Liver Health and Disease Management

Introduction to Liver Health

• The European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines do not support the use of herbal supplements, such as milk thistle, chrysanthemum, honeysuckle, wolfberry, dandelion root, and cassia seed, for treating established liver disease or reversing liver damage 1, 2
• Current clinical guidelines do not recommend these herbs for liver disease management 1, 2

Dietary Modifications

• Calorie restriction with a 500-1000 kcal/day deficit is recommended for liver health 3
• A Mediterranean diet pattern is recommended for liver health and disease management 3, 4
• A low-carbohydrate, low-fructose diet is especially important for certain populations, such as Korean patients 4
• Increased consumption of plant-based foods high in antioxidants is recommended for liver health 5

Exercise and Lifestyle Modifications

• At least 30 minutes of moderate exercise twice weekly is recommended for liver health 4
• Aerobic exercise, such as walking, running, swimming, or cycling, is recommended for liver health 4
• Complete alcohol abstinence is recommended for liver health 3
• Caution should be exercised when taking medications that can harm the liver, and acetaminophen intake should be limited 6

Supplements and Herbal Remedies

• Potential herb-drug interactions should be considered when taking herbal supplements 6
• Some herbal supplements can actually cause liver damage 6
• The ESPEN guidelines state that antioxidants, such as vitamin C, resveratrol, anthocyanin, and bayberries, cannot be recommended to treat NAFLD/NASH until further data regarding their efficacy are available 2