I’m JJ Virgin, PhD dropout, sorry mom, turned four time New York Times best selling author. Yes, I’m a certified nutrition specialist, fitness hall of famer, and I speak at health conferences and trainings around the globe. But I’m driven by my insatiable curiosity and love of science to keep asking questions, digging for answers, and sharing the information that I uncover with as many people as I can.

And that’s why I created the Well Beyond 40 podcast, to synthesize and simplify the science of health into actionable strategies to help you thrive. In each episode, we’ll talk about what’s working in the world of wellness, From personalized nutrition and healing your metabolism to healthy aging and prescriptive fitness.

Join me on the journey to better health so you can love how you look and feel right now and have the energy to play full out at 100. So there is a It’s a silent disease out there that could be devastating your metabolic health and you could be walking around with it and not even know it. And it turns out 25 percent of us are wild.

And then there’s probably another 25 percent of us that have all the, like, pre signs of it. I am talking about non alcoholic foods. Fatty liver disease. I’m going to be talking today with Kristin Kirkpatrick. She is a, an RD and also a bestselling author. And we’re going to be digging into her book today that she is the co author of, Regenerative Health, How to Discover Your Metabolic Type and Renew Your Liver for Life.

And I was actually really blown away. I mean, I’ve known about fatty liver, but I had no idea how many people it impacted. Now here’s, what’s cool. Your liver is amazing. You can renew it. You can regenerate it. So we’re going to be digging into what your liver does, why you, uh, how you can find out if you are at risk for fatty liver disease.

If you already have non alcoholic fatty liver disease, can you drink alcohol? Um, the important question is coffee good or not good for the liver? Um, and what about those liver cleanses? So we’ll be digging into all of this and you may have seen our, Our guest today, Kristin, on the Today Show or NBC Nightly News or Fox News or maybe you’ve read about her in the Wall Street Journal or Time or New York Times.

She’s been all around. She is currently at the Department of Wellness and Preventive Medicine at the Cleveland Clinic and she also is a senior fellow with the Meadows Behavioral Health Care. And I’m going to put a free chapter from her book. book at jjvirgin. com forward slash liver. You can grab that there.

And I’ll be right back with Kristin to be digging into all of this juicy information. Alrighty. Stay with me.

Kristin, welcome to the show. Let’s talk liver.

Yes. Thank you. Thank you so much for having me. I’m so excited to, to speak to your audience and a huge fan of you, JJ. So thank you for having me.

Well, we really haven’t dug into this whole, the whole liver conversation. We’re not talking liver King. We’re not talking about eating liver.

To be clear, everybody’s listening. We are going to be talking about your liver and specifically, we’re going to talk about your new book, which is Discover Your Metabolic Type and Renew Your Liver for Life. And I guess the obvious place to start is how did you get so interested in The organ, the liver.

Yes. Okay. So, um, back in 2017, when I, when I wrote my first book on liver health, I wanted to write a book on like weight loss or something a lot more sexy than the liver. And then what I noticed was that I was having all of these patients show up. And say the same thing, I’ve seen my doctor, my liver enzymes are elevated, I have too much fat in my liver, this is what I’m told.

And he said or she said, go see you. Here I am, what do I do? So there was no guide, there was no, um, no definitive anything that really gave anyone guidance on what to do. If they were told they had non alcoholic fatty liver disease. So that’s really where the interest came and it just kind of grew from there.

I think it’s um, an area where we don’t see a lot of dieticians kind of, you know, Putting their expertise in, but it was really important for me to provide that guide.

Well, let’s unpack, uh, what I was, I think of it as NAFLD because it’s easier to say that way, but non alcoholic fatty liver disease, because from everything that I’ve been seeing, it’s actually more common and underdiagnosed than people realize.

So what is it? Because it’s, It’s obviously non alcoholic fatty liver disease. Used to be that we thought of fatty liver as something caused by alcohol. Um, what is it and how common is it? And how would someone know if they had it?

Yeah, it’s really quite common. There was American Heart Association study in 2022 that talked about how about one in four individuals has non alcoholic fatty liver disease.

What?

One in four?

One in four. That’s a huge percentage of people. And of course it follows the percentage of people. To some extent who have insulin resistance or type two diabetes. So it is a very big number. You walk down the street, one in four individuals you pass most likely has fatty liver disease, but it’s could be unnoticed.

They most likely don’t know that they have it. So how do you figure out that you have this? Typically it’s going to come after a visit to your primary care physician. Liver enzymes are usually pretty typical in those exams in terms of blood work, so ALT, AST, those are typically taken. If those are elevated, and then you’ve got some other risk factors going on, like, uh, let’s say too high of waste, insulin resistance, etc.

Then your doctor is probably going to say, hey, you most likely have non alcoholic fatty liver disease. Some physicians will go a step further, do an ultrasound. Uh, the physician that I worked with on this book, Dr. Hanane, Sometimes he will actually go in and do biopsy. Typically there’s other things going on if you go that far, but that’s typically how you find out.

You don’t find out through a symptom because there usually are none, which is why this is so easy to, to let’s use the word grow and proliferate and become worse than it was at the beginning because you’re not getting those warning signs.

So, if you have insulin resistance, can you have fatty liver without insulin resistance, or do you have to have insulin resistance to get fatty liver?

No, you can have fatty liver without insulin resistance. If we look at some of the main risk factors outside of alcohol, and that’s a really important statement to make, this is not looking at alcohol. So when we look at insulin resistant, that is definitely a risk factor, but we also know there’s some genetic risk factors as well.

Um, even looking at some of the studies we cited in the book in utero. So if your mom had gestational diabetes or she had fatty liver, you are more likely, more prone to develop this later in life. Uh, so there’s some genetic predisposition as well, but for the most part, it is a correlation that we’re seeing with this non alcoholic version.

Um, Insulin resistance, any kind of dysfunction, metabolic dysfunction in general, most likely is going to lead to an excess amount than normal of fat in the liver. So that’s about 5 percent or greater.

So would, like, since there aren’t really any symptoms, the only way you can really tell if you have this is to Now, this is by these lab tests, correct?

Yes uh, lab tests would be really your, your main definitive approach to looking at that. And then maybe even an ultrasound. So even if your physician is saying, well, I’m not quite sure about this case, uh, an ultrasound will typically tell you if there is fat within the liver, and that would be a definitive diagnosis.

And. I’m assuming there’s a continuum, kind of like with, you know, one person doesn’t wake up with diabetes, they’re, you know, like starting to get less insulin sensitive till they get full blown insulin resistant. Is it the same here?

Yes, it is the same. So when we look at the formation, of non alcoholic fatty liver disease.

Typically we start with excess fat in the liver, so that’s very normal to see. Then what happens is as you go progress through it, so let’s say this could take years, it could take a really long time to develop, so you get years and about 20 percent of individuals develop something called NASH, which is when the liver starts to try and repair the damage of having excess fat.

What causes that, of, of, what, what leads to that, of course, is scar tissue. Inflammation, fibrosis. And so that is really the second stage of what we look at for fatty liver disease. The third stage, about 20 percent of individuals with NASH will get the third stage. So this is pretty rare. It’s getting into cirrhosis, where the healthy tissue of the liver is completely replaced with scar tissue and with unhealthy tissue and with fat, etc.

So the more the liver tries to heal itself, the more scar tissue And the further along you get within the disease and the more severe it becomes.

And I would assume as it starts to go down that path, you can’t repair it, like, which is kind of ironic. The body’s trying to repair itself, but it’s making irreparable damage, right?

Right. Exactly. Exactly. But it’s not until we get to cirrhosis where you can no longer reverse this condition. So the first few stages are very reversible. We have patients that have had this condition for 10, 15 years. They are in NASH. And they take lifestyle steps to reverse the condition. So it is very possible within those first few phases.

Well, and plus you wrote the whole book on how to renew your liver, right? Right.

So you, you, you have to have a good opportunity to be able to reverse. Right.

If you couldn’t do that, you couldn’t have written the book.

It would have been a little bit more dire.

Well, in the book, you have four, Metabolic types.

Can we walk through those?

Sure. Uh, so the reasoning on why we developed the metabolic types was, you know, I, I’ve been a dietitian for, for over 20 years and I would say for the bulk of that time and still continue to this day, I would open up a patient’s chart and their obesity, overweight, underweight, whatever their designation was, was determined by BMI, which is not a good factor.

When we look at whether or not someone is healthy or even how we deem someone overweight or obese, right? Obviously. So BMI, um, just looks at that proportion of looking at your, your weight in kilograms to your height. It doesn’t look at muscle. It doesn’t look at anything else. It

makes me crazy, Kristin.

It makes me crazy, crazy, crazy. Yes.

Crazy. I, I’m glad you use that word, JJ, cause I’m in total agreement with you.

I know the scale and BMI should get abolished. Like literally I went to the To, to a follow-up appointment on my elbow. ’cause I had PRP on my elbow. I go to a follow-up appointment today and they put me on the scale and I go, I’m just curious, , why are you putting me on the scale?

Because you’re like, I’m having a follow-up. You know? And moreover, what is the scale going to? Tell you what, what, you know, what are you looking for? And shouldn’t we know what the scale, what actually your weight’s made up of? So you’re preaching to the choir. It makes me nuts.

It makes no sense. I mean, we did start at Cleveland Clinic to use a GEN body machine.

So my patients would come to see me and we would say, See their, their fat content, their water, you know, everything, right? All this stuff. That’s what I always refer to. Like scale doesn’t tell you stuff, it just tells you a number and then, and then you relate that number to your happiness. None of it makes sense.

Um, but once we can get a little bit more insight into our muscle mass, into our fat, into even how much water. That is, that’s power. There’s power in knowledge there. So that’s really where this came from. So what we wanted to look at was what is the combination of not your BMI, but your waist circumference.

So are you holding excess fat within your midsection? And then number two, What’s your metabolic numbers look like? So, of course, when we look at metabolic syndrome, you have to have at least two different factors of either having, uh, high triglycerides, low HDL, high blood pressure, um, hemoglobin A1C is high, your lipids are high.

So there’s some sort of metabolic dysfunction going alongside with it. And we basically combine those two to come up with the four metabolic types. So, um, our preventer is someone who’s healthy and lean. Perhaps has some genetics that are going on that make that person a little bit more at risk. Um, when we look at the fine tuner that’s healthy and non lean, so their numbers are great, but their waist circumference is a little too high.

So they have the potential to develop some of these comorbidities. From having a too high of waist circumference, recalibrate is unhealthy, uh, unhealthy and lean. So when we, when we think about, um, the metabolic numbers, the metabolic numbers and the waist circumference go hand in hand. But if the waist circumference is normal, that’s when we have more of like the skinny fat mm-hmm,

So, Hey, waist circumference normal, but my metabolic numbers are not looking so hot. And then the regenerator is going to be, um, really dysfunction on both ends. So waist circumference is high, metabolic numbers are abnormal. We just use that as a sense to give people some insight into their risk and maybe even insight into some of the dietary recommendations that we make within the book.

Okay, so someone comes in, because I think it’s really interesting now is that this is something that still really isn’t screened for, people don’t talk much about, and maybe we need to back up a bit and go, and why does this really matter? Why, what’s so important about your liver being able to operate, you know, optimally?

Right. What does it do? Um, I mean, everything. So what I always say is that if your liver is not working right, nothing else is. And so you might get symptoms in other places or you might have dysfunction in other places, but the liver could be one of the sources of that. So we know once you get into fatty liver, for example, even looking at the dysfunction of sex hormones, right?

So looking at the hormonal changes that can occur because the liver plays a role in hormone balance. Making hormones, et cetera. Also plays a role in the, the, just the metabolism of breaking down nutrients. So oftentimes we don’t assign the liver any responsibility for that. Most of my patients think, Oh, my, my GI tract and my, my guts and all of those things, my pancreas, those are all important.

My, my digestive enzymes, but the liver plays a role in that as well, as well as being able to take all those vitamins, minerals, et cetera, uh, plays a role in your lipid panels. So it’s going to be the balance, uh, and of course the one place that most people are aware of is detoxification. So we know that the liver is the primary organ that takes in a toxin from any source, whether that’s um, an environmental toxin, a toxin from our food, and converts it to something the body understands and then creates it as waste to get it out of the body.

Works with the kidneys and that, but it is the main detoxifier. So that’s why I always say if your detoxifier is not working, nothing else will. Because we are faced with toxins each and every day.

So I definitely want to dig deeper into detoxifying and also some of these liver cleanses. Um, but before that, let’s just dig in a little bit to menopause hormone balance, like, you know, How does menopause impact the liver?

How does liver effect health impact menopause? Walk us through that.

Um, so it’s interesting, JJ. I just did a presentation to health practitioners on menopause. So perimenopausal, menopausal women, and kind of what to look for. What are some of the things that we don’t talk about that we should? And I brought up the liver and everyone’s like, what?

Like, and these were health practitioners. We’re talking about the liver here. What they, they’re just didn’t, they just couldn’t figure it out. Um, so from the menopausal perspective, as we know, once we drop in estrogen, um, we then increase our risk for many different conditions. Heart disease is a huge one, obviously, um, bone loss.

So things like that can really be affected. But when we are in perimenopause and we are still getting a menstrual cycle, even though they’re abnormal. We could see different variations in estrogen, even greater than the norm. If we have liver dysfunction. So if we are carrying too much fat in the liver from any reason, and the liver is then responsible for sex hormones and some of the hormonal imbalances, that could create a little bit more of a hormonal imbalance to begin with.

So I think as I started with this, The liver is usually the last place you think about. You think about belly fat and you think about, I need to get my cholesterol under control. My blood sugar is too high. We think about all those things. Um, but really if our liver is unhealthy, none of those things will be easy to achieve.

None of them.

So then let’s move into detoxification. I think of like, you know, even detoxifying people. Estrogen metabolites, like there’s so many things we have to do here. And you hear about all these, like, liver cleanses.

Yep.

I have a whole thing about cleanses in general, like, you know, these juice cleanses and make me nuts.

But, um, another thing that makes me crazy along with the scale are juice cleanses. Um, but, you know, I, I want to walk in after this of what we really want to do to, to love our livers and take care of them. But what about these Liver cleanses that are out there that are so popular.

Well, I get that question all the time.

So number one, uh, of course they lack clinical human trials. So that’s, that’s probably a big one right there. Um, you know, with a lot of different cleanses, they probably do nothing, but the worst part is that they could harm. So this is where some of the challenges with them. We don’t have data showing that they really do anything.

And I get frustrated with it because I have patients that will ask me about this and I That have been working with me for many, many years. Oh, I’m thinking about this liver cleanse. Is there a brand, you know, that you think is better than this one? And I’m always like, yeah, it’s the produce aisle in the grocery store.

That’s that. Take your money head to the grocery store. Go to the produce aisle. Right? So I think, um, we are not everyone, but oftentimes we are living in a society where the quick fix. Dex is something that’s really attractive. So if we are told or we suspect there’s something wrong with my liver, or there’s something wrong with something else and my liver is the culprit, then the cleanse will be the solution.

But we have zero data showing us that, and in fact some of these cleanses do have some herbs, things like that, um, that could be very toxic to the liver as well. So, um, so even looking at, um, for example, there was a patient that I had who wanted to do a cleanse and there was, she was menopausal. And so there was like a cleanse for post menopausal women.

I don’t even remember who was selling it, what it was. It had black cohash in it, which we know if you go to liver talks. Um, can react really, really poorly with the liver. It can create toxicity. Um, so that would be just one example. There’s, there’s, you know, probably a whole list of Chinese herbal medicine that can be very beneficial, but also detrimental as well.

This one was a very unique situation, but the, the point here is, We don’t know how these cleanses are going to interact in our body and we definitely don’t know how they will interact with other medications that we’re currently on.

It’s interesting if someone’s working with you that they would think that they would need a liver cleanse.

Like what does, you know, they’re already working with you to heal their and regenerate their liver. What, what would they need this for? I love the idea of a cleanse or a detox more in a Short term, not to accomplish what I think people think they’re accomplishing. I’m like, we’re that you’re not going to heal your liver in a week or, you know, detox your body in a week, but it’s more to get people to focus and take out some, you know, habits that are not supporting their health and put in some habits that are supporting their health and just go, Oh, I feel better.

And maybe we could take these things and move forward with them. Right. That’s, that’s, you know, I know that’s not why people want to do them, but you can’t have, You know, 10 years of bad habits and fix them in 10 days would be awesome. It’s more, take 10 days to focus on some good things and realize how great you can feel, and let’s pull those into everyday life.

Exactly, right, right. And you’re probably not going to experience some of the detrimental side effects.

Right. Well, I, you know, again, I think the majority of this is done with food and Sleep and dry brushing and Epsom salts and lifestyle habits and sweating, you know, these things. So let’s talk liver health then.

So someone’s coming in and now that we know that 25 percent of people have some level of non alcoholic fatty liver disease. Um, and who knows if we have some pre people in there as well, maybe another 25%. I would assume if we’ve got now less than 7 percent of the population metabolically healthy, we probably have a pre group along with the group.

Yes.

Um, what are some of the things that you would have for us? Someone do to start to heal and regenerate their liver, renew their liver?

So obviously as a dietician, I’m incredibly biased at this one, but I would of course start with looking at general lifestyle, uh, sleep, Stress management, all of those things, um, but diet would be really what’s at the kind of forefront of where I’m going to look at this.

For, for myself and my practice, a lot of times I do like to look at a dietary recall. So going through that while the patient is sitting there, um, as we’ve seen in, in some studies, when you ask the patient to go home. Do a recall and bring it back. They’ll forget things, um, so that’s not always as effective.

So we’ll do it right then and there. Tell me what you eat for breakfast most of the time. Tell me what you do for lunch, etc. Um, I will then look at their, their, their risk profile. So I’ll look at what is, what, what’s their lab work look like? What does their hemoglobin A1c look like? That’s going to be a big marker for me.

What does waist circumference look like? Um, once we dive into that, then I can really look at their diet and get into the meat of it. So I think one thing that, you know, we don’t learn in dietetic school and we’re just, we don’t hear enough about this is that we oftentimes forget about what people prefer.

So this is not to say that we should say it’s, it’s okay to have all this ultra processed food. You like it, but we have to look at what works in terms of what’s beneficial to the liver. So. Just to throw out a few things, we can look at what’s your consumption of cruciferous vegetables, uh, nuts and seeds.

Do you drink coffee in the morning or do you have something else? Or what’s, what’s your coffee habit? And then kind of

coffee habit, good or bad?

Uh, good. There’s over, yeah, there’s over a dozen clinical trials looking at the benefit of coffee to reversal of fibrosis. Um, as well as to overall benefit to liver health, most likely due to all the bioactive compounds.

So coffee is like very much on the table. Um, it’s, I

love hearing that. I literally have been saying for years that coffee is a health food and you know, you would think I was saying that earth is flat and I’m like, look at the antioxidants in it. Yes. Okay.

And I get pushed back JJ on that all the time.

People are, you know, people are always, Oh, not for everyone, but that’s true for every food. Not everyone can tolerate certain vegetables, right? So we, we do know there’s a gene called CYP1A2 that, that puts people in one of two coffee camps. You’re either a slow metabolizer or you’re a fast metabolizer. So individuals that are slow metabolizer, about 200 milligrams a day or less is recommended.

Even that’s not an issue because we know that these studies on liver health have also been shown in decaffeinated coffee as well. So There’s a lot of options for coffee, but what I will do is I will, I will take a look at this and then we will kind of break down what do we need to pull out of the diet?

What do we need to alter? What do we need to add? And that process, unlike the cleanse, can take weeks. So that first appointment when we’re sitting there and saying, you know what, I’m looking at this snack. I know you have pretzels. I know you love pretzels. Is it possible to substitute it for some nuts and seeds?

Can we talk about that, right? So we take this baby steps approach. Based on their metabolic profile, I’m probably also going to, what I call, upgrade their carbohydrates so that they are ingesting less, um, carbohydrates overall, especially if we see someone who is pre diabetic or definitely type 2 diabetes.

And of the, you mentioned cruciferous vegetables, but are there some specific foods, um, that you would love to have someone incorporate into their diet that you’d like. I think of things like, um, you know, brussels sprouts or beets, like certain things that would be especially healing for the liver.

From that detoxification standpoint, um, we see benefit in all of the cruciferous vegetables.

So that’s kind of number one, that’s where preference will come in. So I’ve had patients come in and say to me like, Oh, you’re going to make me eat kale, right? And I’m always like, not if you don’t like it, but what cruciferous vegetable do you like? If you love brussels sprouts.

Who likes kale, seriously, like really?

I’m like,

come on. So if you don’t like it, let’s, let’s find something else. Um, kiwifruit, uh, edamame, which I know could be controversial, especially for post menopausal women. That could, that could go either way. Someone could say, Oh, thank God you mentioned edamame, or someone could say, I’m not touching that.

Um, just based on what they know about that, uh, extra virgin olive oil. So again, like I’m often asked, I’m sure you are as well, Hey, tell me what’s superfood that we’re all missing? People think we’re going to mention some obscure plants, but, but I usually mention extra virgin olive oil. There’s just so much polyphenol content, so much benefits.

Um, the key is how do you purchase an extra virgin olive oil? Like how do you, how do you get a good one? Right.

Yeah. Do you have olive oil Hunter, by the way? Um, what is it called? It’s the fresh pressed olive oil club.

Oh, no, I don’t. Oh,

you do not know about this? Olive

oil hunter. I’ll have to write. So

there’s this guy, it’s TJ something.

Anyway, he’s the olive oil hunter and he goes around the world. It’s much like our dry farm wine guys. Yeah. He goes around the world hunting for these small batch, amazing olive oils. And so you get, you get a little quarterly shipment of these. That’s incredible. Olive oils. That’s so good. There you go.

I’m going to look that up.

I’m going to look that up. Um, green tea. So green tea has been also shown to be, um, really beneficial. Um, dark chocolate. You know, I think a lot of times we look at things that are, you know, Have sweets and we think, oh, I can’t, I can’t have chocolate, right? So dark chocolate, again, we know very high in flavonoids.

We have studies showing that flavonoid high rich foods tend to be very good for the liver as well, but really it’s Get it without sugar.

So come

on. Right. Absolutely. Right. And then, you know, just telling people look for 72 percent or greater, that kind of thing. Sometimes I’ll go a little bit more high level and just say, Let’s just get foods that we know will reduce inflammation.

Cause if it reduces inflammation, it’s going to be good for us. It’s going to be good for the liver. Um, lentils, beans and lentils. So again, we have, we have studies showing that there’s benefit to plant based approaches. So beans and lentils as one protein source. Um, although wild fatty fish is also a great protein source as well for the liver as well.

Um, so I kind of break it down into color. Um, so I think that most of my patients are overwhelmed by the government recommendations of how many servings.

Well, that got us into this place anyway.

Right, right. We could talk for an hour on that one. Um, but from the standpoint of, of color, I just think if you’re getting seven to eight colors in every single day, you’re probably doing pretty good.

Yeah, I love that. It’s, um, Deanna Minnick talks about that in the rainbow diet, and I started just tracking. Colors and how many different types of, I was excited too, because herbs count, but you know, if you really start to pay attention to how many different colors you get in, one of the ways that I pull that off is I do a cauliflower rice pilaf.

And it basically is like, what leftover vegetables do we have? And we throw it all in there with some lentils too, and make this amazing, amazing thing that lasts for a couple of days. I mean, it’s just so easy to do. Since we’re talking liver health, I’d love to step into the most, like, I’m trying to think of what’s the most controversial thing on the internet right now.

This week it might be feed oil, but you know, when, when, uh, Dr. Andrew Huberman came out with this alcohol podcast, that was like shockwaves. And that’s what I teach at DEXA. And I don’t do it because I don’t want to. But I have students, they’re doing it just because there’s a lot of code that I teach them.

familiar with, because there’s a lot of these words that have not been used in a lot of the any of our programs. And so I’m giving them things that they can look

up and

say, oh, I heard about this. And so I just give them a framework and then that’s it. Alcohol. Like, is it an absolute no way? Is it a yes?

Is it, where does it fall in all of this and why, and what do you recommend?

Um, so once you get into cirrhosis, that would really be the, the main place where we would say absolutely no alcohol. There’s absolutely no way for the body to detoxify it. So we don’t have that ability. Um, obviously as, as you know, women, metabolize alcohol very differently than men do.

We get drunk earlier. Uh, we don’t detoxify as well as men do. So there’s kind of that factor.

Why is that?

Um, that has to do with the different enzymes that break down alcohol in those first few segments of breakdown after you’ve ingested it. So after it goes into the stomach, then goes into the bloodstream, then we have enzymes that break that down.

Women contain less of some of these enzymes than men do. Which is why we just can’t break it down as efficiently. Let’s use that word efficiently as men. Um, and we will become drunk much quicker than a man will. And then of course, there’s things like, um, you know, muscle mass and water content. Those are in play as well, in terms of comparing gender differences.

Um, but even if you’re getting into NASH, which is this second phase where you have more scar tissue, you know, if you’re someone who really, really loves to have a glass of wine every once in a while. That’s okay. You know that every once in a while is not what what really gets you and that’s true for most things with food It’s when we have it on a very regular basis.

So I will say Dr. Hananay and I met at Cleveland Clinic before he left to go to Mayo and I was able to shadow him and one of the most shocking things I saw was young people coming into the hospital Almost in cirrhosis simply from just too much binge drinking. And we’re not talking about someone binge drinking for years.

We’re talking about a college student. Wow. Doing it for a few weeks. So I think the binge drinking component is hugely detrimental to the liver and other organs, right? The brain, the heart. Um, but I think we have to look at a more personalized nutrition approach. Look at where we are in life. And what are some of our risk factors before we decide, okay, alcohol’s for me or alcohol is not.

I think what we were talking about offline, finding alcohol with less residual sugar, with less additives, less preservatives, I think that makes a huge difference. Um, a huge difference, but for the most part, if you love a glass of wine, you can pretty much have it throughout the course of, um, this disease until you get to cirrhosis.

But hopefully you’re listening to this, you won’t ever get to that place because you’re going to do all the other right things. And what we were talking about is our love of dry farm wine. Shout out to Todd White. And I still remember I grew up in Northern California and we literally used to leave high school because they didn’t back then they didn’t card and we would go drive to the wine country and wine taste.

So we Peel out on Fridays, wine taste all afternoon, go home and act like nothing happened. Um, and I also came out of that thinking that college kids drank Caymus and all these amazing silver oak, all these amazing wines. And then I got a reality check. Nope, it’s in a box. So, then I met Todd and he really explained to me about, you know, alcohol content, residual sugars, additives, what you can do in the United States.

DEXA, bio impedance, subscribetojj. com. Different. So my take on this is if, you know, you, you want to make sure you’re drinking something that’s clean, just like we’re focused on eating clean food, right?

Exactly. Right. I mean, there’s so many of my patients that are so like, I’m a clean eater and I’m doing all organic and then their wine choice is Disaster, even though it might be a high price point out of, you know, some great winery in California.

So I, I just think that’s, that’s definitely, um, uh, a place that I look at. I had a dinner party with a bunch of moms in my neighborhood last year, and I only served, um, the dry farm wines. And afterwards, Everyone was asking me questions about it. And I think a lot of people got subscriptions to it. So I think, um, I think once you, you, you try it out and I was like mentioning my favorites, the rosé.

So I like, I have that on the subscription all year round, not just summer,

winter and dead. You know, it’s what they say rosé all day. It’s rosé all year. There’s. There’s no, you can wear white in the winter and you can have drink rose in the winter. So there. What about, what about supplements? Because you talked about things that could be problematic.

Are there things that would be helpful here?

Yeah. Um, so we definitely know that vitamin D, most people are deficient in vitamin D unless they’re taking some sort of supplements. Um, at least my patients, right? So my patients, most of them are going to be coming from Cleveland, huge vitamin D deficiency. Uh, but even here in Denver, you know, if you’re outside and if the sun is shining, but you have sunscreen on, you’re going to block those UV rays.

Which are the best source of vitamin D. So vitamin D tends to be beneficial in terms of the inflammation process. Um, fish oil, so it doesn’t have to be, uh, derived from marine life if you’re a vegan, but fish oil tends to be something that we know can be really beneficial. Um, general, just general General multivitamins.

So just kind of looking at where are you missing things within your diets? And then the other place we look at, well, this is a lot more specific, but for my patient base, I have a ton of patients who have MTHFR deficiencies. I will look at methylated folate, for example, um, you know, maybe methylated all of their B vitamins.

So that’s a real specific factor, but again, um, Making sure you have that, that nice combination. And then the last thing that I typically would recommend to my patients. Based on a lot of other things going on, um, it’s probably a probiotic and maybe even a prebiotic, just depending on where their diet is, um, where their gut health might be, etc.

Speaking of gut health, the final question, because, you know, it’s when you look at some of the benefits, it’s definitely a benefit of taking this, is, um, on fatty liver and a deficiency is because of fatty liver. So I’m thinking of the GLP 1 agonists because I’ve, when I started to look, when I started to look at them and go, why are they working so well?

The next question is, well, are we deficient in this? And then you start to look and go, yes, insulin resistance, obesity, NAFLD are deficient in GLP 1. So, um, what are your thoughts with these? Um, I, I, um, peptide side, not the drug dosing side of this, but what is your, what are your thoughts on these types of peptides?

Yeah. Um, so it’s interesting, uh, if I think about my patient base today, I would say half of my patients are on some sort of GLP 1 agonist drug, half of them. Um, that’s, that’s a pretty big percentage. It’s bigger than I thought. And I was just looking at, you know, my kind of my, my list of patients the other day because I had a lot of patients coming to me because they wanted to see me because they wanted to get on these drugs.

So I think, um, we’re still early in terms of the weight loss perspective of it, right? Most of the data is just looking at blood sugar control, but I think for a lot of people it is, um, game changing. It really is. And, but the problem comes with, someone said this to me just yesterday. Well, actually she said it to her friend in front of me.

The friend wanted to lose weight. The other person was there and she said, you know what? Just get on, just get on Ozempic. You can eat whatever you want. You’re still going to lose weight.

Oh, no, no, no, no.

Fallacy in what we’re, what we’re kind of, Not addressing enough of, in my opinion. So while there is a lot of benefit I’m seeing in terms of helping people lose weight and then subsequently reduce their insulin resistance, uh, blood sugar, reduce cholesterol, all of those kind of, you know, factors for metabolic syndrome come down.

That’s all beneficial. But I think Peter Attia said this, so I don’t want to steal it, but he said it so well. He said that a lot of people, these people are becoming metabolically fatter because They’re just not getting enough protein or they’re just not getting what I call bang for their nutritional buck.

So I think if it’s something you want to consider for liver health, it’s something that could be beneficial. The caveat that no one thinks about with liver is that rapid weight loss often can lead to fatty liver disease. So there’s kind of the, the issue with GLP 1 and liver. If you really lose it very quickly, that is a risk factor for forming too much fat within the liver.

So I think you got to work, my, my bottom line, it took me way too long to say this, but you have to work with a professional. You can’t just, you know, Go any place and just get on these drugs and then just say, Oh my gosh, I can’t wait to lose weight. And by the way, you might have to stay on them for life.

All right. We just don’t know. We don’t know. Um, but for, for the people that are working with me, they’re working really hard alongside the drug. And I think those are the people that are going to find the most success.

In my perfect world, I would say if I was the benevolent dictator, if you were going to use this drug, you would have to absolutely be getting, you know, in body or DEXA scans.

You’d have to lift weights. You’d have to be prioritizing protein and eat like you’d have to do the things. And then you’d probably get to a point where you can taper it down, low dose. And you know, become very metabolically healthy. All of these things ultimately, like if you look at it, you know, you don’t lose weight to get healthy.

You have to get metabolically healthy so that your body can drop fat. It can hold on to and build muscle. Like, so if these things can help, great. But if you’re not doing the other changes, then they’re not, they’re not able to do what they’re, they need to do in the first place. So I’m right there with you now with your new book, you’re going to give, uh, our So I’m going to put that free chapter at jjvirgin.

com forward slash liver, because that will make it easy. Liver, they’ll remember. And this is the book that we’ve been talking about, Discovering Your Metabolic Type, How to Renew Your Liver for Life. That um, yeah. You’ll dig into all the different things you can do to support your liver. But I think the bigger important thing here is shine the light.

That I think that this is an area that we need to look at a lot more that I hadn’t, didn’t realize it was 25%. And again, I know we’re, we’re not really even talking about the people who are at risk and don’t show the actual numbers yet and that you really wouldn’t know, which is frightening.

Right. Yeah, it is.

Um, I always say like the liver packs, they’ll, they’ll take a beating. I mean, just take a beating before it gives you any sign. So we can’t, you know, we can’t take advantage of, of that, that quality that the liver has that it can take a lot. Um, we want to be able to help it before it takes too much.

It’s like, what is, was that a, Timex watch.

What was it that could take a, take a beating? Don’t treat your liver like a Timex watch.

Yes, that’s it. You can have that one because

you’re the, you’re the liver. I would say the liver queen, but you don’t want to be that because there’s that liver king. So that’s not a good thing. No. Well, thank you so much, Kristin.

And again, I’m putting that at jjvirgin. com forward slash liver.

Thank you so much.

Be sure to join me next time for more tools, tips, and techniques you can incorporate into everyday life to ensure you look and feel great and are built to last. Check me out on Instagram, Facebook, and my website, jjvirgin. com. And make sure to follow my podcast at subscribetojj. com so you don’t miss a single one.

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Hey, JJ here. And just a reminder that the Well Beyond 40 podcast offers health, wellness, fitness, and nutritional information that’s designed for educational and entertainment purposes only. You should not rely on this information as a substitute for, nor does it replace professional medical advice, diagnosis, or treatment.

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