Chapter 6
The Saturated Liver
Nonalcoholic fatty liver disease has now become the leading liver disease worldwide. Studies now estimate that in the United States, 75 to 100 million people are already affected—about one in three adults. The cause of the excessive accumulation of fat in the liver is excessive calorie consumption, but not all calories are equally fattening to the liver. Too much sugar is often seen as the main cause, but saturated fats are even worse. For details, see my video see.nf/liver, but essentially, excessive consumption of sugary foods such as candy or soda can increase liver fat by 33 percent, whereas too much saturated fat (butter and cheese) increases fat in the liver by 55 percent. Excessive consumption of unsaturated fats, such as pecans and olive oil, caused only a 15-percent increase in liver fat, probably because unsaturated fats do not impair AMPK as strongly as saturated fats.
Saturated fats are particularly insidious because they can increase liver fat even without exaggerated consumption. Excess sugar calories can turn your liver into a foie gras liver, but even if you eat 25 spoonfuls of sugar per day in the form of candy and soda instead of other foods, liver fat remains unchanged as long as total calorie intake does not change. But if you test this with a fraction of that in the form of saturated fats from meat and dairy products, even without forcing the participants to overconsume, their livers are marbled with 39 percent more fat after four weeks.
Foods That Can Boost AMPK
We know of more than 100 plant products that can activate AMPK, but many of them defend themselves against predators with poison. Take nicotine, for example. Biopsies of fat tissue show that smokers have five times higher AMPK activation than nonsmokers. It is therefore not surprising that smokers often gain weight when they quit and that nicotine gum can mitigate the phenomenon. Although cigarette smoking is probably among the worst things you can do to yourself, thanks to AMPK it is one of the most reliable weight-loss aids. Is there a way to boost your AMPK without risking a gruesome death from lung cancer?
Barberries
Since activation of AMPK leads to weight loss, in my book How Not to Diet I cover a number of natural AMPK activators, including berberine, which is found in barberries. Instead of repeating it here, I refer you to the relevant section on barberry power in the chapter “AMP-activated protein kinase.”
In short, barberries, which can be bought dried inexpensively in Middle Eastern grocery stores, have been shown on average to successfully lower LDL cholesterol by 14 points (measured in milligrams per deciliter) and can additionally improve acne, arterial function, triglycerides, blood sugar, and insulin resistance. The dose of barberries that is widely used in China to treat diabetes and that likely boosts AMPK could be achieved with two teaspoons of barberries three times a day or one tablespoon twice a day. Preferably, one should consume whole berries, especially since an analysis of berberine supplements found that 60 percent did not contain what was stated on the label.
But beware: Consuming barberries during pregnancy is not considered safe, and it is also not recommended for breastfeeding mothers. The reason so many different plants produce AMPK-activating substances may be self-preservation; perhaps they try to deter herbivores by producing substances that damage the animals’ metabolism. We can take advantage of these functions, but they could be harmful to fetuses and small children. Cyanide is another AMPK activator and can kill by completely blocking energy production, whereas components such as berberine and metformin are thought to only hinder our mitochondrial function and make energy production less efficient.
Black Cumin
Black cumin is another plant used in Middle Eastern cuisine that can rev up AMPK. Please compare the section on black cumin in my chapter “Appetite Suppression” in How Not to Diet. In summary, among the more than 1000 papers on the spice in the scientific literature, systematic reviews and meta-analyses of randomized controlled trials have found that consumption of black cumin significantly improves weight loss, cholesterol and triglyceride levels, blood pressure, and blood sugar regulation. Typical amounts used in studies are one or two grams of black cumin daily, which is about a quarter teaspoon. The use of such small doses allows researchers to conduct randomized placebo-controlled double-blind trials in which the whole spice is administered in capsules, not just a few individual components from it.
The spice also lowers inflammation markers such as C-reactive protein and has positive effects on inflammatory conditions such as asthma, rheumatoid arthritis, and a common cause of hypothyroidism called Hashimoto thyroiditis. Black cumin also appears to help get rid of kidney stones, and it has favorable effects on menopausal symptoms. The daily dose used in most of these studies costs about three cents.
Hibiscus and Lemon Verbena Tea
Another astonishing AMPK booster is hibiscus, which is responsible for the tart, cranberry-like taste and vivid color of red fruit tea. Tea made from hibiscus, also known as marsh mallow, has for thousands of years been enjoyed around the world as a delicious hot or cold beverage and has also been used since time immemorial as a remedy. In How Not to Die I discussed its beneficial effect on blood pressure, because it worked just as well or even better than some blood pressure drugs when they were compared head-to-head in clinical trials. In How Not to Diet I described in the section “Flower Power” of my chapter on fat blockers its role in AMPK activation and in improving blood sugar levels, LDL cholesterol, arterial function, and weight loss, whether in combination with another herbal tea, lemon verbena, or without it. Do note, however, my comment about tooth enamel and acidic beverages.
Vinegar
Hibiscus and black cumin rev up AMPK in the same way as the berberine from barberries and metformin—they interfere with the cell’s energy production. Can we activate our AMPK without fiddling with the mitochondria?
Alcohol is another plant product that activates AMPK, but through a very different mechanism. Our body detoxifies alcohol into acetic acid, but must expend energy to break it down. Therefore, AMPK is activated as a natural response to this fuel expenditure. But before the alcohol is completely converted into acetic acid, a toxic intermediate product called acetaldehyde is formed, a known carcinogen. This could be the reason alcohol consumption has been identified as a risk for at least half a dozen cancers, including breast cancer—and that even in people who drink only a little. Can’t we skip the toxic intermediate stage and consume acetic acid directly?
As he analyzed the role of AMPK in burning excess body fat, one researcher concluded that “it is crucial to develop oral components of high bioavailability in order to induce safe chronic AMPK activation for long-term weight loss and maintenance.” But why develop such a component when you can already get it in any grocery store? It is called vinegar.
Vinegar is basically nothing more than acetic acid dissolved in water. When we consume vinegar, the acetic acid is metabolized and, in the amount one would typically have in a salad, gives us a natural AMPK boost.
In the section “Sour Makes You Slim” of my chapter on AMPK in How Not to Diet, I describe how vinegar can reduce both visceral and subcutaneous body fat and can lower blood sugar levels in people with diabetes as effectively as anti-diabetes drugs by enhancing the uptake of blood sugar into the muscles. This is an AMPK effect that also occurs with exercise. Astonishingly, vinegar plus metformin was able to regulate blood sugar better than metformin alone, which points either to an additional benefit in stimulating AMPK (the metformin dose was relatively low) or to a benefit of vinegar that goes far beyond AMPK.