The liver doctors’ 7 essential daily habits
Three of the UK’s leading specialists reveal how they look after their livers, to help you reduce the risk of fatty liver disease and stay well as you age.
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Three of the UK’s leading specialists reveal how they look after their livers, to help you reduce the risk of fatty liver disease and stay well as you age.
After the hottest summer since records began in 1884, it’s perhaps understandable that those of us who enjoy a glass of something cold in the sunshine feel like our liver has worked overtime this year.
But did you know that alcohol isn’t the only factor that can stress the liver as we age? “The add-on effects of diet, weight, and other lifestyle factors also start to be more felt,” says leading hepatologist Professor Philip Newsome, director of the Roger Williams Institute of Liver Studies at London’s King’s College Hospital and medical advisor to Liver UK.
The result can be a build-up of fat in the liver which – together with at least one of five risk factors: overweight, high blood glucose, raised blood pressure, high cholesterol, or unbalanced blood fats – is called metabolic dysfunction-associated steatotic liver disease, or MASLD. The condition, which used to be called non-alcoholic fatty liver disease (NAFLD) affects around one in four adults and is increasingly recognised as a problem in later life.
GP records show that the prevalence of MASLD has soared five-fold in the last decade, partly as a result of the growing numbers of people with risk factors, and partly due to better detection and diagnosis – although plenty of cases still slip through the net. Meanwhile a 2025 UK study of 1,021 people, with an average age of 72, found that a third had some build-up of fat on scanning, most of which was MASLD.
“The good news is it’s never too late to make a difference,” says Prof Newsome. “Your liver is remarkably resilient and has an impressive capacity for self-repair.”
Dr Apostolos Koffas, consultant hepatologist at the Royal London Hospital, Barts Health NHS Trust, who also works privately at Leaders in Liver Health, eats a Mediterranean diet.
He tries to eat as few ultra-processed foods as possible, goes easy on saturated fat, sugar and red meat, and opts for wholegrains for fibre, which studies suggest can help protect against chronic liver disease.
“As a family we also try to have fish at least twice a week,” he says. “Salmon is a favourite for its omega-3 content, which is associated with benefits for the liver.”
Coffee had a bad rap, healthwise, until the past few years. But a July 2026 study, which tracked 354,957 people over 13 years, found that regular coffee drinkers had a notably lower risk of liver disease. The biggest benefits were seen for five or more cups a day. It’s worth noting that this was an “observational” study, which can show a link between two things – in this case coffee and liver disease – but can’t prove cause and effect.
“The evidence is nevertheless reassuring,” says Newsome, who enjoys four or five cups of espresso a day himself.
How might coffee protect the liver? The mechanism is still unclear but researchers suggest the secret may lie in antioxidant, anti-inflammatory plant compounds called chlorogenic acids which may guard against liver damage. Caffeine may help check the process of liver scarring, as well as helping maintain proper blood vessel growth and blood flow through the liver. Decaf, instant or ground all count according to research.
“Body composition is more revealing than BMI or weight,” says Dr Saima Ajaz, specialist hepatologist at King’s College Hospital who is also medical director of the Harley Longevity Club Harley Street Longevity Club.
“That’s because excess fat around the abdominal organs reflects visceral fat, which is closely linked to insulin resistance and metabolic liver disease.”
Echoing her words, a 2025 Finnish study of more than 6,400 people found that waist-to-height ratio was better at predicting fatty liver and liver scarring than BMI. Aim for a waist circumference of less than half your height.
“I changed my commute – instead of taking the bus to the tube, I walk,” says Dr Koffas, who has also recently started running. “On average I walk 30-45 minutes a day or more now than I used to.”
He’s also swapped the lift for the stairs at work: “The liver ward is on the 13th floor of the hospital. I can’t manage all 13 yet, but I’m getting there.” Physical activity improves insulin sensitivity as well as the way the body handles fat, which can reduce the amount of fat stored in the liver.
Cutting sedentary time is as important. A 2018 study found that the longer people spent sitting, the higher their liver and abdominal fat. The good news? An extra 1,700 steps a day could help offset the increased risk of fatty liver disease in people who are sedentary, according to a 2026 study.
“Maintaining muscle is especially important as we age, and skeletal muscle plays an important role in glucose disposal, insulin sensitivity and overall metabolic health all of which affect the liver,” comments Dr Ajaz. “I do twice weekly, full body resistance training at the gym with a personal trainer. It involves a combination of free weights, resistance machines, resistance bands and bodyweight exercises, with an emphasis on compound movements.”
Resistance training is a recognised pillar of the treatment of MASLD, according to a 2024 study, which found that it significantly reduced liver fat, liver enzymes and insulin resistance.
“I have never really enjoyed alcohol, although I might have a glass or two of wine socially,” says Dr Koffas. Alcohol is very much part of life for many older people, however. Government figures show 84% of 55-64-year-olds and 81% of 65-74-year-olds say they drink. Meanwhile, according to Drinkaware, 21% of 55-64-year-olds drink at least four times a week.
If you do enjoy a tipple, Dr Koffas stresses the value of restraint: ‘It’s important not to exceed 14 units a week and to have two or three alcohol-free days a week to give your liver a break.” He also cautions against saving up your alcohol quota for the weekend. “What sometimes happens – and I’ve seen this in my practice – is people don’t drink for four or five days, then on Saturday night have six or seven pints of beer, or more.”
Oh, and don’t imagine that “lining your stomach” before drinking protects your liver. It may slow how quickly alcohol is absorbed by the body, as well as taking the edge off some immediate effects, but it doesn’t stop alcohol reaching your liver or prevent damage.
“Liver disease can be silent for years and prevention is better than waiting for disease to set in,” observes Dr Ajaz who has an annual battery of tests to check her liver and metabolic health. “Trends in glucose control, blood fat levels and liver enzymes can alert us to potential problems long before symptoms develop,” she says.
Koffas agrees: “I try to have blood tests including liver function tests, cholesterol and glucose every year. Regular monitoring is especially important in people with one or more risk factors.”
“This is the biggest myth I hear,” says Prof Newsome. “Your liver is already doing a good job of processing and removing toxic substances from your body, including alcohol, medicines and a whole range of other substances. You don’t need to flush it out with detox teas, juice cleanses or supplements. In fact, some supplements and herbal products can cause liver injury.”
Even milk thistle doesn’t stand up that well to scrutiny. “The evidence that it prevents or treats liver disease is limited,” he says.
“Hydration is important for general health, but you don’t need to drink massive amounts of water to ‘flush out’ your liver,” says Prof Newsome. “Drinking regularly according to thirst and making water your main source of fluids is a good idea for most healthy people.”
There’s no magic number of glasses either, he says. Fluid requirements vary with body size, activity, temperature and diet. And remember, watery fruit and veg like cucumber, courgettes and melons all add to your quota
“There’s a common belief that spirits are somehow cleaner than wine or beer. That’s not true,” says Dr Koffas. “What matters is how much alcohol you’re taking in, not what form it comes in.
"There are no good or bad alcoholic drinks, even those that come in expensive bottles. Alcohol can be harmful whatever you drink.”
“Men and women may be affected differently by alcohol, as may different individuals,” says Dr Koffas. “But it’s incorrect to say that men can drink more than women. The safer drinking limits apply to both men and women.”
Until 2016, UK guidelines did allow men a higher weekly limit than women (21 units as opposed to 14 units). That changed following a review of evidence showing that alcohol-related harm can occur at lower levels of drinking than previously thought, prompting a more cautious approach for both sexes. Current guidelines recommend no more than 14 units of alcohol for either gender, but “those with established liver disease should stop drinking any alcohol,” Dr Koffas adds
“One of the myths I hear is that if you feel well or have no symptoms, and your blood tests come back normal, your liver must be healthy,” says Koffas. But normal numbers don’t always mean your liver is healthy.
“Your physician may ask for an ultrasound scan to assess your liver, or recommend a Fibroscan, a non-invasive scan that checks for liver scarring. Scans can also be used to monitor if you have risk factors like alcohol use, diabetes, high blood pressure, or obesity,” he says.
Ask for regular medication reviews
The liver is involved in processing many medications, so it’s important to take them correctly. That includes over-the-counter medicines such as paracetamol, which can cause serious liver damage if you take too much, as well as prescription medicines – including certain cholesterol-lowering and anti-inflammatory drugs.T
he benefits of taking prescribed medication usually outweigh the risks, but it’s worth telling your GP or pharmacist about everything you take, including supplements and herbal remedies. This is especially important the more medicines you’re on, since that increases the chances of interactions or duplication.
Your liver is your largest internal organ. Sitting on the right under your ribs, it performs hundreds of jobs – from processing the nutrients you get from food and storing energy, to helping regulate blood sugar and cholesterol and breaking down toxins.
Here’s how it changes with age:
See your GP if you develop persistent or unexplained symptoms such as:
Get urgent help for:
Liver UK’s Liver Health At Risk checker can help you change your lifestyle, if needed, before serious problems occur, or direct your GP to carry out further tests if necessary.
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