Dhru Purohit Show
The Top Foods That Help and Harm The Liver with Kristin Kirkpatrick
Mon, 21 Apr 2025
This episode is brought to you by Maui Nui, Levels, and Ollie. When we think about chronic disease and vital organs, the liver isn’t always the first that comes to mind—but it should be. The liver plays a role in nearly every metabolic process in the body, from stabilizing blood sugar levels to converting amino acids into usable fuel. Today’s guest joins the podcast for a deep dive into how optimizing liver health is key to supporting overall health. Today on The Dhru Purohit Show, Dhru sits down with Kristin Kirkpatrick to explore the liver’s vital role in detoxification, the rise of fatty liver disease, and how liver health impacts overall mortality. They break down the connection between diet and liver function, debunk myths about dietary fat, and examine the effects of ultra-processed foods and artificial sweeteners. Kristin shares the benefits of coffee, muscle mass, and blood sugar balance for metabolic health, along with key liver-supportive foods, lifestyle tips, and insights into GLP-1 medications for those with obesity and liver issues. In this episode, Dhru and Kristin dive into: The shocking rates of non-alcoholic fatty liver disease (00:00) Understanding fatty liver disease and its twelve major risk factors (2:51) Why Americans are at greater risk (7:50) The crucial role the liver plays in the body (13:28) The phases of detoxification from environmental toxins (18:18) Research linking fatty liver disease to increased mortality risk (22:28) The earlier onset of fatty liver disease in today’s population (27:15) Why carbohydrates may be more to blame than fat (27:54) The impact of Diet Cola, artificial sweeteners, and foods to avoid (32:01) Twelve liver-friendly foods to prioritize (48:31) The importance of building and maintaining muscle mass (58:01) Lifestyle recommendations for managing fatty liver disease (1:05:31) The role of physical activity in liver health (1:08:31) Understanding GLP-1 medications and their effects (1:11:53) Final thoughts on liver health and nutrition (1:18:31) Also mentioned in this episode: Kristin’s Presentation Slides Regenerative Health Book For more on Kristin, follow her on Facebook, Instagram, X/Twitter, Pinterest, Youtube, LinkedIn, and her Website. This episode is brought to you by Maui Nui, Levels, and Ollie. Right now, Maui Nui Venison is offering my listeners a limited collection of my favorite cuts and products. Just go to mauinuivenison.com/dhru to secure your access now —but hurry, supply is limited! Right now, Levels is offering my listeners an additional 2 FREE months of the Levels annual Membership when you use my link: levels.link/DHRU. Make moves on your metabolic health with Levels today. Want to give your dog the best in clean eating? Take the online quiz and introduce Ollie to your pet. Right now, Ollie is offering 60% off your first box of meals when you subscribe today! Just head to Ollie.com, use the code DHRU, and you’ll get 60% off your first box of meals in your subscription. Learn more about your ad choices. Visit megaphone.fm/adchoices
Chapter 1: What is fatty liver disease and who is at risk?
And that fact is that one in four adults in the US is now living with fatty liver, non-alcoholic fatty liver disease. And this is the clincher, most people have no idea. That's almost 100 million Americans walking around with this. as a silent condition that left unaddressed can completely upend our life. What is fatty liver disease? And let's jump right into it. Who's at risk for this condition?
Yeah, so Drew, it's really interesting. This data is actually a little bit older. We don't have the updated data yet. Some assumptions now are that it could be as severe as even one in three. Could be greater than what we think. Definitely one in four. Fatty liver disease is simply having excess fat in the liver. So the liver is supposed to have some fat.
Chapter 2: What role does the liver play in the body?
Once you get over about 10% of fat and fat starts to overtake healthy liver cells, now you have something called fatty liver disease. And that's basically the gist of what it is. But it is what comes because of it that really is the alarming factors, right? And this phrase that I used, once fat overtakes healthy liver tissue.
So once we have kind of that hijacking of overtaking of having healthy liver tissue being replaced by unhealthy, fibrotic, inflamed tissue, the liver no longer works the way it should. And that causes a whole host of problems.
Talk to us about who's at risk, because we talked about this being largely for many people, a silent epidemic. They don't know actually they're on their way to getting this very terrible condition, which has a whole host of problems in their life. So you have a great slide on this. If you could walk us through.
You know, the silent nature of this is really what I've seen in my practice and the hepatologists that I've worked with. Many people don't get diagnosed with this until they see their liver enzymes are up. And then that's kind of the warning symbol. What's going on here with your liver? So let's just go over some of the risk factors. Insulin resistance is probably one of the greatest risk factors.
The reason for that is because the liver plays such a huge role in regulation of blood sugar. When the body senses that blood sugar is too low, the liver will work towards releasing the stored form of blood sugar. So we don't have that low blood sugar. And so there's a huge connection here. In fact, when we look at that one in four statistic,
we are looking at individuals who have insulin resistance or type 2 diabetes much greater in the stats, right? So probably 80% to 85% of individuals that are suffering from insulin resistance or type 2 diabetes probably also have fatty liver disease as well. And this just speaks to the dysregulation of what is going on in sugar, in their blood sugar.
You and I were talking earlier today about wearing CGMs. I have my CGM on right now as well. It's so interesting to compare my patients and their data with someone who doesn't have insulin resistance and looking at how poor and how less efficient the body is at recognizing how much insulin is necessary. losing what we call that sensitivity.
Insulin resistance is not having the sensitivity needed to give you the right amount of insulin to match the right amount of carbohydrate. So that is a huge risk factor. Obviously, that falls within the type 2 diabetes as well. Obesity, and we're looking at obesity here as waist circumference.
So one of the reasons, and we can talk about this later, but one of the reasons that the nomenclature from non-alcoholic fatty liver disease, which was NAFLD, changed to MASLD, M-A-S-L-D, so that is metabolic dysfunction associated steatotic liver disease, is because of the fact that we needed to recognize the metabolic features of this condition.
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Chapter 3: How does diet impact liver health?
from good foods that you might be eating. Hormone production. So we know there's connections with looking at things like hypothyroid and things like that, that we know are directly impacting the liver. So when we think about hormones in general, the liver plays a role in our hormone function.
And so again, if we start having the liver break down, not have the healthy tissue it needs, then hormone function can be also a huge component as well. Obviously, bile production, we need bile production that works with the gallbladder to be able to break down things like fats, iron storage. So there's a condition called hemochromatosis, which is basically iron overload.
It's relatively rare, but we have to make sure we have a good balance of iron within the body. And of course, iron gives us that energy, if you will, to our red blood cells. It oxygenates those red blood cells. So that's really important.
Protein synthesis, we already talked about glycogen and really kind of that stored form of glucose, being able to recognize, hey, we're a little bit too low here in our tank. We need to release some. And so the liver plays a role with that. Cholesterol synthesis. So the liver plays a huge role in cholesterol. In fact, such a big role that
When individuals are for the first time prescribed a statin, liver enzymes are typically one of the things that a physician will be monitoring to make sure that the statin is actually going through that detox phase, right? So the statin goes directly to the liver. The liver isn't working or there's some components of the statin that's not jiving with the body. The liver enzymes will indicate that.
Quick question about that, actually, just while you're on it. If people have, obviously high cholesterol comes from a lot of different things and there's different types of cholesterol that's there. But if somebody has high LDL and it's not genetically driven from hyperproducing or hyperabsorbing, could the liver not working well play a role in people having high LDL?
Absolutely. Absolutely. And we've seen studies, which we talk about in the book as well, that looking at heart attack, stroke, cardiovascular conditions is one of the main causes that we sometimes see of death with individuals that have liver disease.
And this, of course, speaks to many different factors, including inflammatory factors, but also looking at the mismanagement of overall lipids as well. So the liver definitely plays a role in that. And that kind of leads to one of the most important factors, which would be the detoxification qualities that the liver provides.
So I think sometimes when I talk to my patients, many of them say, well, you know, I'm just really trying to avoid toxins. So I just have glass. I'm not using plastic anymore. And, you know, they'll name a few things that they think are kind of the keys to not having those toxins. But really, We are exposed to toxins all the time. So it's not just diet.
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Chapter 4: What are the top foods to support liver health?
Chapter 5: What lifestyle changes can help manage fatty liver disease?
Yeah, absolutely. This was such an alarming paper. It just came out a few weeks ago. And looking at the fact that individuals with fatty liver disease have twice the mortality rate of individuals that do not. So quite frankly, speaking on that one and more simply, you're more likely to die early, right? This is what it means. And the death would come from other associated diseases typically.
And this is what we have actually seen when we look at the data on fatty liver disease in general. Looking back at that data at heart disease and heart attack and stroke, more likely to occur in someone who has fatty liver disease. This paper also brought up death from common diseases such as cancers as well. So looking at the cellular changes that could occur based on poor liver health.
We haven't seen as many studies looking at cancer in general. Of course, we do know that fatty liver disease is one of the top causes of liver cancer. You know, it used to just be that if you drank too much, then you're more likely to get liver cancer. Of course, that is also true. And we could talk two hours about drinking, right? and the data on drinking today.
But really, I think this looks at a varying degree of cancers, not just that liver cancer as well, if I remember correctly. So cancer is another big one. So it's kind of like the liver is like the hub. I referred to the liver in my first book as like the great and powerful Oz. And he's just kind of like the puppeteer to the other organs. And this study really shows it.
So the liver's not working great. It's probably not the first thing we're thinking of, but it's impacting cancer. It's impacting our thyroid. It's impacting our hearts, our brain. And so we think of those organs that are associated there, not realizing that it was the guy behind the curtain kind of pulling the puppet strings all along.
Could you make that connection a little bit more for us, for the audience who may not be familiar with this? Why would it be that you would be more likely to get cancer, for example, if your liver is not working well and you find yourself with fatty liver disease? What do you think potentially could be going on? Is it as straightforward as toxins are not getting filtered?
And so now you have cellular damage and mutations of cells that then can get out of control? What are your thoughts on that?
You know, I think that it's probably very complex, multifaceted. So it's probably not one thing that we can pinpoint. Once the liver goes bad, here's what happens. But it's probably a combination of things. I think the detoxification process that you brought up and the cellular damage, I think is a huge component.
I think inflammation in general, we do know that when you have liver disease and you're at more severe stages of it, your C-reactive protein, your sedimentation rate, inflammation levels tend to go up. We know that the microbiome is impacted. And so there's also that association between all of the components looking at gut health and the risk of cancer based on some of the components there.
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Chapter 6: What are the effects of artificial sweeteners on liver health?
Chapter 7: How does liver health relate to overall mortality?
Chapter 8: What are GLP-1 medications and their effects on liver health?
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Yeah, I would put the blame more on carbohydrates than than fat. You know, it's interesting. I was listening to a podcast the other day and saw this debate over red meats. And I just for my for my Today Show column, I just wrote an article on the carnivore diet. And my thought once I published it was like, well, this isn't going to be popular, right?
It will be evidence-based, but not necessarily popular. But there's this whole debate, right? Should we just eat meat? And the debate is, well, look at our ancestors. They didn't have the modern diseases we had. But if we go back to the cavemen, they also didn't live that long, right? So if they lived into their 80s or 90s, would we have seen the development of heart disease?
Maybe, maybe not, right? They also didn't have access to carbohydrates as much. So back to this question about fats. You know, really, if you look at fat in general, fat tends to be a very healthy component, a dietary component for fatty liver disease. Number one, because it doesn't impact our blood sugar levels, right?
We don't have an impact to insulin, which is a huge factor in fatty liver disease. But number two, we don't associate fat really, even with things like... you know, elevated obesity. This is a little controversial, but, you know, if you look at kind of how fat was vilified back in the 80s with heart disease, we don't really see that connection. Now we see it with sugar, right?
So there's all these components here that would make you... really kind of question, gosh, is my low-fat diet a really good option here? And it might not be, especially if that low-fat diet is paired with a very high carbohydrate level and especially if those carbs are stripped.
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