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Alanine amino transference, or ALT, is a liver enzyme made in the cytosol of liver cells. This enzyme plays an important role in amino acid metabolism and gluconeogenesis. While this enzyme is primarily found in the liver, it is also found in skeletal muscle. While these enzymes are typically found in the blood at low levels, any compromise of liver or muscle cell integrity can cause an increase in ALT concentrations. (source, source, source)
Low blood ALT levels can be influenced by physiological factors related to liver and muscle health and function. From a nutritional perspective, deficiencies in certain vitamins and minerals that are essential for liver function can also negatively affect levels. (source)
Prioritize foods high in vitamin B6: ALT concentrations have been positively associated with vitamin B6. (source) Pyridoxal-5-phosphate (PLP), a form of vitamin B6, is a necessary cofactor of ALT. Thus, an increase in vitamin B6 will increase ALT activity. (source) Recommendation: Consume at least two servings a day of high vitamin B6 foods.
One serving examples: Salmon (3 oz), Chicken Breast (3.5 oz), Potatoes (mashed skin on) (1 cup), Yellowfin Tuna (3 oz), Chickpeas (1 cup)
Resistance training: Resistance training has been shown to increase ALT levels. (source) ALT concentrations have been positively associated with muscle mass. (source) Resistance training helps to increase muscle mass, positively affecting ALT concentrations. Recommendation: Follow a structured resistance training program with moderate to heavy loads at least two times a week. The final set of each exercise should be taken within two repetitions of failure.
Supplement with a vitamin B Complex: ALT concentrations are positively associated with vitamin B6 supplementation. (source) Pyridoxal-5-phosphate (PLP), a form of vitamin B6, is a necessary cofactor of ALT. Thus, an increase in vitamin B6 will increase ALT activity. (source) Recommendation: Supplement with a vitamin B complex that has at least 50% of daily recommendations for each B vitamin.
Commonly, high blood ALT levels can be linked to physiological factors affecting liver and muscle health. ALT is found primarily in liver cells and released into the bloodstream when liver cells are damaged or inflamed. ALT is also found in skeletal muscle. When skeletal muscle is damaged, ALT is released into the blood, increasing concentrations. Further, extreme exertion and nutritional habits that strain the liver, such as excessive alcohol intake, can contribute to elevated ALT levels. (source, source, source)
Limit sugar intake: Sugar intake has been shown to increase ALT concentrations. (source) Consuming excess sugar, particularly fructose, has been associated with increased liver fat accumulation, decreasing liver efficiency and negatively affecting function. (source) Decreasing sugar intake can help relieve liver stress and decrease ALT concentrations. Recommendation: Monitor and limit excess added sugar intake.
Incorporate green tea: Consuming green tea extract has been shown to lower ALT. (source) EGCG, or epigallocatechin gallate, the main catechin in green tea, has been shown to reduce liver oxidation stress and inflammatory responses and regulate energy balance. (source, source) Reducing liver stress helps to decrease ALT concentrations.Recommendation: Drink at least one 8 fl oz cup of green tea daily.
Train regularly: Both resistance training and aerobic training have been shown to positively affect ALT concentrations. (source). Exercise training increases insulin sensitivity and decreases markers of inflammation, as well as fatty acids in the liver, which has a direct impact on ALT levels. (source) Recommendation: Follow a structured training program that exerts your body through multiple resistance and aerobic intensities. This includes a structured aerobic program that ensures at least 150 minutes of moderate intensity (50 to 70% max heart rate) or 75 minutes of high intensity (75% max heart rate or greater) a week and a structured resistance training program with moderate to heavy loads at least twice a week for resistance training. The final set of each resistance training exercise should be taken within two repetitions of failure.
Maintain an athletic body composition: As body fat increases, so do ALT levels. (source, source) Body fat is associated with increased cholesterol levels, which is also associated with increased ALT levels. (source, source) Cholesterol is metabolized in the liver. (source) These findings suggest that body fat increases liver stress through increased cholesterol metabolism. Reducing body fat can positively affect cholesterol levels and decrease stress on the liver, leading to improved ALT concentrations. (source) Recommendation: Maintain a high-performance diet and exercise program that supports a body composition of no more than 15% body fat for men and 20% for women.
Avoid alcohol: Alcohol consumption has been shown to negatively affect ALT concentrations. (source) Chronic overuse of alcohol causes elevated ALT levels due to increased inflammation and oxidative stress from the breakdown of alcohol. (source) Reducing alcohol intake helps to decrease liver stress and its associated biomarkers, like ALT. Recommendation: Monitor alcohol intake. Try to limit consumption to one or two drinks daily, with the goal of less than three per week.
Supplement with green tea extract: Consuming green tea extract has been shown to lower ALT. (source) EGCG, or epigallocatechin gallate, the main catechin in green tea, has been shown to reduce liver oxidation stress and inflammatory responses and regulate energy balance. (source, source) Reducing liver stress helps to decrease ALT concentrations. Recommendation: Supplement with at least 500 mg of green tea extract.
