The Liver, Bile and Heart Health
The liver is one of the largest organs in the body and is most commonly known for its role in detoxification, but did you know the liver performs over 500 essential jobs every day? This includes producing cholesterol, detoxifying the blood, maintaining blood glucose levels, and even storing certain vitamins. Lifestyles that include processed poor-quality foods, excessive alcohol use, smoking, exposure to environmental and chemical toxins, and even stress, can all add burden and contribute to sub-optimal functioning of the liver, which can negatively affect various body systems, including the cardiovascular system.
Another one of the jobs that the liver does is producing bile, a digestive juice made up of bile acids, cholesterol, and waste products. It is stored in the gallbladder and released into the small intestine to help breakdown fat and support the absorption of the fat-soluble vitamins A, D, E, and K.
Bile is actually a bit of an unsung hero in the human body, particularly in supporting the detoxification of toxins, regulating fat metabolism and balancing sugar levels, all of which can have an impact on inflammation, blood sugar regulation, and energy balance. Poor bile function, which can include low production or reduced efficiency (let's call this ‘sludgy’ bile), can lead to toxins and used hormones that should otherwise be on their way out of the body, being reabsorbed into circulation.
But what does this have to do with heart health? Well, along with having an impact on many aspects of metabolic health which can have a direct effect on every body system, bile is also able to bind to and support the excretion of cholesterol, overall helping to regulate levels and reduce the risk of cardiovascular diseases. It must be noted that, contrary to belief, cholesterol is an essential lipid that we do need for many functions in the body! It is needed to maintain cell structure, make important sex hormones, support vitamin D production, produce bile acids, and support fat digestion to name a few.
The importance of bile for gut health is also worth noting as any imbalances in the gut microbiome can contribute to the poor recycling of bile acids, greatly affecting cholesterol and fat metabolism. Bile is also an important antimicrobial agent, which helps to support a healthy microbiome and regulate motility to reduce the incidence of constipation, all of which contribute to a healthy cardiovascular system.
In summary, bile is made from the breakdown of cholesterol, reducing levels initially. Bile then goes on to support optimal liver and digestive function, including the removal of cholesterol, toxins, and other substances that could negatively impact cardiovascular and metabolic health. Research has found that bile acid dysfunction is associated with cardiovascular diseases, and so supporting liver, bile and digestive health is another way to support overall cardiovascular health.
How do you know if you have a bile issue?
Many people will report ‘not being able to tolerate’ fatty foods and experiencing digestive issues after a fatty meal. While it is recommended to reduce the consumption of highly processed fatty foods such as baked goods and fried foods, the avoidance of healthy fats, such as avocado, oily fish or extra virgin olive oil, is not usually recommended for these are beneficial for health and are needed to absorb essential fat-soluble nutrients such as vitamin D.
Nutrition and lifestyle support
The good news is that you can support liver health AND digestive function by eating foods that stimulate bile flow – this includes bitter foods such as turmeric, fennel, dandelion, radishes, and rocket.
Eat a wholefood diet by following the principles of the Mediterranean diet, which is abundant in natural plant-based foods (fruits, vegetables, nuts, and legumes) and oily fish, along with a reduction in processed meats, red meats, and ultra-processed products has a wealth of supportive evidence for its benefits for cardiovascular health.
Eat enough fibre and avoid constipation by including healthy whole grains, legumes, fruit, and vegetables. Fibre helps to promote cholesterol excretion and good intakes are associated with lower body weights, blood pressure and total and LDL cholesterol. Avoid refined carbohydrates such as white bread, rice, and pasta as these are stripped of fibre and nutrients and can promote blood sugar imbalance.
Reduce alcohol due to the extra burden it has on the liver. Excessive alcohol consumption can lead to high blood pressure, and increased heart rate and over time, can lead to cardiomyopathy; where the heart muscle is thinned, affecting its ability to pump blood.
Regular exercise is not only good for your heart health and mood, but research has found it can also support your microbiome.
Mindfulness prioritising restful sleep, practicing mindfulness, deep-breathing, yoga and being outside in nature are all great ways to relieve stress, which can beneficially affect your cardiovascular health.
The liver relies on a range of different nutrients to perform at its peak, so a healthy diet and a comprehensive multivitamin and mineral could be a great place to start. A number of herbal ingredients have a long history of traditional use for supporting liver and bile health, including milk thistle, dandelion, curcumin, burdock, and artichoke.
1. Zhang S, Zhou J, Wu W, Zhu Y, Liu X. The Role of Bile Acids in Cardiovascular Diseases: from Mechanisms to Clinical Implications. Aging Dis. 2023;14(2):261-282. Published 2023 Apr 1. doi:10.14336/AD.2022.0817
2. Pushpass, Rose-Anna G., et al. "Circulating bile acids as a link between the gut microbiota and cardiovascular health: impact of prebiotics, probiotics and polyphenol-rich foods." Nutrition Research Reviews 35.2 (2022): 161-180.
3. Rezaie P, Bitarafan V, Horowitz M, Feinle-Bisset C. Effects of Bitter Substances on GI Function, Energy Intake and Glycaemia-Do Preclinical Findings Translate to Outcomes in Humans?. Nutrients. 2021;13(4):1317. Published 2021 Apr 16. doi:10.3390/nu13041317
