Liver-Friendly Diet

Liver-Friendly Diet Update (and what my liver enzymes are up to)

I’ve been on a liver-friendly diet for over a month now. If you’re not sure why, you can read about it here. A few days ago, my doctor redrew my blood to check my liver enzymes and they were…*drumroll please*…normal! Thank goodness that whatever was the reason for my elevated liver enzymes has resolved at this point and is no longer an issue!

As far as following the liver-friendly diet itself, here are my observations:

The Good

Eating 5 servings of fruits and vegetables every day makes me feel so good! I have great energy, great digestion, and my skin is super clear compared to when I eat fewer servings of the good stuff. Whenever I make sure to get my plant foods in it always reinforces to me how important it is for my body.

The Bad

No raw sushi. 🙁

The Ugly

Not a whole lot…probably the toughest part of the whole month was navigating social situations where others were drinking alcohol or eating high-fat or high-salt foods and I was trying to limit those. I wrote about a few of those situations in my post about eating out on a liver-friendly diet. It wasn’t miserable, but it was a bit tough. I think the difficulty would depend on how often you normally drink alcohol, take NSAID medications, or eat high-fat foods. Since none of these are a huge part of my normal, I didn’t feel like I was missing out too much.

Thanks for following along with my liver-friendly journey! Stay tuned to find out what I’ll be up to next!

The Story of my Mystery Illness (and how I got my new diet!)

Does Dietitian on a Diet Need to Ditch Dairy?

Eating out on an Anti-Inflammatory Diet

Liver-Friendly Diet

Eating Out on a Liver-Friendly Diet

This past weekend I had the opportunity to try out a weekend of celebration, liver-friendly style. Every year in January we go with some friends for a weekend away, this time to McMenamin’s Grand Lodge in Forest Grove, OR. Typically, this weekend consists of delicious food, a few cocktails and ciders, and a lot of board games. We always have a great time. Since I’m on a liver-friendly diet this year, I decided to do the best I could to navigate my nutritional recommendations while still having a great time with my husband and friends.

Whether it’s a whole weekend away or a single meal, my primary strategies for meeting dietary recommendations while eating out: plan and prioritize.

Planning Ahead

Check out the place you’re going to (if you haven’t been there before) and find out what kinds of food are going to be available. We have been to the Grand Lodge many times, so I already know that the lunch and dinner fare is primarily pub-type food (with amazing tater tots). Veggies, protein, grains, and dairy will be no problem, but fruits will be lacking. I’ll have to be careful with fat and sodium, for sure.

Also, I know that there is an amazing chocolate milkshake made with their Terminator Stout that I usually get that I won’t be getting this time because it’s loaded with saturated fat and sugar and contains alcohol.

To address these two anticipated issues, I brought along some mandarin oranges and a dark chocolate bar. The chocolate bar contains some saturated fat and sugar, but it will be far better for lil’ ol’ liver than that Terminator Stout milkshake, and I’ll still get some chocolate!

Prioritizing

Think about what menu item would most delight you to eat, whether it’s an entree, a side, a dessert, you name it. Even if it’s a bit high in sodium, fat, or sugar, get that thing. Enjoy it! Surround it with healthier options.

We headed out Friday afternoon and on the way down we decided to stop at a burger joint recommended to us by a friend. None of us had been to Smashburger before, but we decided to give it a go. After checking out the menu, I saw that they had some rosemary herb tater tots. I am a big tot fan, so that was going to be my priority. My main dish was going to have to be healthier. They had a black bean burger on a multigrain bun with avocado, and it sounded tasty!

It was pretty dang good, but the tots were even better. I rounded it out with a water.

Later that evening, we went to soak in the hot tub. This is when I would usually end up getting a mojito, but since alcohol is a no-go on my liver-friendly diet, I asked for a seltzer water with a lime.

Was it as delicious as a mojito? No, but it was refreshing, tasty, and certainly more hydrating! Besides, I’m really out there to relax in the soaking pool, so mission accomplished.

After soaking we settled in for some board games and snacks. The Grand Lodge has some epic Cajun-spiced tater tots. If you remember from earlier, tots are definitely a priority for me. Those had to happen. We ordered some pretzel sticks with cheese sauce, but I only ate a couple of the pretzel sticks and avoided the cheese sauce. I would rather have tots!

They were fantastic as always.

The next morning I was fortunate enough to eat one of my favorite dishes, and it just so happens to be liver-friendly! This salmon and red potato hash is made with veggies, anti-inflammatory salmon, and red potatoes. If you want to try it, check out this copycat recipe. My hubby’s breakfast came with a fruit cup but he’s not a melon fan, so he ate the rest and then I got some fruit too!

Breakfast did not disappoint.

That afternoon, my friend and I went to see Mary Poppins Returns. It was so well done! For the movie I would normally have chosen to order a hard cider. I wanted something sweeter than the lime water I had last night, so I ordered a seltzer water with lime juice and a half-shot of simple syrup. It had a couple grams of sugar, but it was a definite liver-friendly improvement.

A side benefit of these “alternative” drinks is that the bartenders wouldn’t even charge me for them since they were mostly water and a little bit of fruit juice. I spent a few dollars in tips instead of the $20-25ish I would have spent on my usual drinks throughout the weekend!

For a late lunch, we ended up at a Hawaiian fusion restaurant. Everything on the menu looked so good, but I had to go with chicken katsu curry. While it does contain veggies and lean meat, the meat is deep fried and the curry is loaded with sodium. This one may have been a little over the top, but the last time I ate katsu curry was in Japan and I about died from delicious, so I wasn’t going to pass it up. It was supposed to come with macaroni salad, but I subbed that out for the house salad. The curry was the priority!

After lunch, we were going to settle in for some more board games and snacks. The crew stopped at the grocery store to buy some junk food. My oranges and chocolate bar came to the rescue so I was satisfied with only 2 cookies instead of…however many I would otherwise have eaten…

For our final breakfast, I had been itching to find out what the chef’s “daily scone” was. I am Scottish, after all. I asked my server – it was caramel apple. Guys. I was definitely going to have that. Now, I realized that a caramel apple scone was basically breakfast dessert, so I needed some protein and ideally veggies to balance this sucker out. I ordered the veggie sausage on the side and got another cup of unappreciated melon from my husband. The whole thing was dee-licious.

liver friendly breakfast

Then it was time to leave relaxation for the regularity of normal life. Sigh…it was such a great weekend. While the food I ate was certainly not as low in sodium, fat, or sugar as what I would eat at home, I feel great about the balance. When you’re eating out, gauge your choices based on the foods that are your priorities. The tastiest and most wonderful should take center stage, backed up by a chorus line of nutritious extras. You’ll enjoy yourself and feel great!

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Liver-Friendly Diet

Liver-Friendly Diet 101

Since my foray into the realm of the feverish I was placed on a liver-friendly diet for a month before my doctor re-checks my liver enzyme levels. I always joke with my clients that liver is a very busy guy, and he has many, many jobs. Sometimes they get overwhelming. Enter this comic from The Awkward Yeti.

There are many things you can do to support liver in his work. First, let’s briefly cover some of his job responsibilities, to name a few:

Create bile to help digest fat
Metabolize and store carbohydrate, protein, fat, vitamins, and minerals
Modify or eliminate toxic substances
Create many of the compounds that help blood clot
Prevent low blood sugar

The composition of a liver-friendly diet is, in essence, a healthy balanced diet. There are some more specific things you can do, depending on what is wrong with your liver (which in my case is pretty unclear). Read on for the typical recommendations to support liver health.

Liver-Friendly Recommendations

Follow a diet that will help you achieve or maintain a healthy weight. If you need to lose weight, mild calorie restriction is a safe and effective method that has been shown to reduce liver damage in non-alcoholic fatty liver disease.¹
Eat moderate (not high or low) amounts of carbohydrates, proteins, and fats. Diets high- or low- in one of these groups inevitably lead to unhealthful compensation from other groups.¹
Antioxidants, vitamins, and minerals are very liver protective and supportive. Eat several servings daily of fruits, vegetables, nuts, and seeds to give your liver all the help he needs.^{1, 2} Hey, a rhyme!
Avoid “megadoses” of vitamin or mineral supplements (supplements that provide significantly more than 100% of the recommended daily allowance).¹I know someone whose doctor was convinced he was an alcoholic because of the damage his vitamins were doing to his liver. Yikes!
Avoid foods that are high in fat, added sugar, or salt.^{1, 3}
Avoid alcohol and over-the-counter NSAID medications, unless approved by your doctor.³
Avoid raw or undercooked shellfish.³

Liver-Friendly Suggestions

(Not proven by research, may or not be helpful, but certainly aren’t going to hurt anything)

Probiotic consumption may be linked to improved liver health.¹ We don’t have studies to confirm this or give a specific dosage, but upping your intake of non-alcoholic fermented foods like pickles, sauerkraut, kimchi, yogurt, or miso could benefit your liver.
There is no proof that eating organic produce can improve liver health or protect your liver; however, one of your liver’s jobs is to remove toxins, which would include pesticides. More than 99.3% of foods test as “well below” the Environmental Protection Agency’s acceptable levels of pesticides; however, eating organic foods may take a bit of extra strain from your liver.

To summarize, I’ve been eating plenty of fruits and vegetables (organic when they fit the budget), plenty of nuts and seeds, and not so much of the super high fat, high sugar, or high salt stuff. Yes, Christmas was a tad tough but I had to do my best to find balance. Also, no alcohol, no sushi, no NSAIDs, and no vitamin or mineral supplements. My doctor plans to re-check my liver levels in a couple of weeks, so hopefully this will help it heal and all of my liver levels will be back to normal!

References

McCarthy, E and Rinella, M. “The Role of Diet and Nutrient Composition in Non-Alcoholic Fatty Liver Disease.” Journal of the Academy of Nutrition and Dietetics. March 2012. 112:3 (401-409). Accessed from https://jandonline.org/article/S0002-8223(11)01703-2/fulltext.
Cook, L, et al. “Vegetable Consumption is Linked to Decreased Visceral and Liver Fat and Improved Insulin Resistance in Overweight Latino Youth.” Journal of the Academy of Nutrition and Dietetics. November 2014. 114:11 (1776-1783). Accessed from https://jandonline.org/article/S2212-2672(14)00107-5/fulltext.
American Liver Foundation. “Liver Disease Diets: A Healthy Diet, a Healthier Liver, and a Healthier You.” 2017. Accessed 6 January 2019. Accessed from https://liverfoundation.org/for-patients/about-the-liver/health-wellness/nutrition/#1504047357338-1da02851-5896.

Liver-Friendly Diet

The Story of My Mystery Illness (and how I got my new diet)

You may have noticed that my posts have been a bit absent in the last few weeks. More than likely you didn’t necessarily notice…until now. 🙂 That’s okay, it doesn’t hurt my feelings! Anyway, here’s why I’ve been MIA: Starting the Saturday after Thanksgiving, I started to feel like I was coming down with something. Fever, achy muscles, fatigue…bummer. I did my best to stay hydrated and geared up to work through a cold or flu. For several days after I continued to feel feverish, tired, and achy (including headache), but I never developed any other symptoms. No runny nose, no sore throat, no cough, no nausea/vomiting, nothing. It was strange, but not too concerning at first.

After a few days with no worsening or improvement, I decided it might be wise to go to a walk-in clinic to get checked out. During the course of that appointment, the doctor brought up some concerns of pelvic inflammatory disease and/or toxic shock syndrome, so she sent me to the emergency room to be evaluated. At the emergency room, the doctor was not very concerned about me. He was confident that I did not have toxic shock syndrome. He also figured that pelvic inflammatory disease was unlikely. He took a flu swab and a urine sample (to check for UTIs, and of course, pregnancy and STDs – standard procedure) and sent me home. All of those tests came back negative, so I figured I just had some kind of wonky virus that I just needed to wait out.

I rested, I ate soup, fruit, and Haagen-Daas sorbet (heaven!), and I took Nyquil to sleep at night.

Three days later I was steadily getting worse (a week and a half with a 101-degree fever at this point) and I was starting to get concerned that I had some kind of more serious infection. I went to another clinic and they were, thankfully, able to get me in right away. The nurse practitioner I saw was definitely concerned about the possibilities, so she ran me through a gamut of tests. She gave me a complete physical exam, took my blood, swabbed for strep, and took more urine. Because, you know, pregnancy and STDs.

Three days later, I was feeling even worse and really starting to get concerned about my continued fever with no treatment of any kind whatsoever. I called the clinic, who did not yet have my results but they told me they wanted me to have an abdominal and pelvic ultrasound to check everything out. They also told me I could take a dose of antibiotics prophylactically, so I did. The next day I felt significantly better, as I did for the next few days. I completed the ultrasound and awaited the results of all of my testing.

When all the results came in, every single thing was negative and there was no explanation for my 2-week-long fever. I was floored. At this point, we knew that I didn’t have flu, I didn’t have strep, I wasn’t pregnant, had no STD’s, and theoretically had no infection whatsoever because my white blood cells (even those that respond to bacterial or viral infections) were normal!

I was totally baffled – why did that antibiotic make me feel so much better? Placebo?

My nurse practitioner was also at a loss, and offered to put me on the schedule of the most experienced MD at their clinic. Meanwhile, I continued to feel better but still had a 101-degree fever. I was started to get very annoyed with being sick. You know, sick and tired of being sick and tired. I hadn’t worked out (or hardly worked) for 2 and a half weeks and was just getting kinda done with it. I can only lay around and watch Netflix for so long before going nuts. What was wrong with my body?

The MD tested me for mono, ran a comprehensive metabolic panel (kind of an all-systems-check), and checked my thyroid. When the results came back, everything was negative except one thing – my liver enzymes were 8 times higher than they should have been. Now, for the most part, liver enzymes belong inside your liver and not in your blood, so if the liver enzymes in your blood are high, then your liver is leaking them for some reason. Your liver is somehow damaged, and that’s typically not a good thing. Since the ultrasound of my liver had come back normal, the doctor wanted me to have a CT scan to get a clearer picture to rule out stones (and cancer…eek!).

I happen to know that Nyquil (which I hadn’t taken for about a week at this point) contains acetaminophen, which can affect your liver enzymes for a couple of weeks. I asked my doctor’s office about that, but they said that based on the dose I had taken and how long it had been since I had taken them, it was unlikely that they would affect my liver enzymes SO much.

So off I went, back to the radiology clinic for a CT scan. I was reluctant to have the CT scan (radiation and all…) but I knew I needed to have everything checked out. The CT scan itself was super easy. Five minutes tops. Then came the waiting and the trying to not think too much about every possible thing that could be wrong with me.

Fortunately, it only took a couple of days to get the results back and everything was completely normal. While the doctor still had no explanation for why my liver enzymes were so high, the good news was that my liver looked totally fine.

Since all of that testing, I have been feeling basically back to normal energy-wise. I still occasionally feel feverish, but I’m back to my normal life. I even got to go back to (light) working out in the last few days! That was such a blessing and a mood boost, for sure.

First day back in the gym!

The mystery of what was/is wrong with me continues, but here are my marching orders: as long as I continue to feel better, I need to follow a liver-friendly diet and come back to have my liver enzymes tested next month to see if my liver has healed from…whatever was wrong. So while I didn’t exactly plan on doing a diet feature right now, I figure if I have to be on a diet anyway, I might as well feature it! It is the Christmas season, so my posts may not be as frequent or thorough as they typically are during a feature, but I’ll do my best.

Stay tuned to learn more about what a liver-friendly diet is and follow along with me while I follow it for the next month!

Heart Healthy Diet 101

Anti-Inflammatory Add-Ins and Supplements

Anti-inflammatory Diet Carb Counting Heart Healthy MyPlate Guidelines Recipes

Salmon and Red Potato Hash with Dijon Aioli

Salmon and red potato hash with dijon aioli

This delicious dish is a copycat of a breakfast from a favorite restaurant of ours – the Ironwork Grill at McMenamin’s Grand Lodge in Forest Grove, Oregon. The original is made with a dill sauce but I always swap it for this dijon aioli, and I’ve never been disappointed!

The salmon, veggies, and potatoes make this a complete, protein- and potassium-laden anti-inflammatory power meal. Plus, it is so, so tasty and very easy to make!

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Salmon and Red Potato Hash with Dijon Aioli

This dish is a complete dinner - it's loaded with omega-3, antioxidants, and other anti-inflammatory power punches. It's also very easy to make!

Total Time 35 minutes

Servings 4 people

Ingredients

Salmon and Vegetables

4 fillets salmon
1 diced red bell pepper
1 medium onion, diced
10 spears asparagus, cut into 2" lengths
1 Tbsp canola oil
1/2 tsp kosher salt
1/2 tsp black ground pepper

Dijon Aioli

1/4 cup avocado oil mayonnaise
1 Tbsp dijon mustard

Instructions

Preheat oven to 375 degrees.
Place fillets skin-side down in a greased 9 x 13" baking pan. Surround with vegetables.
Drizzle with canola oil and sprinkle with salt and pepper.
Bake for 25 minutes or until thickest part of salmon measures 145 degrees.
While salmon is baking, whisk together mayonnaise and dijon mustard.
Serve salmon with aioli spread on top.

Notes

Each portion contains 499 calories, 29 g carbohydrate, 32 g protein, 3 g saturated fat, and 458 mg sodium.

Food Trim Healthy Mama

10 Tips from a Registered Dietitian for Following the Trim Healthy Mama Plan

So you’ve read about the Trim Healthy Mama Plan, and you’ve decided you’re a good candidate for using Trim Healthy Mama as your structure for moderation. Your next step is to get started! Over the course of my time following the plan, I gathered a list of a few tips to help you make the most out of your THM journey.

1. There’s a learning curve

Don’t feel bad if you unintentionally eat something that’s “not on plan.” It’s bound to happen (it happened to me!). Also, figuring out what you’re allowed to eat may feel super overwhelming at first. There is a lot to learn in the beginning! Take it in steps. Read one chapter of the book at a time (or as much as you can without feeling overwhelmed) and sit with the information for a day or more. It will get easier.

2. Having certain products on hand makes a world of difference

There were several products that made the THM plan so much simpler for me. Which products help you will vary based on your schedule and preferences. Here were some of my faves:

Pressed peanut flour – Basically ground-up peanuts with a good portion of the natural peanut oil removed, pressed peanut flour is great for E meals because it is a low-fat protein source that goes great with sweet flavors. It works well in smoothies or you can reconstitute it with water to use it as you would normal PB. Click here to purchase the one I used.
Almond milk (or other milk alternative) – Technically, dairy milk is not “on plan” with THM if you’re aiming for weight loss because, as the authors state, it is a “natural crossover” containing both carbohydrates and fat. That’s true unless your milk is fat free – but if you want to follow the plan to the letter, an alternative like unsweetened almond milk is useful. This one might not be as “essential” for others as for me since my family is comprised of hard-core dairy lovers, but it came in very handy for both S and E meals and as a milk alternative in recipes.
Low-carb wraps – These are so convenient for S meals. Sometimes you just want to put all that fatty goodness into some kind of bread-like thing. They were awesome topped with pizza toppings and/or Caesar salad. Click here for the wraps I used (also recommended by the THM authors).
Sprouted whole grain or sprouted sourdough bread – Your THM-approved bread option for E meals! I goofed up and used non-sprouted sourdough for my first week and had to course-correct with this tasty sprouted Dave’s Killer bread for the next two weeks. Note: eating only sprouted bread is not necessary for blood sugar management, though the plan requires it
Stevia – If you want something sweet, it’s nutritionally your best on-plan option. Choose one that is primarily pure stevia or stevia with erythritol or xylitol. Here’s one option that fits these criteria.
Almond flour (or other grain-free flour) – I’m a little torn on this one because almond flour and I didn’t exactly get along. I can’t see how you could get too far cooking without any kind of flour at all, but I didn’t take the time (or money) to explore options besides almond.

3. Don’t forget the protein

They mention this repeatedly in the book, but I can’t reiterate it enough. You need protein to stay full until your next meal, especially after E meals. The carbohydrate in E meals will go much farther if you put some protein in the tank to slow down digestion.

4. Be careful with your saturated fat

My biggest nutritional gripe with THM is the amount of saturated fat that can very easily be consumed within plan guidelines. Eating high amounts of saturated fat is correlated with inflammation and higher levels of harmful cholesterol. I personally ate way more saturated fat than daily recommendations most of the days I was on the plan. Be careful with the animal-based fats they recommend like butter, cream, and fatty red meats. Even the small amounts they encourage can easily push you over the recommendations.

5. Make sure to eat your veggies.

The plan itself is focused on fuels and though encouraging of vegetables, does not have a specific requirement for meeting veggie recommendations, and veggies are a very important part of a healthy lifestyle! It can be easy to skimp in this area, (I found some Youtube THMers who warned against this very issue) so be sure and give these powerful plants plenty of attention.

6. Ignore some of the verbiage from the authors

One of my pet peeves as a dietitian is seeing foods labeled as “good/clean/guilt-free” or “bad/sinful/naughty” as though each individual food could be placed in a single cut-and-dry category of either good or bad. Years of this kind of mindset can make it difficult for people to enjoy any kind of food without feeling guilty (except for raw, non-starchy, organic vegetables). I’ve had many clients who follow up every statement about what they eat with “and I know that’s bad.” (“My family likes pasta and I know that’s bad…I like to eat a lot of fruit and I know that’s bad…Sometimes I eat a piece of chocolate and I know that’s bad.”) It makes me so sad! While there are clearly foods that are more nutritious and deserve to be chosen more often than others, please ignore anyone who tells you that any food is “naughty” or that you should feel guilty for eating.

7. The plan is more restrictive than is necessary

In reading the first few chapters of the book, you’ll be preparing for “food freedom”…the authors start the book with that phrase and spend plenty of time discussing the cons of all the diets that are overly restrictive and that eliminate food groups. I was really on board with all of that.

Then for the remainder of the book, you find there is a pretty large list of common foods that are “not on plan” aka “not allowed.” It was a bit of a letdown for me, to be honest. They even cut out healthful options like whole grains based on some overly restrictive and outdated guidelines that I talked about in this post. For the most part, these complete eliminations are unnecessary to meet health goals, so bear in mind that 100% on-plan compliance is not necessary and that you could swap in foods that you know to be healthful.

8. Fuel isolation is not necessary for fat loss

I have not seen research to back up the concept of isolating either carbohydrate or fat at a particular meal as a method of weight loss. It can, however, be a structure for moderation that would make sense to some personalities. There’s no magic in the fuel isolation itself, it’s just a way to help some folks balance their overall diet.

9. Baked goods are tough

As I mentioned throughout my time on the plan, baked goods are tough cookies on THM. I know several ladies who follow THM and have found options that they enjoy, and I’ve also tried many plan-approved recipes that just could not cut it for me. If you are a baker (or lover of things baked), be prepared that finding “on-plan” recipes or tweaking your family recipes to your satisfaction may be a long road. You may need several specialty flours, oils, and sweeteners. This was my biggest struggle throughout the plan.

10. Do what works for you

Try the plan out – see what you think! If you are one of the people that loves it and finds it freeing, enjoy! Keep your eye on nutritional balance and rock your food freedom. If the plan is a struggle or parts of it don’t make sense, feel free to let them go! Personalize your nutritional plan and only keep the changes that work for your lifestyle and personality.

Disclaimer: This is not a sponsored post and I have no affiliation with the producers or manufacturers of these products. As an Amazon Associate, I receive compensation for purchases of products through the links on this post.

Recipes Trim Healthy Mama

Recipe Feature: Banana Split Oatmeal (THM E Meal)

My favorite breakfast on the Trim Healthy Mama Plan was this banana split oatmeal recipe from Oil of Joy. I tweaked the recipe a tad from the original, partly for taste and partly to improve the nutrition to better meet the Trim Healthy Mama guidelines.

Here’s what I did: cut the chocolate chips in half, removed the salt, and used fresh mashed strawberries instead of strawberry jam. I also added 2 scoops of plain whey protein to boost satiety and help regulate blood sugar. The vanilla in the oats really helps to make this oatmeal rich and delicious. It definitely feels like a dessert (it doesn’t have to just be for breakfast!) and it is so, so sweet. I have continued to make it even after finishing Trim Healthy Mama!

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