#447 How to Reduce Liver Fat and Improve Your Liver Health - Andy de Santis RD, MPH

Andy de Santis (0:00)

Let's say the hallmarks of fatty liver are insulin resistance, high triglycerides, inflammation, and then gut microbiome imbalance. So for those individuals, they need to hear that. You can optimize your diet, do smart things with your supplements, and hey, even walk 150 minutes a week, and you can significantly reduce your liver fat content and reverse the condition. You don't necessarily need to lose 30 kilos.

Siim Land (0:18)

Welcome to the Siim Land Podcast. Our guest today is Andy de Santis. Andy is a registered dietician in Toronto, and he has a master's degree in public health nutrition. Andy, welcome to the show.

Andy de Santis (0:31)

Thank you so much for having me. It's a pleasure to be here.

Siim Land (0:34)

Yeah, I'm happy to have you. And you talk a lot about the liver, which in a lot of ways is one of the most underrated organs in the body, and it's definitely very important. And it's also very, I guess, unique in the sense that you could lose almost the entirety of your liver, and it would still be able to regenerate, which is not the case with your heart or your brain even. So yeah, maybe we can get started with why is the liver so important when it comes to overall health? Yeah.

Andy de Santis (1:11)

Well, the fact of the matter is the liver performs over 500 functions in the human body. On a broad level, some of those functions include carbohydrate metabolism, fat metabolism, protein metabolism, iron metabolism, it stores vitamin D, it stores other vitamins. But the most famous function and what it's most known for and arguably its most important function is the detoxification function, right? Because when blood, and I'm sure this will come out in today's discussion, but when blood flows through the digestive system, it goes to the liver next. Before, it is suitable to enter the rest of the body. And there's a very important reason for that. It's because it needs to be detoxified. Certain things need to be recycled and so on. So that would be a glimpse of some of the liver's functionalities.

Siim Land (2:00)

Got you. Yeah. And how did you get involved with making liver? You're one of the main focuses.

Andy de Santis (2:08)

Yeah, it's a great question. Essentially, what I found is I, as a professional in the space of nutrition, over a decade now, I've written several books, looked into broad areas, helped people with many different issues. What I found is that liver health is a very good proxy for my philosophy, which by that I mean, I have a vision for what high level eating is. And if I want to share that vision broadly, well, I have a choice. I can talk about weight loss, which is relevant, but I don't love to put all my eggs in that basket. I could talk about general health, which is not always compelling, or I can speak about liver health. And now the liver, the health of the liver is compromised in a third of the population or more, as it relates to fatty liver. So it just seems like a great proxy for me to send a positive message where people are compelled to listen and act. So that is the reason primarily, and there are others, but that's the really big reason why I've chosen to specialize on liver health.

Siim Land (3:03)

And I guess in the modern world, there's just a lot more things that impose more stress on the liver. So like all these different environmental toxins, chemicals, bad diet, alcohol. So yeah, I guess more and more people's livers are overburdened.

Andy de Santis (3:19)

Yeah, theoretically, that's absolutely true. I mean, we're exposed to more and more objects in the air, in our food and elsewhere. And so the importance of the choices we make around lifestyle, diet, exercise, supplementation, it's not to say that those choices, the relevance is changes or the nature of them changes, but they're more important because the stakes are higher. So I think that's fair to say.

Siim Land (3:40)

So maybe we can start with something like that is, I guess, more general. So what would be something that people kind of should do as a foundation in the 21st century to keep their liver healthy? And I guess maybe we can also backtrack of what happens if you don't have your liver health optimal. Like what other diseases can you get? And do actually people die to poor liver health?

Andy de Santis (4:09)

Yeah, it's a great question. So let me start with the second question first. So just last month, a study was published in a reputable cancer journal, and it found that fatty liver disease is now the number one cause of liver cancer in Sweden specifically. Now I would expect that as more data becomes available in the years, months ahead, that this will become a more abundant finding, okay? Now having spoken to doctors in this area, they expect that fatty liver disease, for example, will become the number one reason for liver transplant and so on. So the stakes are high insofar as if you don't take care of your liver health in the long term, you can get cirrhosis, you can get liver cancer, etc. But if you get a fatty liver diagnosis, it's not urgent in the short term. Now, part of your question is what happens in the medium term, which is between when you first get a diagnosis, in between when really bad things happen. And that's a bit of a gray area. And the reason why is the number one symptom of fatty liver generally is fatigue, right? Which is a very general symptom, which can occur for a variety of reasons, right? So it's not as if like you can have multiple reasons why you're tired and fatty liver could contribute to that. But more interestingly, and this is actually the hard part, is we don't know how does like slight malfunction in the liver manifest in terms of your daily life. One example I can give you is that what happens is when someone ends up with a fatty liver, which is the most common thing to go wrong with the human liver, right? It affects one in three people globally, and it will affect four in 10 by 2050, I believe is the estimate. What happens is if that goes unresolved, then the liver can accumulate scar tissue, right? Which is known as fibrosis, and it becomes more stiff. When that happens, blood does not flow as well through the liver, which means that the detoxifying cells in the liver may be less likely to access that blood that's flowing through, which means theoretically more stuff is getting through your liver undetected, right? And so there could be an accumulative effect of that in terms of how that affects inflammation and your other body cells exposure to toxins. But that's very hard to quantify if we're being honest about it, right?