2023-06-22 11:56:44
Why have you devoted a book to the liver?
Already I am hepatologist and nutritionist, so that’s what interests me. But above all, I see patients who, whatever their socio-economic level, have liver diseases. Many of them ask me recurring questions through which I perceive their astonishment at being sick with the liver without ever having been drunk. They do not realize that they are inflicting these diseases on themselves because of their way of life. However, I think it is all the more important to let people know when we see that there are almost no more cases viral hepatitis.
There is, in fact, a vaccine once morest hepatitis B and very effective drugs once morest hepatitis C.
What illnesses do you most often treat in hospital?
I observe an increase in liver diseases and a change in their nature. Until regarding ten years ago, those most prevalent were related to hepatitis B and C. Today, the incidence of liver cancer, even without cirrhosis, continues to increase. I also treat more and more the Nash [Non-Alcoholic Steato Hepatitis en anglais, NDLR]that is to say the metabolic steatopathy, which I refer to as nutritional diseases of the liver, including junk food and alcohol. When I say junk food, I’m referring to the sugars found in sugar itself, starches, processed foods, fats — of course, there are good ones and bad ones — and alcohol. All this mixed together explodes the incidence of these pathologies. I repeat, too many patients tell me “ I’m liver sick but I’ve never been drunk “.
Read also Hepatic steatosis, fatty liver disease, NASH: fad or real epidemic?
It takes two associated causes, you say, to develop liver disease…
Yes, most often. If you combine a little overweight with a little alcohol, say two drinks a day, you will potentially develop liver disease. If you drink those same two glasses of alcohol a day and you’re not fat, it will be better tolerated. On the other hand, if you drink them and combine them with a diet low in fiber, high in sugar and fat, alcohol can then make you sick.
How do you treat these illnesses?
It’s very complicated. As easy as it is to take medication, it can be complicated to lose weight and change your diet. That’s why I wrote my book “fuck it”: on the one hand, as a doctor, you force patients to change their way of life and, on the other hand, the organism has a memory. In other words, if you change your way of life and then you go back too quickly to your previous way of life, because of this memory, you are going to have a boomerang effect or yo-yo which means that it will paradoxically get worse. Best to go slowly. I thus explain to my patients the interest of eating well, you biorythm, intermittent fasting and the merits or not of the detox cures that everyone is talking regarding. After that, I leave people free to do what they want. Forcing someone doesn’t work.
Is it possible to know the state of his liver?
It’s not easy: the liver is a very wise child, who doesn’t talk to you. When he starts talking to you, it’s already a bit too late. Sometimes when it’s a bit bigyou may feel a somewhat dull pain under the ribs on the right.
Concretely, you can measure your waistline at the level of the navel using a tape measure: if a person of the European type has a waist circumference greater than 94 cm for a man, and 80 cm for a woman, you have to ask yourself how your liver is doing. It’s quite crude but it already gives a good indication. Even though the body mass index (BMI) is neither very specific nor very sensitive, it still provides information. And then, the dosage of liver enzymes (transaminases Alat and Asat and gamma-GT) thanks to a blood test completes the analyses.
You compare the liver to a kind of barometer of our body. For what ?
The liver has the ability to regenerate, unlike the heart which will be greatly diminished following angina pectoris, blocked coronaries or a stroke. When you have liver disease, it means that it protects you less and less well. But you are more likely to die from the heart than from the liver. With a blood test, we quickly detect a liver problem. It is for this reason that, when you begin to protect your liver, in a way, you protect the rest of the body like a shield.
Read also Hepatic protection
A diseased liver can therefore heal…
Absolutely. If you have a diseased liver, as it regenerates, the harm is reversible. And even if you start worrying regarding it around age 55-65, or even later, you will still increase your life expectancy and quality of life.
What is the best diet for my liver?
The Mediterranean or Cretan diet and the diet of the Japanese in Okinawa. They are characterized by a low intake of pro-inflammatory foods such as meat, ultra-processed products, sugars and dairy products, and by a high intake of fibre, vegetables, anti-inflammatory oils rich in omega 3 and 9 (olive and rapeseed) and small fish. She tolerates a little alcohol, the exact amount of which is difficult to define on an individual basis. Statistically, from the first drink, you increase, in terms of public health, the risk of breast cancer in women. However, in some, a small amount of alcohol may protect. As for drinks, coffee and tea are anti-inflammatory, antioxidant, and from the first cup you protect the liver from cancer and fibrosis.
People who adopt these eating habits often leave the table still a little hungry and let the feeling of satiety come gradually. The high vegetable content of these diets promotes a good microbiota therefore a good liver. It is also the food with the least greenhouse gas emissions. By adopting it, you protect your liver, your bacteria and the planet.
Read also A Mediterranean diet in all seasons
How to best respect the biorhythm of the liver?
It is healthier to eat heartily in the morning and, as the day progresses, to reduce your intake, especially of starchy foods. I am of course talking regarding an ideal world because we all have societal constraints. Anyway, thehe chrononutrition is an important parameter if one wishes to extend one’s life expectancy. Intermittent fasting consisting of staying a long period (12 to 16 hours) without eating is also positive. It limits insulin secretion and therefore the inflammatory process and the storage of sugar and fat.
What is the link between the liver and the intestinal microbiota?
My research team is working on this topic, and the link is very clear. The susceptibility of developing liver disease related to junk food or alcohol consumption depends on the profile of your microbiota. We are currently starting trials to find out whether, by targeting the intestinal microbiota by prebiotics like apple pectin for example, it is possible to improve the liver of patients, or even to limit the irrepressible urge to consume sugar or alcohol. We hope to identify liver-protecting bacteria.
Why “doesn’t your liver like the same foods as my liver”?
Gut microbiota and genetic polymorphism differ from individual to individual. You can change your diet, but your genetics are more complicated. To prevent these polymorphisms from being expressed, you have to take care of your diet. It is true that in some individuals, errors will be better forgiven by the liver than in others. These polymorphisms are not yet researched in clinical practice, but I am hopeful as a doctor that one day it will be put to use in the context of more personalized medicine.
For further
x 100. How to protect your liver to live to 100, ed. Flammarion, 224 pages, €19.
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#liver #shield #live #longer #Gabriel #Perlemuter