The Impact of Ageing on Liver Health and How it Can Be Improved

The Liver: Its Importance and Functions

The liver, a vital organ, performs over 500 crucial functions essential for maintaining the body's well-being. It plays a key role in removing waste products and toxins from the bloodstream, regulating blood sugar levels, and producing essential nutrients. Some of its primary functions include:

• Albumin Production: The liver synthesises albumin, a protein that prevents fluid leakage from the bloodstream and facilitates the transport of hormones, vitamins, and enzymes throughout the body.
• Bile Production: Bile, produced by the liver, is crucial for the digestion and absorption of fats in the small intestine.
• Blood Filtration: All blood from the stomach and intestines undergoes filtration in the liver, where toxins and harmful substances are removed.
• Amino Acid Regulation: The liver ensures the maintenance of healthy amino acid levels in the bloodstream, vital for protein production.
• Blood Clotting Regulation: The liver plays a role in blood clotting by producing coagulants using vitamin K, which is absorbed with the assistance of bile.
• Infection Resistance: As part of its filtering process, the liver removes bacteria from the bloodstream, contributing to the body's immune defence.
• Vitamin and Mineral Storage: The liver stores significant amounts of vitamins (A, D, E, K, and B12) and minerals (iron and copper).
• Glucose Processing: It regulates blood glucose levels by removing excess glucose and storing it as glycogen, which can be converted back into glucose as needed.

It also acts as a central processing unit for nutrients and drugs, ensuring their proper metabolism and utilisation by the body. Additionally, the liver aids in the clearance of bilirubin regulates blood clotting and participates in the excretion of waste by-products through bile and urine.

Fig. 1. This image depicts the impact of ageing on the liver. It is very important to take care of the liver with increasing age to ensure vitality.

Liver volume and blood flow tend to decrease gradually with age, as evidenced by ultrasound studies indicating a 20-40% reduction in liver volume and a 35% decrease in liver blood volume in individuals aged 65 or older compared to those under 40. Radioisotope scans, however, reveal a decline in the mass of functional liver cells rather than the total liver volume. Ageing also leads to an expansion of neural fat and cholesterol volumes in the liver, accompanied by an increase in blood cholesterol, high-density lipoprotein cholesterol, and neutral fat levels.

Ageing-related alterations in liver cells involve changes in volume, polyploidy, accumulation of lipofuscin (dense bodies), reduced smooth endoplasmic reticulum area, and diminished number and functionality of mitochondria, resulting in lower ATP levels. Liver cell volume typically increases until maturity but declines with ageing. Lipofuscins, formed from damaged proteins due to oxidative stress, contribute to increased reactive oxygen species and decreased cell survival. 

These ageing-related changes, marked by increased oxidative stress, heightened inflammatory response, accelerated cellular senescence, and progressive organ dysfunction, significantly impact cellular responses to injury. Additionally, the decline in mitochondrial function associated with ageing enhances vulnerability to injury. (Kim et al., 2015d)

Healthy foods for the liver:

Here is the list of foods that you can incorporate into your diet to keep your liver healthy with increasing age. 

Coffee: Studies have shown that people who drink coffee have lower levels of liver enzymes, markers of liver health. For example, high levels of AST/ALT ratio, liver enzymes, in the blood may be a sign of liver disease or damage. This benefit of coffee may increase with the amount you drink, with evidence pointing to particularly low enzyme levels in those who consume 3 or more cups a day. (Morisco et al., 2014)  

Green Tea: Green Tea has powerful antioxidants and anti-inflammatories, especially a compound called epigallocatechin-3-gallate (EGCG). This compound is beneficial because it can reduce inflammation in a type of liver disease known as non-alcoholic fatty liver disease (NAFLD), which is frequently caused by fatty foods. It also helps your body make a substance called adiponectin, which fights inflammation and slows down NAFLD. So, drinking green tea improves your liver function and even lowers your liver cholesterol. (Mahmoodi et al., 2020)             

Red Beetroot: Beetroots are highly nutritious plant foods, packed with essential nutrients like vitamins, minerals, phenols, carotenoids, nitrate, ascorbic acids, and betalains. Studies on rats suggest oral beetroot extract doses of 250 or 500 mg/kg can enhance liver health, potentially by impacting apoptosis or secondary necrosis pathways. (Olumese & Oboh, 2018b)         

Broccoli: Broccoli supports important liver functions like glutathione synthesis and healthy fat production. A recent study on rats revealed that when adding broccoli to 10% of their overall diet for just two weeks, both their gut bacteria and liver health markers improved significantly. (Eve et al., 2020)

Blueberry: Blueberry extract holds promising potential in managing age-related liver dysfunction, offering a potential avenue to delay the onset and progression of liver diseases associated with ageing. The supplementation of blueberry extract notably increased levels of protective antioxidant molecules, effectively combating oxidative stress. This resulted in a reduction of markers of inflammation within the liver, fostering a more balanced cellular environment. Moreover, the expression of genes linked to liver fibrosis, a key feature of chronic liver damage, was significantly suppressed. (Albrahim & Alonazi, 2022b)               

Supplements for a Healthy Liver

Using health supplements can be a supportive addition to a healthy lifestyle, and some have shown promise in specific areas of liver health. Find out how supplements can benefit you by supporting liver function and your general health. 

Resveratrol: 

Resveratrol, a natural compound present in certain foods like grapes and berries, has been identified in research studies as a potential agent for mitigating fatty liver by influencing insulin resistance and lipid profiles in animals. Investigations indicate that resveratrol may offer protection against the detrimental effects of alcohol on the liver. In experiments with mice exposed to alcohol alone, there was notable liver damage and a high mortality rate. However, when alcohol was administered along with resveratrol, the extent of damage was significantly reduced, and the mortality rate decreased substantially. This suggests a protective role for resveratrol against alcohol-induced harm to the liver. Additional studies involving rats and human liver cells have demonstrated that resveratrol can diminish inflammation and mitigate damage caused by alcohol (Faghihzadeh et al., 2015).

Furthermore, in vitro studies conducted on human hepatic cells have revealed that pretreatment with resveratrol effectively shields liver cells from oxidative stress. This protective effect is associated with an increase in the antioxidant enzymes. Resveratrol also demonstrates the capability to counteract alcohol-affected energy metabolism by maintaining ATP content and enhancing mitochondrial ATP turnover. These findings highlight the potential of resveratrol in protecting liver cells and supporting their functionality in the face of oxidative stress and alcohol-induced challenges.

Quercetin: 

Quercetin has emerged as a potent liver-protective agent with extensively studied pharmacological effects in liver diseases. Its mechanisms of action are diverse and address various stages of liver diseases, reducing inflammation and oxidative stress. Notably, it exhibits liver-protective effects by inhibiting liver inflammation through the modulation of immune signalling pathways. Additionally, quercetin reduces oxidative stress, regulates mTOR activation in autophagy, and inhibits the expression of apoptotic factors associated with the development of liver diseases. In different stages of fatty liver, quercetin demonstrates efficacy by inducing fat browning and inhibiting fat accumulation. Both in vitro and in vivo pharmacological studies have indicated the safety of quercetin, with no significant toxic side effects observed.(X. Zhao et al., 2021)

Conclusion: 

The ageing process contributes to a gradual decline in the liver's ability to maintain homeostasis, rendering individuals more susceptible to various liver conditions. Age-related alterations in liver cells, involving oxidative stress and inflammatory responses, impact the organ's resilience and susceptibility to injury.

While dietary interventions with foods like coffee, green tea, beetroot, broccoli, and blueberries show promise in supporting liver health, supplements such as resveratrol and quercetin demonstrate potential liver-protective effects. 

 

FAQs:

1) How does ageing impact the liver?

Ans: Ageing significantly affects the liver, leading to a gradual decline in blood flow and volume. This results in altered liver cell characteristics, such as increased oxidative stress, inflammatory responses, and diminished mitochondrial functionality. These age-related liver alterations collectively contribute to a higher susceptibility to various liver conditions and decreased overall liver function during ageing.

2) What are the main roles of the liver?

Ans: The liver, a vital organ, performs over 500 crucial functions essential for maintaining the body's well-being. Its primary functions encompass synthesising albumin, a protein that prevents fluid leakage and aids in the transport of hormones, vitamins, and enzymes. Additionally, it produces bile essential for digesting and absorbing fats in the small intestine, filters toxins and harmful substances from all blood from the stomach and intestines, regulates amino acid levels crucial for protein production, and stores significant amounts of vitamins (A, D, E, K, and B12) and minerals (iron and copper).

3) How can I maintain liver health?

 Ans: To uphold liver health, adopt these practices: Maintain a balanced diet, focusing on fruits, vegetables, whole grains, and lean proteins, and avoid excessive sugar and processed foods to prevent fatty liver disease. Ensure proper hydration by drinking plenty of water to facilitate toxin elimination from the liver. Engage in regular physical activity for a healthy weight and overall well-being. Consume alcohol in moderation to prevent liver damage. Prioritise adequate sleep, aiming for 7-8 hours per night, to reduce stress hormones and promote optimal liver function.

4) At what age do liver problems start?

Ans: Liver problems can occur at any age, but specific conditions may be more prevalent in different age groups. Studies indicate a 20-40% reduction in liver volume and a 35% decrease in liver blood volume in individuals aged 65 or older, compared to those under 40.

5) How can I make my liver strong?

Ans: To enhance liver health, consider dietary choices. Coffee, especially 3 or more cups daily, is linked to lower liver enzymes, benefiting those with risks like heavy alcohol use or Hepatitis C. Green tea is antioxidant-rich, reducing inflammation in non-alcoholic fatty liver disease. Beetroot, which is nutrient-packed, supports liver health. Broccoli improves gut bacteria and liver health markers, while blueberry extract manages age-related liver dysfunction. Incorporating these choices maintains a robust liver, which is particularly advantageous for individuals with specific risk factors.

6) What supplements are best for the liver?

Ans: To boost liver health, consider taking transresveratrol and Quercetin.

Resveratrol: Derived from grapes and berries, resveratrol shows potential in mitigating hepatic steatosis and protecting against alcohol-induced liver damage. It shields hepatocytes from oxidative stress, enhancing antioxidant activity.

Quercetin: Emerging as a potent hepatoprotective agent, quercetin addresses various stages of liver disease, reducing inflammation and oxidative stress. It modulates immune signalling, induces fatty browning in hepatic steatosis, and inhibits extracellular matrix deposition in liver fibrosis. 

 

 

References: 

Kim, I. H., Kisseleva, T., & Brenner, D. A. (2015c). Aging and liver disease. Current Opinion in Gastroenterology, 31(3), 184–191. https://doi.org/10.1097/mog.0000000000000176 

Institute for Quality and Efficiency in Health Care (IQWiG). (2016, August 22). How does the liver work? InformedHealth.org - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK279393/ 

Morisco, F., Lembo, V., Mazzone, G., Camera, S., & Caporaso, N. (2014). Coffee and liver health. Journal of Clinical Gastroenterology, 48(Supplement 1), S87–S90. https://doi.org/10.1097/mcg.0000000000000240 

Mahmoodi, M., Hosseini, R., Kazemi, A., Ofori‐Asenso, R., Mazidi, M., & Mazloomi, S. M. (2020). Effects of green tea or green tea catechin on liver enzymes in healthy individuals and people with nonalcoholic fatty liver disease: A systematic review and meta‐analysis of randomized clinical trials. Phytotherapy Research, 34(7), 1587–1598. https://doi.org/10.1002/ptr.6637 

Olumese, F. E., & Oboh, H. (2018b). Hepatoprotective effect of beetroot juice on liver injury in male Sprague–Dawley rats. Annals of Tropical Pathology, 9(1), 83. https://doi.org/10.4103/atp.atp_34_17 

Chang, H., Huang, C., Yeh, D., Wang, S., Peng, C., & Wang, C. (2013). Oat prevents obesity and abdominal fat distribution, and improves liver function in humans. Plant Foods for Human Nutrition, 68(1), 18–23. https://doi.org/10.1007/s11130-013-0336-2disorders. 

Eve, A. A., Liu, X., Wang, Y., Miller, M. J., & Jeffery, E. H. (2020). Biomarkers of Broccoli Consumption: Implications for Glutathione Metabolism and Liver Health. Nutrients, 12(9), 2514. https://doi.org/10.3390/nu12092514 

Abazarfard, Z., Eslamian, G., Salehi, M., & Keshavarzi, S. (2016). A Randomized Controlled Trial of the Effects of an Almond-enriched, Hypocaloric Diet on Liver Function Tests in Overweight/Obese Women. Iranian Red Crescent Medical Journal, 18(3). https://doi.org/10.5812/ircmj.23628 

Al‐Dosari, M. S. (2010). Antioxidant and protective effects of spinach (Spinacia oleracea L.) leave against carbon tetrachloride-induced liver injury. Clinical and Experimental Medical Journal, 4(1), 129–140. https://doi.org/10.1556/cemed.4.2010.1.13 

Albrahim, T., & Alonazi, M. (2022). Effect of blueberry extract on liver in aged rats. Oxidative Medicine and Cellular Longevity, 2022, 1–11. https://doi.org/10.1155/2022/3490776 

Faghihzadeh, F., Hekmatdoost, A., & Adibi, P. (2015). Resveratrol and liver: A systematic review. Journal of Research in Medical Sciences : The Official Journal of Isfahan University of Medical Sciences, 20(8), 797-810. https://doi.org/10.4103/1735-1995.168405 

Zhao, X., Wang, J., Deng, Y., Liao, L., Zhou, M., Peng, C., & Li, Y. (2021). Quercetin as a protective agent for liver diseases: A comprehensive descriptive review of the molecular mechanism. Phytotherapy Research, 35(9), 4727-4747. https://doi.org/10.1002/ptr.7104