutes, stirring now and then, until soft but not browned. Add the garlic and thyme and cook for 1 minute more.
2. Stir in the pearl barley, then pour in the hot stock. Bring to the boil, reduce to a gentle simmer and partly cover. Cook for 30 to 35 minutes, stirring occasionally, until the barley is tender but still has a little bite. Add a splash of hot water if it starts to look dry.
3. While the barley cooks, toast the hazelnuts in a dry frying pan over a medium heat for 3 to 4 minutes until golden, then set aside.
4. Bring a pan of water to a simmer. Lower in the eggs and cook for 6½ minutes for a soft yolk, or 9 to 10 minutes for a firm one. Cool under cold running water, then peel.
5. Stir the butter beans, sprouts and cabbage into the barley. Cook for 5 minutes, until the greens are just tender and still bright.
6. Take the pan off the heat. Stir in the mustard, the lemon zest and juice, and the cheese if using. Season with black pepper.
7. Spoon into warm bowls. Halve the eggs and place them on top, then scatter over the hazelnuts and parsley.

Make It Your Own
Pearl barley contains gluten, so for a gluten-free version, swap for short-grain brown rice or buckwheat and follow the cooking time on the packet. For a veggie version, use vegetable stock and a vegetarian hard cheese.

Any leftover risotto will keep in the fridge for up to 2 days without the eggs. Reheat it until piping hot with a splash of water and top with freshly cooked eggs.

And if you're interested in more easy, nutritious recipes, why not head to the Recipe Index?

Top Tips for Looking After Your Liver

Over the last two blogs we have looked at what MASLD is, and at how sugar, saturated fat and alcohol each affect the liver. If there is one message to take from both, it is that your liver does not need a detox. What it responds to is the ordinary, repeated stuff of daily life: what is on your plate, what is in your glass and how much you move.

The encouraging part is that these habits are not unique to the liver. They are the same ones that support blood sugar balance, heart health and energy, so every change does several jobs at once. Here are eight evidence-based places to start.

1. Eat the Mediterranean Way
European liver guidelines recommend improving diet quality along the lines of a Mediterranean-style pattern. This is less about specific foods and more about the overall shape of your meals: plenty of vegetables, fruit, beans and lentils, wholegrains, nuts and seeds, extra virgin olive oil as the main added fat, regular fish and fewer ultra-processed foods.

You do not need Mediterranean sunshine to eat this way. A bowl of lentil and vegetable soup, roasted autumn vegetables with olive oil and herbs, or tinned sardines on wholegrain toast all fit the pattern. The NHS suggests at least two portions of fish a week, one of them oily, such as salmon, mackerel, sardines or trout.

2. Make Plants the Main Event
The NHS recommends 30g of fibre a day, yet most adults manage only around 20g. Closing that gap is one of the simplest ways to move towards the pattern above. Add beans, lentils or chickpeas to stews, curries and salads. Choose wholegrain versions of bread, pasta and rice. Include vegetables with every meal and keep unsalted nuts and seeds to hand.

A helpful way to think about it is to build the meal around the plants first and then add your protein, instead of the other way round.

3. Rethink What Is in Your Glass
Of all the dietary changes studied, cutting back on sugary drinks has some of the most consistent evidence behind it. In the analysis I described in my last blog, having seven or more sugar-sweetened drinks a week was linked with a 53% higher risk of fatty liver.

European guidelines advise avoiding sugar-sweetened drinks. The NHS suggests swapping to water and keeping fruit juice and smoothies to no more than 150ml a day. Sparkling water with a slice of lemon or lime, a few crushed berries or some fresh mint is a good place to start, as are herbal teas, hot or iced.

4. Enjoy Your Coffee
Here is a tip most of us will be happy to hear! A UK Biobank study followed almost 495,000 adults for a median of 10.7 years. Compared with people who did not drink coffee, coffee drinkers had a 21% lower risk of chronic liver disease and a 49% lower risk of dying from it. The association was strongest at around three to four cups a day and was seen with ground, instant and decaffeinated coffee.

This was an observational study, so it cannot prove that coffee itself is protective, and European guidelines describe the evidence in the same cautious terms. But if you enjoy it, there is no need to give it up for your liver's sake. Just watch the syrups and sugar and keep it earlier in the day if it affects your sleep.

5. Move More, Most Days
Physical activity is recommended in its own right for reducing liver fat. European guidelines suggest more than 150 minutes of moderate activity a week, or 75 minutes of vigorous activity, which is in line with NHS advice for all adults. Moderate activity includes brisk walking, cycling, dancing and water aerobics.

A 2023 meta-analysis of 14 studies put some numbers on this. Around a third of people in the exercise groups (34%) achieved a meaningful reduction in liver fat, compared with 13% of those in the control groups. The benefit was seen at around 150 minutes of brisk walking a week, and it did not depend on losing a significant amount of weight.

That last point is worth repeating. Movement appears to help the liver even when the scales do not change. If you are new to exercise or have a health condition, check with your GP first, then start small and build up.

6. Build and Keep Your Muscle
Muscle is one of the main places the body sends glucose after a meal, so maintaining it supports the metabolic health your liver depends on. As I mentioned in my first blog, people who have MASLD at a healthy weight tend to have less muscle than their peers.

The NHS recommends strengthening activities that work all the major muscle groups on at least two days a week, and Liver UK gives the same advice for people with MASLD. This does not have to mean a gym. Resistance bands, bodyweight exercises such as squats and press-ups, yoga, Pilates and heavy gardening are all examples. The NHS also advises breaking up long periods of sitting, so a short walk after meals or standing up for phone calls is a useful habit.

7. Be Honest About Alcohol
The NHS advises drinking no more than 14 units a week, spread over three or more days. Liver UK adds that two to three alcohol-free days a week are a good idea, and that if you have MASLD, alcohol can make liver damage worse. A 175ml glass of 12% wine is 2.1 units, so it adds up more quickly than many of us realise.

With party season approaching, a few practical habits help. Decide in advance which occasions matter to you. Measure what you pour at home. Alternate alcoholic drinks with something soft and put your alcohol-free days in the diary. If you have been diagnosed with a liver condition, or you are worried about how much you drink, speak to your GP.

8. If You Have Weight to Lose, Aim for Steady and Sustainable
Weight is a sensitive subject, and it is only one part of the picture. Where it is appropriate, though, modest changes matter. European guidelines recommend a sustained weight loss of 5% or more to reduce liver fat in people living with overweight. Liver UK notes that losing 5% to 10% of body weight can help control MASLD and may reverse some liver damage. For someone weighing 90kg, 5% is 4.5kg.

The word "sustained" is important. The habits above are designed to be kept up, which a crash diet is not. If you are already a healthy weight, the same guidelines still recommend diet and exercise to reduce liver fat, so the first seven tips apply to you too.

And remember, MASLD usually causes no symptoms, so it is easy to overlook. The NHS advises seeing your GP if you think you could have it or are at higher risk, for example if you have type 2 diabetes, PMOS, high blood pressure or high cholesterol. If you have already been diagnosed, the NHS says you should have check-ups at least once a year.

It is also worth mentioning any supplements or herbal products you take. Liver UK advises always talking to your doctor or pharmacist before trying supplements, as some can harm the liver.

Start with One Thing
You do not need to do all eight at once! Choose the one that feels most achievable this week, whether that is a daily walk, swapping a fizzy drink for sparkling water, or adding a tin of lentils to a stew. Give it a few weeks to become routine before adding another. Small, consistent changes are far more useful than a perfect week followed by nothing.

If you would like something delicious to begin with, my final blog this month is a liver-friendly seasonal recipe.

Need Some Support?
If you have been told you have MASLD, or you are concerned about your liver, your GP should always be your first port of call for testing, diagnosis and monitoring. Alongside that medical care, personalised nutrition and lifestyle support can help you work out which of these habits to prioritise and how to make them fit your life. Why not book in a free call?