Alcoholic liver disease is a term that encompasses the liver manifestations of alcohol overconsumption, including fatty liver, alcoholic hepatitis, and chronic hepatitis with liver fibrosis or cirrhosis.^[1]

It is the major cause of liver disease in Western countries. Although steatosis (fatty liver) will develop in any individual who consumes a large quantity of alcoholic beverages over a long period of time, this process is transient and reversible.^[1] Of all chronic heavy drinkers, only 15–20% develop hepatitis or cirrhosis, which can occur concomitantly or in succession.^[2]

The mechanism behind this is not completely understood. 80% of alcohol passes through the liver to be detoxified. Chronic consumption of alcohol results in the secretion of pro-inflammatory cytokines (TNF-alpha, Interleukin 6 [IL6] and Interleukin 8 [IL8]), oxidative stress, lipid peroxidation, and acetaldehyde toxicity. These factors cause inflammation, apoptosis and eventually fibrosis of liver cells. Why this occurs in only a few individuals is still unclear. Additionally, the liver has tremendous capacity to regenerate and even when 75% of hepatocytes are dead, it continues to function as normal.

The risk factors presently known are:

• Quantity of alcohol taken: Consumption of 60–80g per day (14g is considered one standard drink in the USA; drinking a six-pack of beer daily would be at the top of the range) for 20 years or more in men, or 20g/day (about 25 mL/day) for women significantly increases the risk of hepatitis and fibrosis by 7% to 47%,^[1][4]
• Pattern of drinking: Drinking outside of meal times increases up to 3 times the risk of alcoholic liver disease.^[2]
• Gender: Women are twice as susceptible to alcohol-related liver disease, and may develop alcoholic liver disease with shorter durations and doses of chronic consumption. The lesser amount of alcohol dehydrogenase secreted in the gut, higher proportion of body fat in women, and changes in fat absorption due to the menstrual cycle may explain this phenomenon.^[2]
• Hepatitis C infection: A concomitant hepatitis C infection significantly accelerates the process of liver injury.^[2]
• Genetic factors: Genetic factors predispose both to alcoholism and to alcoholic liver disease. Both monozygotic twins are more likely to be alcoholics and to develop liver cirrhosis than both dizygotic twins. Polymorphisms in the enzymes involved in the metabolism of alcohol, such as ADH, ALDH, CYP4502E1, mitochondrial dysfunction, and cytokine polymorphism may partly explain this genetic component. However, no specific polymorphisms have currently been firmly linked to alcoholic liver disease.
• Iron overload (Hemochromatosis)
• Diet: Malnutrition, particularly vitamin A and E deficiencies, can worsen alcohol-induced liver damage by preventing regeneration of hepatocytes. This is particularly a concern as alcoholics are usually malnourished because of a poor diet, anorexia, and encephalopathy.

Foods to Avoid with Fatty Liver

After going through all food groups, let’s go into specifics on the foods bad for the liver. These foods are mostly high on fat, cholesterol, and sugar (including artificial sweeteners).

You won’t be able to avoid them completely, and I’m not going to ask you to do so. But it must be controlled – and that’s what we’re going to do.

When you’re in a supermarket, look for the ingredients of every product you want to buy. If it’s high on fat or sugar, take only 1 or 2 units of these in whole shopping basket.

By avoid or drastically reducing unhealthy foods intake, you will make your liver’s life a lot easier and it will take the time to repair itself.