Credit: Adobe Stock/lilechka75

In an interview with The Educated Patient, Joseph Odin, M.D., Ph.D., a professor in the Department of Medicine at the Recanati/Miller Transplantation Institute and co-director of the Mount Sinai Autoimmune Liver Disease Programs, sheds light on autoimmune liver diseases, their symptoms and the importance of maintaining liver health through lifestyle choices and diet.

He shares a simple, liver-friendly recipe for baked lemon herb chicken, combining lean protein, sweet potatoes and broccoli to support liver regeneration and overall health. While autoimmune liver diseases can lead to serious complications, adopting a heart-healthy diet and avoiding toxins can help patients manage their condition and enhance liver function.

Baked Lemon Herb Chicken

Ingredients

• 4 ounces skinless chicken breast
• 1 tablespoon lemon juice
• 1 teaspoon dried thyme
• 1 teaspoon dried rosemary
• 1/2 cup broccoli
• 1/2 cup sweet potato (cubed)

Instructions

1. Preheat oven to 375 degrees F.
2. Remove chicken from packaging and prepare in baking dish. Brush chicken with lemon juice and sprinkle with thyme and rosemary. Add cubed sweet potatoes to the baking dish as well.
3. Place baking dish in oven and bake for 30-35 minutes or until cooked through (165 degrees F internal temperature). While chicken and sweet potatoes are cooking, steam broccoli.
4. Remove from oven and allow to cool. Serve with broccoli and sweet potatoes on the side.

This recipe was originally published on the American Liver Foundation (ALF) as a part of their 30-day meal plan.

In addition to liver-healthy recipes, the ALF offers a simple liver health quiz, available in English and Spanish. To learn more about liver health, including education, awareness and screening, visit Think Liver Think Life, and to help researchers find better treatments and cures for liver diseases, visit ALF’s Patient Registry.

What is liver autoimmunity, and how does it affect the liver?

Joseph Odin, M.D., Ph.D.: Autoimmunity is a disease process in which one’s immune system inadvertently damages an individual’s own organs or tissues. The process can be localized or systemic. In liver autoimmunity, either the primary liver cells, called hepatocytes, or the liver bile duct cells, called cholangiocytes, are damaged by the immune system. In the most common autoimmune liver disease, called autoimmune hepatitis (AIH), the hepatocytes are primarily damaged. On the other hand, cholangiocyte damage predominates in primary biliary cholangitis (PBC) and in primary sclerosing cholangitis (PSC).

What are the common symptoms of autoimmune liver diseases, and how can patients recognize them early?

JO: As with any liver disease, the most common and earliest symptom is usually fatigue, whereas the jaundice typically associated with liver disease appears only after extensive liver damage has occurred in autoimmune liver diseases, particularly in AIH. Other symptoms may include localized or systemic itchiness, more frequently in PBC. Right upper quadrant abdominal pain, fever and jaundice may suggest associated liver infection or gallstone disease. Many affected individuals have no symptoms until the liver becomes cirrhotic, unfortunately. Screening blood tests can help identify indications with early-stage autoimmune liver disease.

What causes the immune system to attack the liver in autoimmune liver diseases?

JO: The trigger(s) that initiates autoimmune liver diseases are not well understood. Both environmental factors and genetic factors play a role, as well as possible hormonal factors. Women are much more susceptible to AIH than men, and pregnancy may trigger onset or flare-ups of AIH. Exposure to environmental factors such a bacteria or toxins naturally triggers protective immune responses, but these responses can sometimes go amiss and the immune system continues to attack one’s own liver cells even after the environmental factor is removed. Some individual genetic variations make it more likely for the immune response to switch to targeting one’s own liver cells.

Can lifestyle choices or diet influence the development or progression of autoimmune liver disease?

JO: Lifestyle choices and diet are not known to play a role in the development of autoimmune liver diseases. However, the liver has a tremendous regenerative capacity, which is dependent on lifestyle choices and diet. Maintaining the regenerative capacity of the liver will allow it to keep ahead of the damage caused by autoimmune liver diseases.

Alcohol avoidance helps reduce liver damage, though having a sip of champagne on New Year’s Eve will not kill you. A heart-healthy, Mediterranean-style diet with lots of fruits and vegetables is also good for your liver. Skip the raw oysters, which may contain a particularly liver-toxic bacterium. For those who hate vegetables, one can consider a multivitamin supplement. Additional vitamins A, D, E and K may counteract their poor absorption observed in some with PBC and PSC. Other antioxidant supplements or liver “cleanse” products have not been shown to add benefit.

Coffee consumption is associated with slower progression of fatty liver disease, but not necessarily with autoimmune liver diseases.

Vigorous exercise three to four times per week for at least a total of 150 minutes is recommended along with eight hours of sleep per day. Avoidance of other liver toxins besides alcohol is clearly indicated as well. It is safe to take acetaminophen at up to 2,000 milligrams per day for headaches and other aches and pains even if you have liver disease.

Joseph Odin, M.D., Ph.D., has a clinical background in gastroenterology and liver disease. He has research interest in liver autoimmunity and drug-induced liver injury. His current research studies are focused on primary biliary cirrhosis, primary sclerosing cholangitis, autoimmune hepatitis and evaluation of drug hepatotoxicity. He cares for individuals with all liver diseases, including those with liver transplants. His research is supported by the National Institutes of Health, and he has received past support and awards from the American Gastroenterological Association and the American Association for the Study of Liver Diseases. He also receives support from pharmaceutical companies for participation in clinical treatment trials for liver diseases.
Odin is an inaugural Fellow of the American Association for the Study of Liver Diseases (FAASLD) — the highest honor among AASLD membership categories — which recognizes superior professional achievement in clinical or academic practice, and in basic or clinical research.