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?