Beyond Dry January: How to look after your liver

Written by: Dr Jeremy Cobbold
Edited by: Nicholas Howley

With alcoholic liver disease reported to be on the rise, many of us want to know: how do you actually look after your liver? How much can you safely drink? Are some types of alcohol better than others? And does Dry January actually work? We put these questions to consultant liver specialist Dr Jeremy Cobbold, who gave us some surprising answers:


Is there a “safe drinking limit” when it comes to your liver?

Alcohol affects the whole body, not just the liver. Drinking limits are based on risk profiles for a population rather than an individual, but drinking 14 units of alcohol or less per week, spread through the week, is considered safe for men and women.

To get a sense of how much this is, there are about 10 units of alcohol in a standard bottle of wine and 2-3 units in a pint of beer, a large glass of wine or a home serving of spirit.

Drinking more than 35 units a week for a woman or 50 units a week for a man is considered harmful and can lead to liver disease. In the grey area between, risks of health problems are increased, particularly if you have another liver condition like (non-alcoholic) fatty liver disease.

NICE recommends that people who regularly drink at harmful levels (35 units/week for a woman, 50 units/week for a man) should have their liver tested to look for advanced scarring or cirrhosis, using a test such as FibroScan®.

Are some types of alcohol better than others for your liver?

No. There is no good evidence to suggest that one type of alcohol is better for the liver than others for a given amount. It is more that some types of alcohol may be associated with heavier drinking overall, or a different patterns of drinking – like binge drinking.

Can you really “reset” your liver by going alcohol-free for a few weeks?

As many people are aware, the liver has a wonderful capacity for regeneration…up to a point. If the liver is persistently damaged over time, the healing process can lead to scar tissue formation throughout the liver (fibrosis), eventually leading to severe scarring ( cirrhosis) when complications are much more likely to occur. Nevertheless, a few weeks going alcohol free, such as “dry January”, can lead to improvements in liver function, fatty liver and has been shown to reset alcohol consumption as people then drink less over subsequent weeks.

So all in all, it is a good thing!

Can a good diet help protect your liver?

A good diet is crucial to general health and certainly a poor diet high in sugar, fat and overall calories is likely to harm the liver. This type of causes an accumulation of fat and damage-causing free radicals – which can lead to non-alcoholic fatty liver disease.

Conversely, a diet high in vegetables and fruit, nuts, oily fish and with moderate quantities of high quality protein from pulses and lean meat, and high in fibre is associated with better cardio-metabolic and liver health and can be protective to a degree.

Nevertheless, a good diet cannot be relied upon to protect the liver from damage in the context of harmful alcohol intake. Increasingly regular moderate exercise is also very important both for liver health and overall health and wellbeing. The good news is that 3 or 4 cups of coffee per day is associated with improved liver health and reduced fatty liver disease (just lay off the syrup and cream)!

By Dr Jeremy Cobbold
Hepatology (liver specialist)

Dr Jeremy Cobbold is a distinguished Consultant Hepatologist and Gastroenterologist based in Oxford. Practising at The Manor Hospital and the John Radcliffe Hospital, Dr Cobbold has considerable expertise in the diagnosis and management of a wide range of liver conditions, including investigating abnormal liver function tests, managing alcohol-related liver disease, non-alcohol fatty liver disease, cholestatic and autoimmune liver diseases, and cirrhosis. Dr Cobbold takes care to offer a relaxed consultation setting where patients are given sufficient time to voice all of their concerns.

Dr Cobbold qualified initially from the University of Cambridge and the University of London in 2001. He then underwent specialist training at some of the UK's top centres of excellence, including the Royal Free Hospital and St Mary's Hospital, Paddington.

While pursuing a PhD at Imperial College London, he developed an interest in teaching, first as Clinical Lecturer then Honorary Clinical Lecturer in Hepatology. In 2013, Dr Cobbold was appointed Consultant Hepatologist and Gastroenterolist at the John Radcliffe Hospital, Oxford, where he is the clinical lead for Hepatology. He runs a clinical research program in liver disease, and, as a Honorary Senior Clinical Lecturer at the University of Oxford, continues to teach the next generation of medical trainees.

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