In addition, the liver plays an important role in regulating blood sugar, cholesterol, and hormone balance.

Any disruption in liver function can have significant effects on health and wellbeing as a whole. Anti-oxidants are compounds that protect the cells of the body from damage caused by free radicals, which are harmful molecules. As a byproduct of various metabolic processes, free radicals can cause oxidative stress, which has been associated with a number of chronic diseases, including liver diseases.

In recent years, the role of anti-oxidants in combating oxidative stress and promoting liver health has received considerable attention. When there is an imbalance between the production of free radicals and the body's ability to neutralize them with anti-oxidants, oxidative stress occurs.

Free radicals are highly reactive molecules that are capable of causing harm to cells, proteins, and DNA. When the liver is subjected to excessive oxidative stress, it can result in inflammation, cell damage, and the onset of a variety of liver diseases.

Long-term exposure to oxidative stress can negatively impact liver health. It can disrupt normal liver cell function, impair liver detoxification, and promote inflammation. This can contribute to the development of liver diseases such as non-alcoholic fatty liver disease, alcoholic liver disease, viral hepatitis, and liver cirrhosis.

Numerous studies have demonstrated the close relationship between oxidative stress and liver disorders. For example, research has shown that patients with NAFLD and ALD commonly exhibit elevated oxidative stress markers.

Oxidative stress has also been linked to the progression of liver fibrosis, a condition characterized by the accumulation of scar tissue in the liver.

Anti-oxidants are substances that inhibit or neutralize the oxidative damage caused by free radicals. They stabilize free radicals by donating electrons, thereby preventing them from causing cellular damage.

Antioxidants can be produced by the body naturally or obtained from external sources like food and supplements. Numerous foods, including fruits, vegetables, nuts, seeds, and whole grains, are rich in anti-oxidants.

Antioxidant-rich foods include berries, dark green vegetables, citrus fruits, tomatoes, and dark chocolate. To ensure an adequate intake of anti-oxidants, it is important to maintain a balanced and diverse diet.

There are numerous anti-oxidant types that promote liver health in unique ways. Vitamins C and E, selenium, N-acetylcysteine NAC , and milk thistle are examples.

Each anti-oxidant type has distinct mechanisms of action and benefits for liver health. ROS are highly reactive molecules that are capable of causing oxidative damage to cells.

By donating electrons and preventing ROS from reacting with cellular components, anti-oxidants help neutralize ROS. Antioxidants can protect liver cells from oxidative damage by reducing ROS levels.

The liver is responsible for detoxifying drugs, alcohol, and environmental toxins, among others. Antioxidants play a vital role in liver detoxification by promoting the activity of detoxifying enzymes and enhancing the elimination of toxic compounds from the body.

It has been demonstrated that antioxidants protect liver cells from oxidative damage and inflammation. They contribute to the preservation of the structural integrity of liver cells, prevent cell death, and promote cell regeneration.

Antioxidants contribute to the overall maintenance of healthy liver function by preserving liver cell health. Vitamin C is an effective antioxidant that protects liver cells against oxidative damage. In addition, it supports immune function and collagen synthesis, which are essential for liver health.

Citrus fruits, berries, kiwi, and bell peppers are excellent dietary sources of vitamin C. Moreover, height, weight, waist circumference, as well as systolic and diastolic blood pressure were measured by trained personnel based on the study protocol Socio-economic status was measured according to the wealth score index WSI.

This index was determined using multiple correspondence analysis MCA of the participants' variables, such as access to a washing machine, access to a computer, access to the internet, access to a car, owning a mobile phone, and international trips in a lifetime.

Physical activity was measured according to the h physical activity and a item questionnaire. Cigarette smoking, alcohol drinking, and opium consumption were self-reported. Consumption of opium at least once per week for six months was defined as opium usage History of diseases including fatty liver, diabetes, hypertension, myocardial infarction MI , and heart disease was recorded according to these questions "Do you have a history of fatty liver, diabetes, hypertension, or heart disease diagnosed by a physician?

The main questionnaire used to collect the data was derived from the PERSIAN Cohort Web-based Electronic Standard Questionnaires The validity and reliability of questionnaires were assessed in previous studies 18 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , Validity and reliability of the Food Frequency Questionnaire FFQ were evaluated in a prospective cohort study in northern Iran.

To assess the validity, the results obtained from multiple FFQs with those from multiple h diet recalls and biochemical markers of dietary intake in serum b-carotene, retinol, vitamin C, and a-tocopherol and urine nitrogen were compared.

Moreover, to assess the reliability reproducibility , intraclass correlation coefficients between results of four FFQs administered to the same participants were evaluated.

The results showed good validity and reliability of the FFQ The participants completed a semi-quantitative FFQ with items which asked about dietary intake over the past year by trained nutritionists.

The participants were interviewed about each food item by two questions: 1 the number of times per month, week, or day the food was consumed during the previous year, and 2 the amount of the food that was usually consumed every time portion size according to the standard serving sizes that Iranians usually consume.

Nutrient intakes were calculated using the United States Department of Agriculture USDA food database. In the present study, intakes of some antioxidants, including vitamin C, vitamin A, vitamin E, selenium, and carotenoids α-carotene, β-carotene, lycopene, and β-cryptoxanthin were assessed.

Blood samples were taken from all subjects between and a. after fasting for at least 12 h. Fasting blood sugar FBS , total cholesterol, high-density lipoprotein cholesterol HDL cholesterol , low-density lipoprotein cholesterol LDL cholesterol , triglycerides TG , AST, ALT, GGT, and ALP were measured by a biotecnica analyzer BT , Italy at the Central Laboratory in Cohort center.

Activities of serum ALT and AST were determined by kinetic method Pars Azmoon Co, Tehran, Iran. In addition, as substrates, p-nitrophenol phosphate and p-Glutamylcarboxynitroanilide phosphate were used for measuring serum ALP and GGT activities, respectively kinetic method, Pars Azmoon Co, Tehran, Iran.

The laboratory's reference range in the Cohort center was used to define elevated ALT, AST, GGT, and ALP. Baseline characteristics of individuals, including demographic characteristics, personal habits, and medical and laboratory characteristics, were compared across the groups of the present study elevated liver enzymes using chi-square χ 2 for categorical and t-test for continuous variables.

In addition, dichotomous logistics regression models were applied to investigate the association between elevated liver enzymes and intake of dietary antioxidants.

The authors used two crude and adjusted models in the regression analysis and identified confounder variables using relevant epidemiological texts and according to subject matter knowledge. Potential confounding variables were sequentially entered into models according to their hypothesized strengths of association with liver enzyme levels and intake of dietary antioxidants.

The crude model was stratified on the status of dietary antioxidants. All analyses were performed through Stata V. Stata Statistical Software: Release College Station, TX: Stata Corp LP , and all p-values are two-sided.

The ethics committee of Rafsanjan University of Medical Sciences approved this study Ethical codes: ID: IR. Written informed consent was obtained from the participants. The data of Participants kept confidential and was only accessible to the study investigators. All methods were performed in accordance with the relevant guidelines and regulations.

In the present study, participants from the baseline phase of the Rafsanjan adult cohort study, who had completed data on serum liver enzymes, were included. Table 1 presents the lifestyle variables, personal habits, socio-demographic characteristics, and anthropometric measures in individuals with normal and elevated liver enzymes.

All elevated liver enzymes had significant associations with a higher mean BMI. Significant associations were shown between elevated ALT and ALP with age, BMI, education, WSI, alcohol consumption, cigarette smoking, and opium consumption.

Moreover, there were significant associations between elevated ALT with gender and elevated ALP with physical activity. In addition, elevated AST was significantly associated with physical activity, BMI , alcohol consumption, and cigarette smoking, and elevated GGT was significantly associated with age, gender, education, physical activity, BMI, and WSI.

Table 2 indicates the associations of liver enzymes with the medical and laboratory characteristics of the study participants. The elevated level of four liver enzymes was significantly correlated with diabetes, triglyceride, LDL cholesterol, cholesterol, and FBS.

Moreover, elevated serum levels of AST, GGT, and ALP were significantly associated with hypertension and MI. Elevated serum levels of ALT, GGT, and ALP were significantly associated with heart disease and HDL cholesterol.

A significant association was observed between fatty liver with elevated ALT, GGT, and AST. Moreover, elevated serum levels of GGT and ALP were significantly associated with the consumption of hepatotoxic drugs.

Furthermore, Table 3 demonstrates the associations of liver enzymes with the mean dietary antioxidant intake. The results presented that elevated ALT had a significant association with the mean of Se, lycopene, Vit A, β-cryptoxanthin, and Vit E consumptions.

A significant association was observed between subjects with elevated levels of GGT and the lower mean of Vit E consumption. In addition, the subjects with elevated levels of ALP had significantly lower mean of all antioxidant consumption except lycopene.

Table 4 demonstrates the association of elevated liver enzymes with dietary antioxidant intake using the crude and adjusted models. According to this table, in the crude model, higher odds of elevated ALT were significantly associated with higher intake of Se, β-carotene, lycopene, Vit A, Vit C, β-cryptoxanthin, and Vit E; however, this positive association was not observed after adjusting for all confounder variables.

Moreover, in the crude model, lower odds of elevated GGT were significantly associated with higher intake of Se, Vit A, and Vit E, and this association was not seen in the fully adjusted model.

The decreased odds of elevated ALP had a significant association with the higher intake of Se, β-carotene, α- carotene, lycopene, Vit A, Vit C, β-cryptoxanthin, and Vit E in the crude model, which remained significant even in the adjusted model except for lycopene and Vit C.

In the fully adjusted model, in subjects with higher consumption of Se, β-carotene, α-carotene, Vit A, and β-cryptoxanthin, the odds ratios of elevated ALP were decreased in the 4th quartile compared to 1st quartile ORs: 0.

In the fully adjusted model, the odds ratio of elevated ALP in subjects with consumption of Vit E in the 3rd quartile was 0. Moreover, after multivariate logistic regression, we graphed the predicted probabilities of elevated ALP against the quartiles of Se, Vit A, Vit E, β-carotene, α-carotene, β-cryptoxanthin intakes using the command margins in STATA Fig.

In addition to adjusting for using hepatotoxic drugs and fatty liver, we performed a sensitivity analysis since some of the increased odds of elevated liver enzymes probably are driven from residual confounding due to using hepatotoxic drugs or fatty liver. After excluding the subjects that used hepatotoxic drugs or had fatty liver, no association was observed between dietary intake of antioxidants and the levels of serum liver enzymes.

In the present study, we assessed the association of some dietary antioxidant intakes, including vitamin A, vitamin C, vitamin E, selenium, and carotenoids α-carotene, β-carotene, lycopene, and β-cryptoxanthin with odds of elevated liver enzymes in a large population of Iranian adults.

In people with higher consumption of Se, Vit A, Vit E, and provitamin A carotenoids β-carotene, α-carotene, β-cryptoxanthin , the odds ratios of elevated ALP were decreased compared to the reference group. However, after performing a sensitivity analysis, no association was observed between dietary intake of antioxidants and the levels of serum liver enzymes, which could be due to the residual confounding effect caused by fatty liver or consuming hepatotoxic drugs.

It is also important to mention that fatty liver can probably act as an intermediate variable in relation to the intake of antioxidants and the increase in liver enzymes so that the reduction of the intake of antioxidants can increase the risk of fatty liver and, subsequently, the fatty liver increases the level of liver enzymes.

There is limited evidence regarding the association between dietary antioxidant intakes and odds of elevated liver enzymes among healthy Iranian adults. Previous results have demonstrated that increased dietary intake 13 , 15 , 29 , 30 of antioxidants was related to lower levels of serum liver enzymes.

In line with the results of the present investigation, a previous cross-sectional study on Iranian adults aged 35—70 years old demonstrated that the consumption of phytochemicals was associated with improvements in ALP.

There was an inverse association between the dietary phytochemical index DPI score the percent of daily energy intake taken from phytochemical-rich foods and serum ALP in the adjusted model. No significant associations were found between DPI score and elevated serum levels of AST, ALT, and GGT Similarly, in a cross-sectional study on Japanese employees aged 18—69 years, the association of dietary non-enzymatic antioxidant capacity NEAC in overall diet with serum AST, ALT, and GGT levels was evaluated.

After adjustment for confounding factors, no significant associations were found between overall dietary NEAC intake and the levels of these liver enzymes Moreover, in a cross-sectional study including apparently healthy Japanese men aged 22—86 years, green tea consumption as a polyphenol antioxidants source was not associated with serum GGT In contrast with our results, Abazarfard et al.

showed lower ALT and AST levels in women with an almond-enriched diet as a good source of fiber and antioxidants A recent systematic review and meta-analysis of randomized controlled trials found that the Mediterranean diet, as a plant-based diet, significantly reduced AST and GGT but had no significant effect on ALT Previous results have shown that higher blood concentrations of antioxidants were inversely associated with serum liver enzymes In a longitudinal study of participants aged 30—79 years at the baseline phase of the Mikkabi cohort study, after adjusting for confounders, reduced risks for elevated serum ALT were significant for serum β-carotene, β-cryptoxanthin and total provitamin A carotenoids over a mean follow-up period of 7.

Moreover, reduced risks were not significant for α-carotene, non-provitamin A carotenoids, and lycopene Furthermore, intakes of fruits and vegetables, as a rich source of antioxidants, were correlated with lower levels of liver enzymes in some studies 16 , 29 , 32 ; however, the results of another investigation were not in line with this claim In a cross-sectional study conducted on healthy adults with a mean age of 35 who were living in Tehran city in Iran, individuals in the upper quartile of vegetable intake were less likely to have elevated ALT and AST levels.

After controlling for potential confounders, only the association between vegetable intake and ALT level remained significant. Liver enzymes had no significant relationship with the quartiles of fruit intake In addition, Nanri et al. reported an inverse relationship between serum GGT levels and a diet rich in fruits and vegetables Some previous studies evaluated the association between antioxidant micronutrients and NAFLD 33 , 34 , In a cross-sectional analysis of 72 patients diagnosed with NAFLD, the association between serum and dietary antioxidants and liver fibrosis was evaluated.

The NAFLD-diagnosed patients showed a significant serum deficiency of retinol Patients with advanced liver fibrosis had reduced levels of serum retinol In a case—control study in Iran, with NAFLD patients and people in the control group, the association between polyphenol consumption during the year prior to the investigation and the risk of NAFLD was evaluated.

Accordingly, higher total polyphenol intake was associated with a lower risk of NAFLD Moreover, Ekhlasi et al. observed that ALT and AST levels decreased and total antioxidant capacity increased in NAFLD patients who consumed pomegranate juice as an antioxidant and polyphenol-rich source The heterogeneity in the results of the present study compared with other studies might be due to differences in sample size, genetic background, geographically various antioxidant content of foods, the method used to assess dietary intake, study design, the health status of participants, different level of adjustment for confounders, and analysis method.

The large sample size, population-based research, and extensive information regarding potential confounders, especially those of liver injury e. Another major strength of the current investigation was the measurement of four enzymes ALT, AST, GGT, and ALP for liver function assessment.

Moreover, in the present study, face-to-face interviews were used to ask about FFQ data, making these data more reliable. In addition, another positive point of this study was that the anthropometric measurements were conducted instead of self-reporting.

Despite of these advantages, there were also several limitations. First, since the type of the present study was cross-sectional, a causal association could not be inferred. Accordingly, it is suggested that this relationship be reconsidered in the follow-up phase of this prospective study. Second, FFQ is susceptible to recall bias; the subjects might under- or overestimate their food consumption during the year before the investigation.

Another limitation was that we could not measure oxidative stress parameters to evaluate their influence on the activity of liver enzymes.

Given that alcohol use 36 has a dose-dependent effect on elevated liver enzymes, the probability of residual confounding effect could be in our results.

The datasets used during the current study are available on the Persian Adult Cohort Study Center, Rafsanjan University of Medical Sciences, Iran.

The data is not available publicly. However, upon a reasonable request, the data can be obtained from the corresponding author. Mitra, V. Metabolic functions of the liver. Anaesthesia Intensive Care Med. Article Google Scholar. Hinton, D. Toxic Responses of the liver. Target Organ Toxicity in Marine and Freshwater Teleosts , — CRC Press, Guyton, A.

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High extra virgin olive oil consumption is linked to a lower prevalence of nafld with a prominent effect in obese subjects: results from the micol study. Jayedi A, Shab-Bidar S. Fish consumption and the risk of chronic disease: an umbrella review of meta-analyses of prospective cohort studies.

Adv Nutr. Safe S, Kothari J, Hailemariam A, Upadhyay S, Davidson LA, Chapkin RS. Health benefits of coffee consumption for cancer and other diseases and mechanisms of action.

National Cancer Institute. Ma J, Fox CS, Jacques PF, et al. Sugar-sweetened beverage, diet soda, and fatty liver disease in the Framingham Heart Study cohorts.

J Hepatol. He K, Li Y, Guo X, Zhong L, Tang S. Food groups and the likelihood of non-alcoholic fatty liver disease: a systematic review and meta-analysis. Br J Nutr. Farvid MS, Sidahmed E, Spence ND, Mante Angua K, Rosner BA, Barnett JB. Consumption of red meat and processed meat and cancer incidence: a systematic review and meta-analysis of prospective studies.

Eur J Epidemiol. Henney AE, Gillespie CS, Alam U, Hydes TJ, Cuthbertson DJ. Ultra-processed food intake is associated with non-alcoholic fatty liver disease in adults: a systematic review and meta-analysis.

Park H, Shin SK, Joo I, Song DS, Jang JW, Park JW. Systematic review with meta-analysis: low-level alcohol consumption and the risk of liver cancer. Gut Liver. National Library of Medicine.

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It is essential for protecting liver cells from oxidative damage and for maintaining liver function. Brazil nuts, seafood, meat, and whole grains are excellent dietary sources of selenium. Here you can see Vorst's Vitamin E iu 90 Capsule. NAC is derived from the amino acid cysteine and possesses potent antioxidative and anti-inflammatory properties.

It helps replenish glutathione levels in the body, a key anti-oxidant that is essential for liver detoxification. Garlic, onions, and cruciferous vegetables are dietary sources of NAC, in addition to dietary supplements.

Milk thistle has been utilized for centuries to promote liver health. It contains the powerful antioxidant silymarin, which has demonstrated hepatoprotective properties. Supplements containing milk thistle are frequently used to promote liver detoxification and protect liver cells from damage.

In addition to consuming anti-oxidant-rich foods and specific anti-oxidants, there are a number of other dietary and lifestyle factors that can promote healthy liver function. A diet abundant in fruits, vegetables, whole grains, and lean proteins provides a diverse array of nutrients and anti-oxidants that promote liver health.

To ensure an adequate intake of different anti-oxidants, it is essential to consume a variety of colours and types of fruits and vegetables. Alcohol consumption in excess can be detrimental to liver health. Inflammation, fatty liver disease, alcoholic hepatitis, and cirrhosis can result.

Limiting alcohol consumption or abstaining entirely is essential for maintaining a healthy liver. Important for liver health are maintaining a healthy weight and engaging in regular physical activity.

There is an association between obesity and sedentary behaviour and an increased risk of liver diseases. Regular exercise and weight control can aid in reducing liver fat, enhancing insulin sensitivity, and enhancing liver function overall.

Certain chemicals and toxins can be harmful to the liver if they are exposed to it. It is essential to limit exposure to environmental toxins like pesticides and industrial chemicals.

In addition, certain medications and herbal supplements may have hepatotoxic effects; therefore, it is essential to consult a healthcare professional prior to taking any new medications or supplements.

Numerous studies on the effects of anti-oxidants on liver health have produced encouraging results. The potential benefits of anti-oxidants in reducing liver inflammation, improving liver function tests, and preventing the progression of liver diseases have been demonstrated by clinical trials. It is essential to note, however, that additional research is required to fully comprehend the optimal dosages and combinations of anti-oxidants for specific liver conditions.

In conclusion, antioxidants play an essential role in promoting liver health. They protect liver cells from oxidative damage, promote liver detoxification, and decrease inflammation. Incorporating anti-oxidant-rich foods and specific anti-oxidants into your diet and maintaining a healthy lifestyle can promote optimal liver health.

Prior to making significant changes to your diet or lifestyle, it is essential to consult with a healthcare professional. By prioritizing liver health and implementing anti-oxidant strategies, you can maintain a healthy liver and overall well-being. Close search. Ends Feb 11, PM PST!

The Role of Antioxidants in Promoting Healthy Liver Function by Vorst Canada July 19, Table of Contents Introduction Oxidative Stress and Liver Health Antioxidants: An Overview Mechanisms of Action of Anti-Oxidants Specific Anti-Oxidants for Liver Health Dietary and Lifestyle Recommendations Clinical Studies and Evidence Conclusion References The liver is a vital organ that plays a crucial role in the maintenance of overall health and wellbeing.

A Summary of the Liver The liver is located on the upper right side of the abdomen and is the largest internal organ in the human body. Importance of Normal Liver Operation Maintaining a healthy liver is important for a variety of reasons. Function of Antioxidants Anti-oxidants are compounds that protect the cells of the body from damage caused by free radicals, which are harmful molecules.

The Relationship Between Oxidative Stress and Liver Health Understanding Environmental Stress When there is an imbalance between the production of free radicals and the body's ability to neutralize them with anti-oxidants, oxidative stress occurs.

Liver Effects of Oxidative Stress Long-term exposure to oxidative stress can negatively impact liver health. Liver Disorders and Oxidative Stress Numerous studies have demonstrated the close relationship between oxidative stress and liver disorders.

Anti-Oxidants: An Overview What is an Antioxidant? Antioxidant Food Sources Numerous foods, including fruits, vegetables, nuts, seeds, and whole grains, are rich in anti-oxidants.

Categories of Antioxidants There are numerous anti-oxidant types that promote liver health in unique ways. Antioxidant Mechanisms Neutralize Reactive Oxygen Species ROS.

Increasing Hepatic Detoxification The liver is responsible for detoxifying drugs, alcohol, and environmental toxins, among others. Protecting Liver Cells against Harm It has been demonstrated that antioxidants protect liver cells from oxidative damage and inflammation.

Specific Antioxidants for Healthy Liver Vitamin C Vitamin C is an effective antioxidant that protects liver cells against oxidative damage. N-Acetylcysteine NAC NAC is derived from the amino acid cysteine and possesses potent antioxidative and anti-inflammatory properties.

Milk Thistle Milk thistle has been utilized for centuries to promote liver health. Lifestyle and Dietary Recommendations In addition to consuming anti-oxidant-rich foods and specific anti-oxidants, there are a number of other dietary and lifestyle factors that can promote healthy liver function.

Including Antioxidant-Rich Foods in Your Diet A diet abundant in fruits, vegetables, whole grains, and lean proteins provides a diverse array of nutrients and anti-oxidants that promote liver health.

Restricting Alcohol Intake Alcohol consumption in excess can be detrimental to liver health. By incorporating five beneficial foods and supplements into your diet, you can give this all-important organ the boost it needs.

Grapefruits are packed with two antioxidants that naturally protect your liver — naringenin and naringin. They help your body respond to inflammation and protect the cells while also helping prevent the development of hepatic fibrosis, in which excessive connective tissue builds up in the liver. Like other citrus fruits, grapefruits stimulate the liver, helping it turn toxins into substances that water can absorb.

Grapefruits also have vitamin B, which further reduces inflammation. B vitamins help slow down fatty liver disease and may even assist in preventing it. Olive oil is a healthy fat that positively affects your metabolic and heart health.

It also offers many benefits for your liver. Following a diet rich in olive oil reduces your risk of developing fatty liver disease , especially in older adults. It helps decrease fat accumulation in the liver while also improving the blood levels of liver enzymes.

Because fat accumulation is the first step in the development of liver disease, adding olive oil to your diet goes a long way toward preventing that problem.

The flavonoids present in milk thistle supplements help with liver detoxification. The most important flavonoid in milk thistle supplements is silymarin , which has anti-inflammatory and antioxidant properties. Milk thistle supplements protect new liver cells from alcohol damage as well as damage from other toxic substances.

It can also help with symptoms of jaundice. Most nuts are excellent for liver health because of the antioxidative properties they have, but walnuts are one of the best options.

They have a higher level of antioxidant content, including the beneficial polyphenol antioxidants and glutathione, as well as a high level of omega-3 and omega-6 fatty acids.

Walnuts help reduce the amount of fat in the liver.