A positive diagnosis of alpha-1 antitrypsin deficiency represents an opportunity to take concrete steps to avoid risk factors, limit symptoms, or slow the progression of symptoms you may already be experiencing. Proper care by you and your doctors can have significant positive effects for the rest of your life. Not everyone with A1AD develops symptoms and even if you have, proper treatment by your doctors and lifestyle changes you can make, will significantly increase the quality and quantity of your life. Similarly, even if you have developed symptoms, appropriate medication, treatments, exercise, and lifestyle changes, can go a long way toward ensuring you live a long and happy life.
Your doctor or consultant is the best person to provide information about the medications and treatment available for you now, and to look after you in medical terms, but there are important steps you can take to help take care of yourself.
Be involved in your healthcare
It is important that you develop a good relationship with your doctors and consultants. Things are improving, but unfortunately, many are still not very knowledgeable about A1AD, so they may not always have the answers you are looking for. If that is the case, it would be advisable to ask for a referral to one of the NHS alpha-1 clinics.
One of the first things you need to know is exactly which A1AD genes you have, without that knowledge it is difficult to know how the diagnosis will affect either you or your family.
If you are symptom free, you have a good chance of remaining so by making small but important changes in the way you live.
Smoking
Cigarette smoke is the greatest risk factor for developing life threatening symptoms. If you are a smoker, the single most important thing you can do to help yourself is to give up immediately. Second hand smoke should also be avoided wherever possible.
Lung Irritants
Avoid other lung irritants, especially environmental pollutants used in agriculture, mineral dust, gas and fumes.
Exercise and Nutrition
Regular exercise and good nutrition are beneficial in maintaining lung health, as is maintenance of the fat-soluble vitamins (A, D, E and K).
Eating a well balanced diet should provide good amounts of these fat soluble vitamins, although extra supplements may be advised by your doctor.
Remember, Alpha-1 is also a liver condition and fat soluble vitamins are stored in the liver and fatty tissues. Large doses of some vitamins can harm the liver.
Even if your symptoms are limited to respiratory problems, you also need to take care of your liver in order to minimize the possibility of liver disease.
Avoid things that may cause extra harm to the liver such as an excess of alcohol, street drugs, some over the counter drugs and certain prescribed medications.
There is no specific treatment for Alpha-1 associated liver disease. Eating a well balanced, healthy diet that contains plenty of fruits and vegetables, is essential to provide your liver with the antioxidantsthat it needs to protect against inflammation.
Eating well with Alpha-1 Antitrypsin Deficiency
Taking steps to eat a healthy, balanced diet is one of the most important and effective ways Alphas can support their health. But what specifically does a good diet with Alpha-1 Antitrypsin Deficiency (AATD) look like?
While specific research on diet with AATD is very limited, we do know that the diseases associated with AATD are driven by chronic inflammation and oxidative stress. This is a condition where the body’s natural antioxidant defences are overwhelmed by excess harmful chemicals (called free radicals) produced by ongoing disease processes. The good news is that there’s a wealth of high- quality, recent research on how diet influences inflammation in more common conditions where inflammation plays a key role — including heart disease, diabetes, cancer, and dementia. We can draw from this to shape recommendations likely to benefit people living with AATD.
This isn’t about rigid, joyless dietary rules. Instead, it’s about adopting a lifelong, flexible approach to eating that many Alphas report not only reduces symptoms but also helps with weight control, boosts energy and mood, and — crucially — is satisfying and enjoyable.
The Core Principles of a Healthy AATD
Diet Based on current evidence, two broad principles should underpin a healthy diet for people with AATD:
Minimise Ultra-Processed Foods and Added Sugar
Ultra-processed foods (UPFs) are products typically packaged and containing multiple artificial ingredients you wouldn’t find in a normal kitchen. They’re often high in refined carbohydrates, added sugars, unhealthy fats, preservatives, and flavour enhancers.
Multiple studies have shown these foods promote chronic, low-grade inflammation by causing frequent spikes in blood sugar and fats, disrupting the gut microbiome, and increasing oxidative stress throughout the body. Reducing these as much as possible is a powerful step towards lowering inflammation.
Focus on a Mediterranean-style diet, rich in minimally processed whole foods, predominantly from plants
A Mediterranean-style diet — centred around a wide variety of colourful plant foods, healthy fats, and quality protein sources — is one of the most researched and beneficial dietary patterns for chronic inflammatory diseases.
Why is it so effective?
A. It’s highly nutrient-dense
It supplies a rich, balanced mix of essential vitamins, minerals, and plant compounds (phytonutrients) that work together to support the body’s repair systems. This is especially important in AATD, where disease processes place extra demands on the body. Many of these beneficial compounds — particularly polyphenols, found in brightly coloured fruits, vegetables, herbs, and spices — have proven anti-inflammatory and antioxidant effects, helping to neutralise free radicals and calm chronic inflammation.
B. It nourishes a healthy gut microbiome
This diet naturally contains a wide variety of plant fibres and phytonutrients — the preferred food for beneficial gut microbes. A diverse, well-fed gut microbiome produces anti-inflammatory compounds called short-chain fatty acids (SCFAs), which:
- Strengthen the gut lining, preventing the absorption of harmful compounds.
- Exert anti-inflammatory effects throughout the body, including in the lungs and liver. Emerging research shows gut health to be a crucial factor in controlling chronic inflammation.
C. It provides quality protein to protect muscle health
People with chronic lung and liver conditions are at risk of sarcopenia — a progressive loss of muscle that impairs mobility and metabolic health. Maintaining good muscle health is vital, as muscle tissue is now recognised as an active, disease-modifying organ involved in regulating inflammation and metabolism. This diet supports muscle preservation through adequate, high-quality protein from both plant and animal sources. What Should
Your Plate Look Like?
At each meal, aim to include:
- Generous portions of colourful, highly flavoured, fibre rich plants — making up at least half or ideally three quarters of the plate – including vegetables, fruits, nuts, seeds and wholegrains.
- Healthy protein sources — predominantly plant-based (legumes, nuts, seeds) alongside quality animal options like oily fish, poultry, eggs, and dairy (if tolerated). Red meat should be unprocessed, high quality, and enjoyed occasionally.
- Healthy fats — from whole foods (nuts, seeds, avocados, oily fish) or as cold-pressed oils, particularly extra virgin olive oil.
- Anti-Inflammatory ‘Hero’ Foods to Include regularly (daily if you can!)
While dietary variety is key, some food groups deserve a special mention for their powerful anti- inflammatory and gut health supporting effects:
- Dark leafy greens — like spinach, kale, and chard
- Berries — fresh or frozen; rich in polyphenols and lower in sugar than most fruits
- Pulses — beans, lentils, peas; excellent for gut health and inflammation control
- Nuts and seeds — raw or lightly roasted, for healthy fats and plant protein
- Oily fish — such as salmon, sardines, or trout (aim for at least twice a week) – these are rich sources of Omega 3 fats which are proven powerful regulators of inflammation
- Fermented foods — such as live yoghurt, kefir, kimchi, sauerkraut, or miso; shown to reduce inflammatory markers by supporting a healthy gut microbiome
- Herbs and spices — boost flavour and phytochemical diversity; turmeric, in particular, has documented anti-inflammatory benefits
- Extra virgin olive oil — rich in healthy fats and polyphenols; ideal for dressing dishes and cooking (although not for frying at high temperatures)
- Green tea and ground coffee — both are potent sources of polyphenols (enjoy without added sugar or excessive milk)
What About Treats?
Good news: you don’t need to give up treats completely. Increasingly, recipes are available for cakes, biscuits, and desserts made from natural, minimally processed ingredients — often with less sugar and more beneficial fibres and phytonutrients. While they may take a little more effort than opening a packet, many people find these options just as satisfying and far more nourishing. And for an instant treat at the end of a meal, don’t forget dark chocolate which is packed with beneficial phytochemicals.
How to Get Started (and Stick With It)
Changing eating habits can feel daunting, especially when cooking for a family. A helpful approach is to start small:
- Progressively reduce ultra-processed options without aiming for perfection.
- Introduce one or two new recipes or food swaps each week.
- Keep those you enjoy and build on them over time.
- Allow yourself occasions when anything goes – such as pizza and ice cream with friends. Remember you should aim at a way of eating that is easy to sustain and the odd indulgence (guilt free!) will enhance enjoyment and help keep you on track. Fortunately, there is no evidence that occasional diversions lead to any significant setback in health benefits.
In just a few months, these small, steady changes can transform your overall diet — and many Alphas report substantial, sometimes life-changing, improvements in health and wellbeing as a result.