Chapter 3

Healthy liver, healthy skin

The liver is the second largest organ in the body (after the skin) and it performs a range of important body functions which can greatly affect the appearance of your skin. Your liver filters more than 1 1/2 litres (approximately 3 pints) of blood per minute and receives a dual blood supply: one containing freshly oxygenated blood from the heart, and the other supplying blood from the stomach and intestines, rich with newly absorbed nutrients from your diet, as well as toxins, microbes, drugs and hormones. The liver plays a vital role in detoxifying these substances so the blood remains healthy and it assists with supplying the body with nutrients for beautiful skin.

Fatty liver, where your liver accumulates fat and enlarges, can occur in eczema patients. According to research by Dr Kimata from the Department of Pediatrics and Allergy at the Ujitakeda Hospital in Kyoto (Japan), more than 17 per cent of non-obese children with eczema also have fatty liver. This result is significantly high compared to 3.2 per cent of non-atopic children, 3.7 per cent of hay fever sufferers and 5 per cent of asthma sufferers who have fatty liver. Dr Kimata’s research showed that atopic eczema is also associated with fat malabsorption, nutritional deficiencies and eating trans fats, all of which can affect liver health.

Detoxification, a brief history

When a medical drug is prescribed to a patient, what happens to that drug once it enters the body? Over the centuries, the study of detoxification has been undertaken by scientists to help answer this question. It was back in the 1700s that scientists first hypothesised that after a toxin was consumed it was transformed into a water-soluble substance and removed from the body via the urine. And in 1842, in a detoxification experiment, Keller proved this theory, using an amino acid supplement called glycine. In 1947, in Detoxification Mechanisms, R.T. Williams defined for the first time the two separate phases of detoxification. Today the scientific research on liver detoxification of toxins is an essential part of drug safety testing done by pharmaceutical companies to reduce the risk of people overdosing while taking prescription drugs. This research on liver detoxification can also help you to be eczeme-free.

Phase 1 liver detoxification (and why it can make your skin worse)

Food and chemical sensitivities can indicate that your Phase 1 and/or Phase 2 detoxification pathways are imbalanced. Most drugs and food chemicals are processed through a Phase 1 reaction involving cytochrome P450 enzymes. Their role is to make toxic substances water-soluble so they can be further processed during Phase 2 of liver detoxification. Williams found that in some cases during Phase 1 liver detoxification, chemicals could become more toxic than the original substances (he thought the term detoxification could be misleading in these instances). The findings were of great importance because before this time therapeutic agents (such as pharmaceutical drugs) were being prescribed without doctors being aware of the metabolic fate of the drug once a patient had swallowed it.[1] Malfunctioning Phase 1 or Phase 2 liver detoxification reactions have been implicated in adverse reactions to drugs.[2]

Phase 1 can greatly increase free radical production, which can damage DNA and cause genetic mutations if your diet is not rich in antioxidants. When Phase 1 detoxification is high you can experience a worsening of symptoms and you may feel lethargic, and it is around this time that antihistamine drugs are often prescribed. Antihistamine medications can make you temporarily feel better as they can mask the symptoms, but there is a catch: antihistamine medications temporarily block Phase 1 liver detoxification. This is not ideal as blocking liver detoxification reactions creates an increased workload for your kidneys and your skin as both are left with the task of chemical waste elimination.

While antihistamine drugs can be useful in emergencies, there are natural alternatives to antihistamine drugs which can be used on a daily basis. As mentioned in Chapter 2, vitamin C, vitamin B6 and quercetin are natural antihistamines that can prevent histamine toxicity. You can also help to minimise the potentially damaging effects of Phase 1 by consuming the dietary antioxidants vitamin C, vitamin E, quercetin and alpha-lipoic acid.

Phase 1 blockers

Phase 1 detoxification is reduced by antihistamine drugs, benzodiazepines (anti-anxiety drugs), ketoconazole (an anti-fungal drug), fluconazole (Diflucan®, an anti-fungal drug), erythromycin (an antibiotic), acid blockers (anti-ulcer medications), grapefruit (it contains a compound called naringenin which reduces cytochrome P450 activity) and the liver-protective herb St Mary’s Thistle. While short-term blockage of Phase 1 can be useful to temporarily relieve symptoms, long-term use of these substances can be problematic as reduced liver detoxification function can burden the kidneys.

Phase 2 liver detoxification (and why it can prevent chemical sensitivity)

Instead of blocking Phase 1 detoxification, there is a much healthier solution: boost Phase 2 detoxification. In Phase 2, a toxin that has been partly processed in Phase 1, joins with a substance, such as an amino acid, so it can be safely removed via the urine or bile. For example, eczema sufferers are often sensitive to salicylates which can worsen eczema symptoms. During Phase 2 detoxification, between 55 and 60 per cent of dietary salicylates are joined with the amino acid glycine, allowing salicylates to be removed from the body (this is one of the reasons why glycine is effective at reducing eczema symptoms). Without this glycine-joining step, salicylates can re-enter the bloodstream and accumulate, leading to salicylate sensitivity. Preservatives, toxic heavy metals, histamines, amines and other chemicals, both natural and artificial, are also processed during Phase 2 liver detoxification.

The following questionnaire highlights other symptoms that can indicate your liver detoxification function needs dietary support. This questionnaire is suitable for adults and children. If you have a baby with eczema, you can use this questionnaire to assess maternal diet (the diet of the mother during pregnancy and/or the diet of both parents before conception).

Recommendations

• Your diet can help to reverse or prevent fatty liver: limit or avoid drinking alcohol, maintain a healthy weight, reduce fat intake and add lecithin to your diet. Lecithin contains choline, which breaks down fats so they don’t accumulate in the liver (read ‘Lecithin granules’).

• Avoid trans fats and prevent or reverse nutritional deficiencies with supplementation.

• Take liver detoxification nutrients to promote healthy liver function.

Questionnaire 4: Liver detoxification

Circle any symptom/s you experience on a regular basis and then circle the corresponding answer (YES/SOMETIMES/NO) that best describes the frequency of that symptom or collection of symptoms. YES = weekly or daily; SOMETIMES = monthly or occasionally; NO = never or rarely.

Do you have...

YES/SOMETIMES/NO

YES/SOMETIMES/NO

YES/SOMETIMES/NO

YES/SOMETIMES/NO

YES/SOMETIMES/NO

YES/SOMETIMES/NO

YES/SOMETIMES/NO

YES/SOMETIMES/NO

YES/SOMETIMES/NO

YES/SOMETIMES/NO

YES/SOMETIMES/NO

YES/SOMETIMES/NO

YES/SOMETIMES/NO

YES/UNKNOWN/NO

YES/UNKNOWN/NO

YES/UNKNOWN/NO

YES/SOMETIMES/NO

YES/SOMETIMES/NO

YES/SOMETIMES/NO

YES/SOMETIMES/NO

YES/SOMETIMES/NO

YES/SOMETIMES/NO

YES/UNKNOWN/NO

YES/UNKNOWN/NO

YES/UNKNOWN/NO

Analysis of Questionnaire 4

If you have fewer than two symptoms, then taking supplements would be optional (but highly recommended) while on the Eczema Diet. If you answered yes to three or more questions, you should take supplements while on the Eczema Diet. There is a test that measures how well your Phase 1 and Phase 2 liver detoxification reactions are working (listed in ‘Resources’). On saying this, if you have eczema, it is a sign that Phase 1 and Phase 2 are imbalanced and nutritional support is required.

Your liver is the body’s main chemical processing organ to remove chemicals, histamines and toxins. No drug can ever replace the nutrients required for liver detoxification of these substances. A healthy diet and antioxidants support liver function. What are the specific nutrients needed for liver detoxification of chemicals? Here is the list.

Table 4: Nutrients for liver detoxification

Sensitivities/adverse reactions to:

Phase 2 liver detoxification pathway

Nutrients and foods required

amines (e.g. from meat, frozen fish, deli meats, nitrosamines)glucuronidation (metabolises 33% of drugs such as paracetamol and NSAIDs, and deactivates sex hormones especially oestrogens, food oestrogens)magnesium, zinc, B group vitamins, ground turmeric (spice), essential fatty acids (omega-3) (+reduce dietary amines)
fungal toxins
pickled foods
high oestrogen
histaminesother mechanismsvitamin C, vitamin B6, quercetin, taurine, methionine, cysteine (possibly magnesium and CoEnzyme Q10) (may need to reduce calcium intake)
histamine toxicity
(also see sulfation pathway)
pesticide exposureglutathionation (anti-ageing if it works well)brussels sprouts, cabbage (and other cruciferous veg.), glycine, glutamine, cysteine, methionine, vitamin B2, vitamin B6, vitamin C, selenium, glutathione (+avoid toxic heavy metals)
toxic heavy metals
penicillin
alcohol
paracetamol
salicylates (salicylic acids, aspirin, teething gel)glycinationglycine, magnesium, vitamin B6, taurine (+reduce dietary salicylates)
MSG (tomato, Chinese takeaway, flavour enhanced savoury foods e.g. chips/crisps)
sulfites (additives in wine, vinegar)
tartrazine (yellow food colouring, 102)
preservatives (210–213)
food histamines sulfitessulfationmolybdenum (co-factor for sulphur oxidase), vitamin B12, vitamin B6, folic acid/folate, sulphur-containing foods e.g. garlic, onion and cabbage (avoid additives 220–228, preserved meats, deli meats, pickled foods, vinegar, dried fruits, alcohol esp. wine)

Recommendations

• Consume the nutrients required for Phase 2 liver detoxification function (refer to Table 4).

• Consume the antioxidants vitamin C, vitamin E, quercetin and alpha-lipoic acid.

• Reduce intake of salicylates, amines and histamine-rich foods as they create a heavy workload for your liver, kidneys and skin.

• Refer to Chapter 6, ‘Eczema supplements’.

Acid–alkaline balance

There is another way to help your liver detoxify problematic chemicals: by consuming foods that have an alkalising effect in the body. Keeping your diet in acid–alkaline balance promotes healthy blood and strong bones and it gives your skin a healthy glow. Do you remember learning about acids and bases at school? Your food does more than stop the hunger pangs and boost your energy; once your meal is digested it releases either an acid or an alkaline base into your bloodstream. Your blood needs to be slightly alkaline at a pH between 7.35 and 7.45 to be healthy and your body will do all it can to keep the blood within these limits (more on this in a moment). pH means ‘potential of hydrogen’ and on the pH scale 0 is strongly acidic, 7 is neutral and up to 14 is strongly alkaline.[3]

Alkalisation, a brief history

Alkalisation is the term used for the administration of highly alkalising foods or supplements for a short period of time, such as during a ‘detox’. In the seventeenth century the first medical experiments regarding the body’s balance of acids and alkalis were conducted.[4] Doctors also used alkalisation to treat a range of health problems, including gout. In the mid 1900s the body’s acid–alkaline balance became popular for its role in the detoxification of chemicals.[5] Salicylate sensitivity is the most common chemical sensitivity that eczema sufferers have, and back in the 1950s alkalisation was used as an effective treatment for eliminating salicylates from the body.[6][7] In 1955, according to Gutman in the Journal of Clinical Investigation, medical staff at hospitals used alkalisation to treat salicylate poisoning from accidental aspirin overdose*.[8] Alkalisation also supports detoxification of chemicals such as preservatives, amines, food colourings and MSG. (*When the urine pH exceeds an alkaline reading of 7.5, more salicylates are eliminated than reabsorbed, and three times the amount of salicylates are excreted via the urine.)

The Eczema Diet includes a 3-day Alkalising Cleanse, which is a liver detox and gastrointestinal cleansing program designed specifically for adults with eczema and chemical sensitivities. While this is a nutritious alkalisation program for short-term use, for everyday health your daily diet needs to have acid–alkaline balance. While some of the recipes in the Eczema Diet are highly alkalising, such as Tarzan Juice, Healthy Skin Juice and Alkaline Bomb Salad, most of the recipes are classed as acid–alkaline balanced because they contain both alkalising and healthy acid-producing ingredients so they meet your body’s nutritional needs for protein, fibre, minerals, essential fatty acids and so on.

The following is a brief list of alkalising, neutral and acidifying foods; for the full list refer to Eczema-safe food charts.

Alkalising

vegetables

herbs

all sprouts and sprouted grains

rice malt syrup

apple cider vinegar

a few fruits such as banana, lemon and lime

pure spring water (not carbonated)

Neutral

filtered water

Acidifying

tap water (non-filtered)

protein foods, meat, seafood and beans/legumes

all grains (non-sprouted)

corn

peanuts

most fruits

sugar

all sweeteners (except rice malt syrup)

artificial additives

soft drink (sodas)

alcohol

caffeine products

most vinegars (except apple cider vinegar)

Acidifying diets

The standard American or western diet is unbalanced as it largely consists of acid-producing ingredients. Modern diets are generally high in protein and refined grains and low in alkalising vegetables and it’s well documented that these diets cause chronic, low-grade metabolic acidosis that worsens with age as kidney function declines.[9][10][11][12] What happens when your daily diet is constantly acid-producing? Let’s say you consume a beef burger containing red meat, bacon, tomato sauce and lettuce, and you wash it down with a glass of Diet Coke or a cup of coffee. Once digested, this meal floods acids into your bloodstream and your body responds by releasing calcium (which is alkaline) into your bloodstream. This usually ensures the blood’s pH returns to alkaline and it is an important process that keeps you alive.

Is the problem solved? Not exactly. Your meal has depleted some of your calcium stores, and where does your body get calcium from? Calcium can be taken from the body’s reserves and leached from your bones. Excess acids can be excreted via the skin, lungs and kidneys, which can burden these systems. Acids can be stored in your tissues, which can make the skin itchy. Research shows the consumption of western acidifying diets causes weakened bones, muscle wasting, kidney stone formation and damage to the kidneys.[13][14][15]

How to monitor your pH

Your pH changes throughout the day as each meal and drink influences your blood, urine, saliva and tissue pH readings. You can test your urine and saliva pH at home, several times a day if you wish, using a pH test kit containing litmus paper (these test kits are available from some health food shops and online). The saliva test measures your body tissue pH and it should be done about 30 minutes after eating or drinking. When you test your urine pH (this is the preferred test) the amount of acids your kidneys are excreting is measured. It is useful to monitor your pH several times a day, for at least two weeks, so you can see for yourself how your diet affects your pH (also keep in mind that stress can cause an acid reading). If you note that you are particularly acidic, you can eat or drink one of the double star rated recipes to help restore acid–alkaline balance.

The following questionnaire is suitable for adults and children. If you have a baby with eczema, you can use this questionnaire to assess maternal diet (the diet of the mother during pregnancy and/or the diet of both parents before conception).

Questionnaire 5: Acid–alkaline balance

Circle any foods and beverages you consume on a regular basis (or any symptom) and/or circle the corresponding answer (YES/SOMETIMES/NO). YES = weekly or daily; SOMETIMES = monthly or occasionally; NO = never.

Do you...

YES/SOMETIMES/NO

YES/SOMETIMES/NO

YES/SOMETIMES/NO

YES/SOMETIMES/NO

YES/SOMETIMES/NO

YES/SOMETIMES/NO

YES/SOMETIMES/NO

YES/SOMETIMES/NO

YES/SOMETIMES/NO

YES/SOMETIMES/NO

YES/SOMETIMES/NO

YES/SOMETIMES/NO

YES/SOMETIMES/NO

YES/SOMETIMES/NO

YES/SOMETIMES/NO

YES/SOMETIMES/NO

YES/SOMETIMES/NO

YES/SOMETIMES/NO

YES/SOMETIMES/NO

YES/SOMETIMES/NO

YES/SOMETIMES/NO

YES/SOMETIMES/NO

Analysis of Questionnaire 5

If you answered yes to three or more questions, your diet is likely to be acidifying and contributing to your eczema. However, if you drink a cup of coffee or tea, or a glass of alcohol or soft drink every day your pH reading is likely to be highly acidic.

Please keep in mind that it is not necessary, or recommended, to follow a 100 per cent alkalising diet for more than a week at a time. There are many acid-forming foods, such as legumes and wholegrains, which are important for healthy skin, and if you like eating meat you can enjoy it in moderation (with the fat carefully cut off or drained). On saying this, if you can avoid red meat and favour legumes, skinless chicken and eczema-safe varieties of fish this would be ideal. Your aim is to eat a healthy, balanced diet that contains both alkaline and nutritious acid-forming foods.

Balanced meals

Here are some examples of lunch box items that are acidifying and rich in chemicals that can worsen eczema symptoms:

Lunch box 1: wholemeal sandwich using bread to suit your allergies, strawberries, additive-free muesli (granola) bar and organic fruit yoghurt.

Why is this lunch box a bad choice? This lunch box seems healthy but every item is acid-producing, and nothing is alkalising, and it could cause a flare-up thanks to the natural chemicals present in the fruits.

Lunch box 2: ham sandwich on white bread with margarine, orange, cheese, fruit-flavoured yoghurt, cake or biscuits and chocolate milk.

Why is this lunch box a bad choice? Every item is strongly acid-producing and rich in irritating chemicals, so this lunch box would cause your eczema to flare up (and it could be severe).

Here are some examples of eczema-safe lunch boxes:

Lunch box 3: wholemeal salad sandwich using bread to suit your allergies, iceberg lettuce, grated carrot and mung bean sprouts, pear muffin (homemade), plain rice crackers and baked banana chips (homemade), celery sticks and filtered water.

Why is this lunch box a good choice? Celery and salad ingredients are alkalising, sprouts are strongly alkalising (bonus points for this item), the other foods are healthy acid-producing items and filtered water is neutral.

Lunch box 4: free-range chicken and lettuce wrap (using spelt lavash bread/flat bread), banana, carrot sticks, brown rice crackers and filtered water.

Why is this lunch box a good choice? Carrot, lettuce and banana are alkalising and the chicken, bread and crackers are acid-forming but they are also eczema-safe and supply nutrients for a balanced diet.

Recommendations

• Drink a glass of Tarzan Juice, Healthy Skin Juice or eat Alkaline Bomb Salad daily as they are strongly alkalising.

• Avoid pork with crackling, fatty beef meals and alcohol as they are highly acid-forming.

• The Eczema Diet points system will help you achieve acid–alkaline balance: your daily aim is to consume ingredients that tally to five stars or more (this is coming up shortly, see the Eczema Diet points system.)

• For a list of alkalising and acidifying foods and beverages refer to Eczema-safe food charts: Stage 1.

The past 60 years of clinical research on eczema, conducted in university laboratories and by scientists, doctors and professors from all over the world, have been instrumental in showing us how our diets are intrinsically linked to skin health and the appearance of eczema. If we are to decrease the worldwide statistics of eczema and bring much-needed relief to those who are suffering, diet education is the key. Your diet not only alters how well some of your genes function, it can affect the genes you pass on to your children and their children’s children. The good news is, while some genetic abnormalities are permanent, eczema is a skin disease that comes and goes, and you can prevent eczema by lovingly feeding your body to ensure it receives all the nutrients it needs for beautiful skin.