Health for life

An international team of researchers led by Duke-NUS Graduate Medical School (Duke-NUS) and the Duke University School of Medicine suggest that increased caffeine intake may reduce fatty liver in people with non-alcoholic fatty liver disease (NAFLD).

Worldwide, 70 percent of people diagnosed with diabetes and obesity have NAFLD, the major cause of fatty liver not due to excessive alcohol consumption. It is estimated that 30 percent of adults in the United States have this condition, and its prevalence is rising in Singapore. There are no effective treatments for NAFLD except diet and exercise.

Using cell culture and mouse models, the study authors - led by Paul Yen, M.D., associate professor and research fellow, and Rohit Sinha, Ph.D of the Duke-NUS Graduate Medical School’s Cardiovascular and Metabolic Disorders Program in Singapore - observed that caffeine stimulates the metabolization of lipids stored in liver cells and decreased the fatty liver of mice that were fed a high-fat diet. These findings suggest that consuming the equivalent caffeine intake of four cups of coffee or tea a day may be beneficial in preventing and protecting against the progression of NAFLD in humans.

The findings will be published in the September issue of the journal Hepatology.

The team said this research could lead to the development of caffeine-like drugs that do not have the usual side effects related to caffeine, but retain its therapeutic effects on the liver. It could serve as a starting point for studies on the full benefits of caffeine and related therapeutics in humans.

As you may have read in this recent edition of Ask the Internet, I recently concluded thirteen years of vegetarianism. (The short version is that, back when I was fifteen, I tried going veg just to see if I could, and stuck with it largely out of stubbornness/determination. I later – like Queen Elizabeth & the Church of England – added some principles, but my belief that eating animals isnt wrong, but making them suffer is, is still compatible with conscientious meat eating. Also, I dont eat a lot of grains, so I was really, really bored.)

And lo, adding an entire food supergroup back into one’s options is fun! And tasty. It’s been a long time – I guess since I fell in love with farmers markets and cooking itself three or four years ago – since I’ve had such exciting culinary adventures. I roasted a whole chicken! I made stock from its carcass! I am developing an addiction to hamburgers! Etc.

I’m also reconnecting with a lot of foods from my (distant, almost-half-a-lifetime-ago) past. Rotisserie chicken is one of a very few meat-foods that never stopped making my vegetarian mouth water, and sure enough, it is amaaaaaaazing. I would take it over bacon any day.

This chopped liver comes out of both of those impulses – the adventures and the amazing foods from way back when. (Oh, and my new friendship with the small butcher’s shop half a block from my apartment.) Who am I to be afraid of some organs, I who have ventured into the unknown recesses of greenmarket farm stands, I who have taken home the ugly, strange, and cheap vegetables of every season? Also, dude, organs are CHEAP.

I bought my pound of chicken livers from Bob and Julio down the street from me – they sell organic chickens (among many other things, like homemade lasagna), and I guess not everyone wants every part of the bird? Which is bananas, because these things are tasty and super good for you – howsabout some vitamin A, a bunch of B vitamins, folic acid, iron, copper, and CoQ10, which helps your heart do its thing, along with plenty of protein?

And then there is the flashback factor. Specifically, flashbacks to my Grandma Martha’s studio apartment on Long Island, hanging out before a holiday dinner, tiny Jaime with her tiny cousins and sister in tiny party dresses, scooping rich chopped liver onto crackers or, given the season, little matzah squares. Were we too young and caree to know that livers might be squicky? Or would we not even entertain that thought because the stuff was so darn good?

This recipe comes not from a Jewish Grandma but from my friend’s decidedly non-Jewish own mother, a lovelier and WASPier lady you never shall meet. But somewhere in the mists of history her great-greats and mine lived in adjacent cottages in a Polish village, and as far as I can tell across the gulf of, like, twenty years, this chopped liver recipe yields a product identical in taste to Grandma’s.

(That means it’s delicious.)

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If this seems neato, you will also appreciate:

• Guacamole-Bean Dip Mashup
• Sweet Potato Kugel
• White Bean Dip

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Chopped Liver
(makes 16 2-Tbsp servings)


1 lb chicken livers (thawed if they came frozen)
3 Tbs butter
½ onion, chopped (1/2 to ¾ cup)
A few dashes of Worcestershire sauce
2 Tbsp mayonnaise (sorry Kris!)
Juice of half a lemon (or to taste)

1. Melt the butter in a sauté man over medium-high heat. Add onions and a few dashes of Worcestershire sauce, and sauté until onions start to soften.

2. Add chicken livers and sauté until they are cooked through (no pink), about 10-15 minutes.

3. Pour/scrape all of that into a food processor. Add mayonnaise. Pulse until it’s the consistency you like – the worst that’ll happen if you overdo it is you’ll get a classy-as-heck mousse – adding a few squeezes of lemon juice to taste.

Approximate Calories, Fat, Fiber, Protein, and Price Per Serving
82.6 calories, 5.4g fat, 0.1g fiber, 7g protein, $0.23

Calculations
1 lb chicken livers: 758 calories, 29.5g fat, 0g fiber, 111g protein, $2.50
3 Tbs butter: 305 calories, 34.6g fat, 0g fiber, 0.4g protein, $0.48
½ onion: 48 calories, 0.1g fat, 2g fiber, 1.3g protein, $0.30
A few dashes of Worcestershire sauce: 3 calories, 0g fat, 0g fiber, 0g protein, $0.05
2 Tbsp mayonnaise: 200 calories, 22g fat, 0g fiber, 0g protein, $0.20
Juice of half a lemon: 8 calories, 0g fat, 0.1g fiber, 0.1g protein, $0.13
TOTAL: 1322 calories, 86.2g fat, 2.1g fiber, 112.8g protein, $3.66
PER SERVING (TOTAL/16): 82.6 calories, 5.4g fat, 0.1g fiber, 7g protein, $0.23

As many as 1in 3 Americans are living with a ticking bomb known as nonalcoholic fatty liver disease (NAFLD). The condition is virtually symptomless until the liver becomes inflamed or scarred from decades of dietary abuse. While a small percentage of cases are attributable to a genetic failure to metabolize fats properly, the vast majority of NAFLD is caused by poor dietary choices that increase dangerous blood fat levels.

Aspirin use is associated with a decreased risk of developing hepatocellular carcinoma and death from chronic liver disease (CLD), according to a study published November 28 in the Journal of the National Cancer Institute.

Hepatocellular carcinoma (HCC), the most common type of primary liver cancer, occurs mainly among patients with CLD. Previous reports have linked chronic inflammation due to CLD to cellular processes that could promote carcinogenesis. Because of their anti-inflammatory properties and widespread use to prevent cardiovascular and cerebrovascular disease, nonsteroidal anti-inflammatory drugs (NSAIDs) including aspirin and nonaspirin NSAIDs are being investigated as cancer chemopreventive agents. NSAIDs have been shown to have a beneficial effect in observational studies and clinical trials on risk of some cancers. However, the relationship between NSAID use and risk of HCC and death from CLD is unclear.

To investigate this relationship, Vikrant V. Sahasrabuddhe, M.B.B.S., Dr.P.H, from the Division of Cancer Epidemiology and Genetics at the National Cancer Institute, and colleagues, performed an observational study of 300,504 men and women aged 50 to 71 years enrolled in the National Institutes of Health-AARP Diet and Health Study who reported their aspirin and nonaspirin NSAID use and were followed-up for 10-12 years. The researchers linked the self-reported use of aspirin and nonaspirin NSAIDs to registry data on diagnoses of 250 cases of HCC and 428 deaths due to CLD to perform their study.

The researchers found that the use of NSAIDs was associated with a reduced risk of HCC and a reduced risk of death from CLD compared to non-users. Study participants who used aspirin had a 41% reduced risk of HCC and a 45% reduced risk of death from CLD, whereas those who used non-aspirin NSAIDs experienced a 26% reduced risk of CLD mortality but no reduced risk of HCC. The authors conclude that "these associations are prominent with the use of aspirin, and if confirmed, might open new vistas for chemoprevention of HCC and CLD."

In an accompanying editorial, Isra G. Levy, M.B., BCh., MSc., and Carolyn P. Pim, M.D., both from the Department of Epidemiology and Community Medicine at the University of Ottawa in Canada discuss how the known causes of chronic liver disease and primary liver cancer are hepatitis B and C virus infections, alcohol use, and a link between obesity and diabetes has been suggested. "We already have cheap, readily available interventions," such as vaccines for hepatitis B and C virus but "effective strategies for reduction of HBV and HCV are not always available or fully applied." Also, alcohol abuse and obesity are complex and multifactorial challenges that require interventions at the individual and system levels." They conclude that although we should study the potential of new chemopreventive strategies such as NSAID use, we should also continue to focus on improving the established practices and interventions.