How to keep your liver healthy - Part V - FINAL on liver

Your liver is very robust and able to continue to function when most of it is damaged. It can also repair itself - even renewing large sections. It can take a lot of abuse, but there is a limit.

Although there are many causes of liver disease (some genetic, inherited or present at birth), the increase in liver disease deaths has been driven by:

• Rising levels of alcohol consumption
• The spread of hepatitis B and C infection
• The increase in obesity

Reducing your risk of liver disease

You can't guard against the dangers of liver disease entirely, but there are many simple measures you can take to reduce your risk of liver damage.

Alcoholic liver disease

A quarter of us drink at levels that could put our health at risk. Drink sensibly by learning about alcohol units and sticking to the government's guidelines.

It's recommend that adult men should drink no more than 21 units of alcohol in a week and adult women no more than 14. These units should be spread over the week - not saved up to be consumed all at once.

• Men should not drink more than 3 to 4 units a day
• Women should not drink more than 2 to 3 units a day
• Everyone should have at least two alcohol-free days every week

What's an alcohol unit?

The alcohol content, or ABV (alcohol by volume), shown on bottles or cans and the standard measures of drinks being served have increased over time. You may be drinking more than you think.

An accurate way of calculating how many units you are drinking is to multiply the ABV by the size of your drink. For example, a typical can of beer is 440ml at 5 per cent ABV strength. Therefore 440 x 5 = 2,200. Divide this by 1,000 = 2.2 units.

You can use this formula to work out how many units you're consuming:

• A standard glass of wine (175ml) at 12 per cent ABV is 2.1 units and a large 250ml glass is 3 units
• One measure 35ml of spirits (40 per cent ABV) is 1.4 units
• A pint of low strength (3.5 to 4 per cent ABV) beer or lager is 2.3 units
• A pint of regular cider (5 per cent ABV) is 2.8 units

Non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease (NAFLD) is a condition in which fatty deposits build up in your liver, which can cause inflammation and scarring.

The rise in levels of obesity, type 2 diabetes andcardiovascular disease (often grouped together as metabolic syndrome) has been termed an epidemic in the west and is associated with an increase in people being diagnosed with NAFLD.

Diets high in fat and sugar and an increasingly sedentary lifestyle mean that three in five adults in England are overweight or obese.

Keeping to a healthy weight, eating a well-balanced diet with plenty of fruit and vegetables and taking regular exercise (30 minutes a day) are the best ways to protect your liver. Regular exercise is important in both the prevention and treatment of NAFLD.

If you're overweight, speak to your GP about losing weight safely. Crash diets and rapid weight loss can cause more health problems.

Viral hepatitis A, B and C

Hepatitis A is spread by eating food or drinking water contaminated with the virus due to poor hygiene standards. It doesn't usually cause lasting liver damage but will make you feel very unwell for several days.

It's a good idea to get vaccinated against hepatitis A if you're going abroad. You can reduce your risk of infection by:

• Keeping good hygiene
• Washing your hands after going to the toilet
• Avoiding raw or undercooked shellfish, salad and vegetables
• Avoiding untreated drinking water, ice cubes and unpasteurised milk

Hepatitis B and C are blood-borne viruses (carried in the blood), which can cause long-term liver damage and liver cancer. There are few symptoms of hepatitis B and C, and people can be infected for many years without knowing, during which time liver damage can occur.

The best way to protect yourself is to:

• Never share needles or equipment for injecting drugs (including steroids)
• Only use licensed tattoo, acupuncture or body piercing studios, and make sure equipment has been sterilised
• Take care when having dental or medical treatment in countries where equipment may not be sterilised or blood donations aren't screened (some people take their own injections (a sharps kit) when travelling)
• Use condoms during sex
• Don't share personal items such as clippers, razors or toothbrushes
• Cover open cuts, especially during sport
• Ask your doctor about vaccination against hepatitis B if you are travelling abroad or if you think you may be at risk because of your job or lifestyle

If you think you may have been exposed to either virus, ask your doctor for a blood test. There are treatments available but it's important to spot the virus before too much liver damage has occurred.

For many people, multiple factors will combine to increase their risk of liver damage, such as being overweight and drinking alcohol above the recommended guidelines. When two causes of liver disease effect a person’s liver, research suggests the result is even greater than the individual impacts combined.