LYMA speaks to a hepatologist about how Dry January actually affects your liver, and how you can protect your largest internal organ.
Hello January, hello hair shirt. A lot of us want to start recovering from December excesses as well as build different behaviours for the year ahead. This might be via new year's resolutions, ‘veganuary’, or even - if your hangover is that bad - Dry January. But how much can a healthier January help us? Can short-term changes yield long-term results?
To learn more, we spoke to William Alazawi, a Professor of Hepatology at Queen Mary University London and Consultant Hepatologist at The Royal London Hospital: a man who certainly knows his way around the liver. We wanted to know if Dry January really can change our liver’s health for the better.
How does Dry January improve health
The first thing to consider, says Prof Alazawi, is why are you doing Dry January in the first place. “If it’s because there’s an underlying problem, don’t forget that alcohol addiction is a condition in itself, which requires attention and support.” Alcohol addiction has many mental health and social ramifications as well as physical implications, and should be tackled as its own thing, and would require more than just Dry January.
Similarly, he adds, Dry January alone will not be a solution for advanced liver disease. In that case, “not drinking alcohol at all is an important part of the recommendation we give.” But what about if you’ve not been instructed to give up alcohol, and want to know how this month will affect you?
It’s true that Dry January can give your liver a ‘rest’, especially after the excess of December. It’s also helpful for cutting down on alcohol-related calories, and alcohol-adjacent calories (snacks, that kebab you order every time you have a glass). Cutting alcohol also might improve your sleep and mood. “In terms of whether or not one month alone can improve your liver or alcohol-related liver damage,” mused Prof Alazawi, “it will certainly help and we know that fat that accumulates in liver cells can come off quite quickly but may not be enough on its own.”
Alcohol is not the only antagonist for the liver
The liver is our largest internal organ, involved in all kinds of bodily functions. “They include metabolism, breaking down what we eat, what we drink, medication that we take,” explained Professor Alazawi. “It's also involved in our immune system.”
It is an organ that we don’t consider the health of enough, what’s more, it is also hard to check for signs of damage. We know that alcohol can damage the liver, even though you may not consider your alcohol intake to be problematic: “alcohol can cause problems even though people may not fit into their preconception of what an ‘alcoholic’ might be,” added Alazawi. Infection with hepatitis B and C viruses can cause life-threatening liver disease and there is a vaccine and treatments for hepatitis B and a cure for hepatitis C. The immune system can react against the liver in certain conditions, or there may be iron or copper excess. Medication and drugs, too, can also effect the liver. There is also a condition known as ‘non-alcoholic fatty liver disease’, which affects about a quarter of the population, “particularly in people who are overweight, obese or have type-2 diabetes.”
It’s hard to find out if you have this condition, however: it tends to be found only when symptoms in the abdomen are already beginning to show, such as pain. “But for most people with fatty liver disease, there are no symptoms,” warns Prof Alazawi. But if you have other liver problems, abnormal blood tests, or something else comes back looking erroneous, it might then reveal that a fatty liver is something to consider.
The benefits of Dry January
What dry January helps to do, says Prof Alazawi, is help build better habits, and make people reconsider their relationship to a drink.
“Anecdotally patients of mine, who feel a bit better, don’t go back to the middle of December on the first of February,” explained Prof Alazawi. “There is a general knock on effect, because of the benefits they experienced while not drinking.”
For Prof Alazawi, curbing your drinking is best done as part of a more catholic spread of better behaviours - “some new year's resolutions, wanting to go to the gym, wanting to eat more healthily, drinking more water, sleeping better” - it’s this combination that manages to not only reduce the amount of fat in the liver, but lead to sustained improvements all around. “It’s more than just a dry January.”
How to look after your liver in February and beyond
If Dry January makes you realise you have a greater issue with drinking, and there are mental health issues connected to it, seek professional help.
For others, the big thing to take away from Dry January is not abstaining forever, but trying to veer closer to recommended alcohol limits down the line. “Less than 14 units of alcohol a week, with three or four days drink free in the week,” he explained. He admits it is easy to get up to 14 units - “if you imagine a bottle of wine may be 9-10 units” - but this is the recommended healthy limit.
If you’ve been drinking more than that – more than 50 units of alcohol a week for a man, or 35 if you’re a woman – then you are at increased risk of liver disease, and NHS advice recommends you get a Fibroscan, which uses sound waves to assess your liver’s health. It may be the first time you actually hear what’s going on in your liver, and the first time you really think about what to do for it.
Generally, looking after your liver just requires following healthy habits. “Have a healthy diet, drifting towards a Mediterranean diet: moderating the amount of carbohydrates, saturated fats and sugar in particular.” Drink more water, intersperse your alcohol consumption with non-alcoholic drinks that are low in sugar. Intersperse wine or beer with non-alcoholic or low alcohol alternatives, he suggests, and if all of that feels too much, there’s one simple way to start building a better relationship between you and your liver: “drink from smaller glasses.”
Originally published Dec 17, 2021.
Written by David Levesley.