What Effect Does Sugar Have on your Liver?

It is generally advised that we begin our days with a fruit rather than tea or coffee, however the majority of us begin our days with tea or coffee that contains sugar. But have you ever thought that is sugar really beneficial for our general health?

Did you know there are 4 types of sugar?

  1.  
  2. Fructose (i.e. fruit sugar)
  3. Sucrose  (i.e. table sugar)
  4. Lactose (i.e. dairy sugar)

What happens in our body when we intake sugar?

When we consume sugar, our body break it down into glucose, use some of it for energy, and reserve it for later use. Excess glucose is used to build fat cells. One of the organs in our bodies where excess fat is stored is the liver. Fat cells gradually replace liver cells over time, resulting in non-alcohol-related fatty liver disease. According to some research, sugar can be just as bad for your liver as alcohol, even if you’re not overweight.

What happens if we consume an excessive amount of sugar?

When you consume an excessive amount of sugar, your body stops responding effectively to insulin, and your pancreas begins producing even more insulin. Your overworked pancreas will eventually fail and your blood sugar levels will rise, putting you at risk for type 2 diabetes, cardiovascular disease, cancer, and obesity, which is a leading cause of liver disease.

What happens when we consume a lot of sucrose?

When the same amount of fructose and sucrose are used, the latter increases fat production even more. Puddings, milkshakes, cakes, fruit juice drinks, deep-fried dishes with sweet sauce, cookies, pancakes, sweets, chocolate, and commercial cereals are examples of high sucrose foods.

According to medical studies, even a moderate amount of sugar consumed on a regular basis might disrupt metabolism. Because the liver can only process fructose found in fruits and vegetables and other sugar sources to a limited amount, consuming additional sugar sources causes’ fat storage in the liver and increases the risk of NAFLD and insulin resistance in individuals.

How much sugar is fit for consumption?

According to the World Health Organization (WHO), people should consume not more than 5% of their daily calories from added sugar. For a person with a typical diet, this equates to 25 g, or around 6 teaspoons.

Did you know that?

Sugar also contributes to skin ageing and causes acne?

What happens to our liver when we consume sugar?

Our liver can only process fructose, which is found in fruits and vegetables and other sugar sources to a lesser extent, but consuming other sugar sources promotes fat storage in the liver and increases the risk of NAFLD and insulin resistance in individuals. When we consume sugar on a daily basis, our bodies produce inflammatory chemicals, which collect in our systems, harming other internal organs and finally contributing to liver disease.

When the liver is damaged, obese, or inflammatory, it cannot work as effectively as it should. It cannot digest or eliminate poisons from our body. It also contributes to obesity by affecting the metabolism of fat and cholesterol, resulting in an increase in fatty deposits.

It has been found that teenagers over consume in fizzy drinks and sweets. This is a serious sign of liver disease in the younger generation, as well as the incidence of NAFLD in children and teenagers, as well as an increase in severe liver disease in adults.

How can you avoid liver damage caused by sugar synthesis?

  • Sugar consumption should be restricted.
  • Consuming a lot of vegetables and fruits
  • Exercise on a regular basis

For further information on liver health and disease you can consult Dr Gaurav Gupta, Liver Specialist in Mumbai.

Most Common Myths about Liver Diseases

Liver disease is commonly regarded as a “silent” condition because its various types may not show any symptoms at all. Cirrhosis and cancer are the most dangerous effects of liver disease. Here’s a look at some of the most popular misconceptions about liver health

It’s always caused by alcohol

This is perhaps the most common misconception concerning liver illness. And it is simply not true. There are numerous varieties of liver disease, which are caused due to numerous reasons. One of them is alcohol. Autoimmune hepatitis occurs when your immune system becomes confused and attacks your liver. Drug-Induced Liver Injury is a rare adverse effect that some people experience after taking a doctor-prescribed medication. Non-alcohol-related fatty liver disease is becoming more common.

 

It’s contagious 

Some types of liver disease are caused by viruses. They are, however, much more difficult to contract than a cough or cold. You cannot contract viral hepatitis by being in close proximity to someone who has the virus, or by touching them or something they have touched.

 It is spreadable with needles. Sharing needles for recreational drugs, for example. Healthcare workers can become infected by accident, and mothers can spread hepatitis to their babies around the time of birth. In addition, some persons get viral hepatitis as a result of medical operations such blood transfusions. Unfortunately, the stigma behind liver disease means that many patients do not receive the necessary tests or care, and are even treated as though they are contagious.

 

The liver has no role in the functioning of body

Your liver is incredible. It has over 500 jobs and can self-repair when damaged. But only so much can be tolerated. If the damage is severe or continues for an extended period of time, your liver will not be able to repair itself. When this happens, your liver can become scarred and rigid, finally failing to function. A liver is required for survival. If your liver fails, your only choice is a liver transplant.

 

Yellow skin and aches are symptoms of liver disease

Major types of liver disease frequently have no symptoms at all. Because the liver is known to not show any visible symptoms, hepatitis A, B, and C, also known as cirrhosis, are usually identified 20 to 30 years later. What appear to be aches and pains in the liver are mainly digestive symptoms induced by a high-fat diet or rich meals.

Medications have no effect on the liver

 All medications have the potential to be harmful to the liver. Elderly people who are undergoing multiple treatments are especially vulnerable to drug-induced hepatitis. Health supplements are also harmful for liver. When ingested in large quantities or not handled correctly, these can also damage the liver.

An increasingly unhealthy lifestyle has contributed to India becoming the world capital of liver disorders. According to the WHO, it is the tenth leading cause of risk of death in India. One of the most common causes is liver cirrhosis, which affects over 10 lakh new cases each year. When liver problems are detected early, they can be treated. Regular visits to a Liver Specialist can assist with the diagnosis of any problems that may arise.

Are you diabetic, overweight and have fatty liver? Study shows how coffee can help

A new study shows that coffee can control fatty liver. But coffee-drinking should be moderate and can only complement the main therapy required to address the root cause of liver inflammation, says Dr Gaurav Gupta, Senior Consultant and Chief Surgeon of Liver Transplant and Hepato-pancreato-biliary (HPB) surgery at Fortis Hospital, Mumbai.

Can a bit of coffee-drinking lower the severity of non-alcoholic fatty liver disease (NAFLD) in overweight adults with Type 2 diabetes? A new study from the University of Coimbra, and published in the journal Nutrients, discovered that caffeine, polyphenols and other natural compounds contained in coffee could do so. Dr Gaurav Gupta, Senior Consultant and Chief Surgeon of Liver Transplant and Hepato-pancreato-biliary (HPB) surgery at Fortis Hospital, Mumbai, decodes the study and says that coffee should be had in moderation in such cases and can be used only as a complementary dietary intervention.

What is non-alcoholic fatty liver disease?

Non-Alcoholic Fatty Liver Disease (NAFLD) is where the patient does not consume alcohol but he/she still ends up with fatty liver. NAFLD is a spectrum of diseases ranging from simple fatty liver to hepatitis to liver cirrhosis. The main causes are diabetes, hypertension, being overweight or obesity, high cholesterol levels and hypothyroidism.

Why are diabetic patients detected with fatty liver?

Patients with diabetes, especially Type 2 diabetes, have insulin resistance leading to high blood sugar. Diabetes may be associated with other lifestyle diseases such as high cholesterol and hypertension. All these diseases lead to fat deposits in the liver, which cause the condition called fatty liver. This can progress to causing inflammation of the liver, which is called hepatitis, ultimately leading to liver damage and liver cirrhosis.

What components in coffee can help to control diabetes?

Coffee helps in preventing damage caused by free radicals. Free radicals resulting in oxidative stress is the main mechanism leading to inflammation or liver damage in patients with diabetes. It’s the same mechanism by which fresh green leafy vegetables, fresh fruits and multivitamins protect our liver from diabetes or high cholesterol.

The study has suggested that the coffee component, including polyphenols, reduces oxidative stress in the liver, in turn reducing the risk of fibrosis as well as improving glucose homeostasis. What does it mean in terms of body health and weight?

Oxidative damage or free oxygen radical damage occurs whenever there is fat deposited in the liver. This deposition of fat in the liver cells can cause liver inflammation. So, all these compounds which are present in coffee, green leafy vegetables, fresh fruits and multivitamins, work on the same principles. They decrease this oxidative stress or free oxygen radical damage, which ultimately helps us in preventing fibrosis or cirrhosis. But once fibrosis or cirrhosis occurs, it cannot be reversed with coffee, green leafy vegetables, or fresh fruit.

If you want to prevent the fatty liver, you must do it through taking measures against its root cause. Consuming coffee, milk, vegetables, or fresh fruit can be complementary actions, but the main treatment still remains the necessary modification in lifestyle like adequate exercise, a good and nutritious diet, controlling sugar and cholesterol levels and controlling blood pressure. But consumption of a moderate amount of coffee can complement and help us in preventing liver inflammation.

Understanding Viral Hepatitis A infection, tips to prevent it especially in kids

HAV or Acute Viral Hepatitis A is defined as the inflammation of the liver, which is generally caused by infection with one of the five Hepatitis viruses and almost 10-30% of cases related to HAV belong to children. Here’s all you need to know about it and tips to prevent it

The world has just witnessed a massive pandemic and while the worst may be over, the impact of the last two years is still quite being felt across countries and communities. However, the good news is that as the world is opening up, people are starting to explore the outdoors again. While this spells good news for economies, multiple factors are increasing our exposure to bacteria and viruses, mainly because we are once again stepping outside without masks and practising basic hand hygiene.

In the last few months, there has been a spurt of infections and contagious diseases like measles, dengue and even Viral Hepatitis A (HAV). In an interview with HT Lifestyle, Dr Gaurav Gupta, Director-Liver Transplant and HPB Surgeon at Fortis Hospital in Mulund, explained, “HAV or Acute Viral Hepatitis A is defined as the inflammation of the Liver, which is generally caused by infection with one of the five Hepatitis viruses. Almost 10-30% of cases related to HAV belong to children. Hepatitis A is an RNA virus, the incubation period for which averages 30 days and can sometimes even extend to 49 days.”

Talking about the symptoms, he said, “HAV infection is usually silent or subclinical in children. Symptomatic Hepatitis occurs in approximately 30% of infected children younger than six years, but mostly it is a self-limiting illness where symptoms may persist for just 2 weeks. In contrast, older children, and adults with HAV infection are usually symptomatic for several weeks, approximately 70% suffer from Jaundice, and nearly 80% per cent have Hepatomegaly (a condition that causes the liver to become larger).”

Revealing some treatment measures, he said, “In most cases, HAV is a self-limiting disease, so it does not require any specific treatment methodology or hospitalization. The best way to recover from HAV is through bed rest, good hydration and nutrition that will help the body to tide over the virus. In the last six to eight months, there have been several cases where HAV infections has persisted for more than three to four months. These patients have shown symptoms related to Jaundice, although they do not have very high INR (International Normalized Ratio). or encephalopathy, which are markers of ALF. These patients are diagnosed with ‘Sub Acute Liver Failure’, which might require a Liver transplant.”

Keeping this in mind, the prevention of HAV is highly critical. Dr Gaurav Gupta cautioned, “As HAV is transmitted primarily through the faecal-oral route, homes and toilet areas must always be kept clean. The virus is shed in the stools of infected persons, with peak viral excretion occurring in the two weeks preceding the onset of Jaundice and during the initial phase of clinical illness. This virus can contaminate food and water or transmit through contaminated fomites. However, person-to-person spread through close personal contact is the most common mode of contamination for this virus, with frequent occurrence of secondary cases among household or school contacts of those infected.”

In India, HAV infection is widespread, although it usually occurs early during a person’s childhood. Dr Gaurav Gupta pointed out, “Infection at this age is often asymptomatic, leading to life-long immunity against reinfection.” According to him, it is also essential to know that prevention and control of HAV infection relies on breaking the chain of transmission using one or more of the following measures:

1. Improving hygiene and sanitary measures

2. HAV vaccine is the most effective method for specific pre-exposure prophylaxis. These vaccines are administered intramuscularly in the deltoid muscle, and two doses are given 6-18 months apart. Also, these vaccines are very effective in protecting a person from HAV infection as they have been able to induce protective antibody levels above 95% in the recipients, even after receiving their first vaccine dose.

Dr Gaurav Gupta concluded, “Hepatitis A is also a common cause of Jaundice in children and adults, with common symptoms being fever, fatigue, nausea, vomiting, loss of appetite and Jaundice. The good news, however, is that HAV infection usually results in an acute, self-limited illness and rarely leads to acute hepatic failure. Less than 0.1% per cent of HAV patients have Acute Liver Failure (ALF) which can become a life-threatening condition. Further, if a patient is diagnosed with ALF, having a Liver transplant is the only way that they can survive the disease. In conclusion, good hygiene practices coupled with widespread vaccination coverage and awareness can dramatically protect us from this common infectious Viral Hepatitis.”

Liver Transplant in India

Crohn’s disease and liver troubles

In 1932, American gastroenterologist Dr Burrill Crohn first described the inflammation and irritation in the digestive system as a medical condition. It was further named after him; this condition of unexplained diarrhoea, weight loss and abdominal cramps that people experience frequently is called Crohn’s disease (CD).

Crohn’s disease is a chronic inflammatory bowel disease (IBD) that begins gradually but worsens over time with periods of remission that lasts for weeks or years. Although the condition largely affects the small intestine and the beginning of the large intestine, some medical practitioners say that people with CD are also at a higher risk for liver problems.

Dr Ravindra B S, director and head of department, gastroenterology and hepatobiliary sciences, Fortis Hospital, Bengaluru, says that it is important to screen the liver of a person who has Crohn’s disease/IBD every four to six months to check its functioning.

 

According to Dr Sudeep Khanna, senior consultant gastroenterology, Indraprastha Apollo Hospitals, Delhi, only five to eight per cent of people with CD develop liver disease. He adds that a regular liver function test (LFT) helps in early detection since the liver disease may be dormant or asymptomatic.

Does CD directly affect the liver?

Dr Gaurav Gupta, senior consultant and chief surgeon, liver transplant and HPB surgery, Fortis Hospital, Mumbai, says that CD is the inflammation of the intestines and there is no direct correlation between the condition and the liver. “However, people who have CD often develop primary sclerosing cholangitis (PSC) which leads to liver problems,” he adds.

Dr Gupta says PSC is the inflammation of the bile ducts that causes ‘beading’ (strictures and dilations that make the bile ducts look like a necklace of beads). The beading obstructs the flow of bile outside the liver, leading to its accumulation in the liver, causing jaundice and consequently liver damage. “When the accumulated bile hardens, it can also form stones within the gallbladder that block the ducts,” says Dr Gupta.

Happiest Health probed further on the probable association between CD and the development of PSC.

Dr Gupta says the only evident associative factor could be that CD and PSC are both auto-immune conditions. However, he clarifies that PSC need not always occur in all people with CD. It can be a separate entity too.

Dr Ravindra says that PSC is a primary manifestation of IBD and explains that the autoimmune elements attack the bile tubes and cause inflammation.

The fatty liver and CD connection

“Fatty liver has more to do with obesity and the excessive intake of red meat than CD,” says Dr Khanna.

Dr Ravindra however mentions that non-alcoholic fatty liver disease (NAFLD) has been observed to be associated with people who have CD.

According to the Crohn’s and Colitis Foundation, a US-based non-profit organisation dedicated to the management of Crohn’s disease, fatty liver disease is the most common liver complication of IBD. It states that in some people with IBD, the liver can become inflamed or damaged; in about five per cent of them, the disease can be serious.

Confirming CD’s association with NAFLD, a 2017 study of 168 patients published in the journal, Inflammatory Bowel Disease, said that about 13 per cent of the people that were included in the study had both NAFLD and either ulcerative colitis or Crohn’s disease. The researchers also found that in people who had both IBD and NAFLD, IBD lasted for a significantly longer time.

Dr Ravindra recalls the case of a 33-year-old woman who had recurrent pain which drove her several times to doctors seeking relief desperately in vain. Her family was baffled at her trauma given the fact that intermittent stomach pain was all she had. She grappled with stomach pain for almost a year without a cause being pinpointed. A CT scan of the abdomen showed that her small intestine had thickened and ulcerated and she was advised to undergo surgery.

Later the woman underwent a special endoscopy called enteroscopy, a procedure to examine the organs, from the mouth to the large intestine, with the help of a thin tube attached to a camera. Further, the results along with a biopsy showed that she was suffering from Crohn’s disease.

The role of medication

Dr Khanna says that immune suppressants (that keep the body’s immune system in check) and certain medicines that stop inflammation used for the treatment of CD may cause liver problems.

However, Dr Ravindra adds that this may happen in very rare cases as regular liver function tests help detect the problem at an early stage.

Dr Gupta doesn’t see any direct role of CD medications in the development of liver problems.

How to know if its PSC

Dr Gupta says PSC manifests as jaundice and itching all over the body (due to the increased concentration of bile salts).

According to Dr Ravindra, the liver condition in people with CD presents itself in three ways – asymptomatic, when mild changes are detected in the LFT; symptomatic, which presents as itching, tiredness, weakness and jaundice and third, as a presentation of liver disease like jaundice itself with symptoms like itching and leg swelling. “The people who already have a liver disease when screened have associated IBD,” he says.

Speaking on the diagnostic procedure, Dr Khanna says an initial blood test (LFT) shows the cholestatic pattern of PSC. Abnormalities in the pattern indicate biliary obstruction. Magnetic Resonance Imaging (MRI) highlights small strictures in the bile ducts and if further confirmation is required, an endoscopic retrograde cholangiopancreatography (ERCP) is suggested, he adds.

ERCP is a technique that combines the use of endoscopy and fluoroscopy to diagnose and treat certain problems of the biliary or pancreatic ductal systems and Dr Khanna says an ERCP is rarely required unless there is a large stricture in the main bile duct which is outside the liver.

“Endoscopy into the bile ducts is carried out to detect cancer of the bile ducts,” says Dr Khanna.

Managing PSC

“Primary sclerosing cholangitis is not curable and can only be controlled,” says Dr Gupta who adds that the condition can be treated with steroids and immune suppressants. But he warns that despite medication, PSC can continue to progress and gradually lead to permanent liver damage and conditions like liver cirrhosis and bile duct cancer.

Dr Khanna says that the treatment is directed toward the symptomatic management of PSC to stabilise the liver and facilitate its adequate functioning.

Dr Ravindra says treatment depends upon the severity of the condition. “When the bile ducts are inflamed and swollen, medication is the best treatment. Stents work best to widen the ducts when they have narrowed.

“Only in severe liver diseases like liver cirrhosis, liver protectors are given (supplements/drugs that protect the liver) and if the condition continues to progress, surgery and liver transplant are advised.

Does diet help?

“Not really,” says Dr Gupta. “Diet doesn’t play a significant role in the management of PSC but a low carbohydrate, low salt diet can help manage a fatty liver,” he says.

Dr Ravindra adds that drinking warm water in the morning, reducing red meat, milk and high-fibre foods and including boiled vegetables and fruits in the diet generally help manage a liver condition better.

He also suggests lifestyle changes like a six to seven-hour gap between meals, an early dinner, and 15 to 20 minutes of exercise daily.

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