Fatty Liver Diet

What is Fatty Liver Disease?

When you consume too much food or alcohol, your body turns excess calories into fat. 

Some fat is stored in liver cells. If your liver is over 5% fat, you may have fatty liver disease.¹ 

There are two types of fatty liver disease: alcoholic and non-alcoholic. 

Alcoholic Fatty Liver Disease

This condition rarely has symptoms. But it's a sign that you're drinking at a harmful level. 

Fatty liver can be reversed, usually by stopping alcohol use for a few days. 

However, if you continue drinking alcohol, it can lead to more severe conditions like:^{2, 3}

• Alcoholic hepatitis: Liver inflammation caused by alcohol
• Cirrhosis: A late-stage liver disease characterized by scarring and permanent liver damage 

Non-Alcoholic Fatty Liver Disease (NAFLD)

NAFLD is not caused by alcohol use. It’s more common in people with obesity and type 2 diabetes. 

In the U.S., 24% of adults have NAFLD.⁴

The severe form of NAFLD is called non-alcoholic steatohepatitis (NASH). People with NASH have liver damage, inflammation, and a fatty liver. 

NASH can potentially lead to more serious conditions like cirrhosis and cancer.^{1, 4, 5, 6}

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How a Fatty Liver Diet Works

Fatty liver disease can be addressed with lifestyle changes, with diet as an essential component. 

Certain foods that can reverse fatty liver disease will have one or more of these qualities: 

• Contain unsaturated fats: These are healthy fats that provide many health benefits. Unsaturated fats are liquid at room temperature. Typical sources include avocados, olive oil, nuts, and fatty fish.
• Packed with antioxidants: These are substances that can fight cell damage caused by unstable molecules. 
• With anti-inflammatory effects: These foods can lower inflammation.
• Rich in fiber: Fiber-rich foods provide many benefits, like promoting digestive health and improving cholesterol levels. 

When it comes to liver-friendly diets, one that’s always mentioned is the Mediterranean diet. 

The diet combines fruits, vegetables, whole grains, legumes, fish, and olive oil. It helps not only those with NAFLD but also people with obesity and type 2 diabetes.^{7, 8, 9}

11 Foods to Include in a Fatty Liver Diet

Here are the top foods to eat for liver health:

1. Fish

Eat mackerel, wild salmon, sardines, tuna, bluefish, anchovy, and trout. These fatty fishes are high in omega-3 fatty acids, a type of unsaturated fat. 

There are several types of omega-3s, which include: 

• A-linoleic acid (ALA) from plants
• Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) from fish 

It is EPA and DHA that are associated with lower inflammation and healthy liver. The body can’t produce EPA or DHA, so you need to get them through dietary sources (like fish) or fish oil supplements.^{10, 11, 12} 

Your body can also convert ALA into EPA and DHA. However, the process is inefficient, resulting in only a small fraction of ALA being converted.¹³

2. Sunflower Seed

Vitamin E is an antioxidant often used in NAFLD treatment. 

If you want to increase your vitamin E intake, sunflower seeds are a good start. A 100-gram serving has 19.6 milligrams of vitamin E, which is more than you need per day.^{14, 15}

3. Olive Oil

Olive oil is rich in unsaturated fats, vitamin E, anti-inflammatories, and antioxidants. Adding olive oil to your diet can help you lose weight and improve liver functions.^{9, 11, 12}

4. Avocado

Avocados are one of those few fruits with several liver-friendly qualities. They include: 

• Rich in unsaturated fats
• High in fiber and water content
• Low in sugar and sodium
• Contain essential vitamins, minerals, and antioxidants (like carotene and lutein) 

Like olive oil, adding avocado oil to your diet can help you lose weight and improve liver functions.^{8, 11}

5. Spinach

This green, leafy vegetable is rich in antioxidants. In particular, eating raw spinach has been shown to reduce the risk of NAFLD.¹⁶

6. Whole Grains

Low fiber intake is typical in people with NAFLD. Eating fiber-rich foods like whole grains can address this problem. 

Whole grains include wheat, rice, corn, rye, barley, and oats. They are associated with reduced NAFLD, obesity, type 2 diabetes, and cardiovascular diseases.^{9, 17} 

7. Legumes

Legumes are rich sources of complex carbohydrates, proteins, dietary fibers, and minerals. 

Examples include lentils, dry beans, chickpeas, peas, and soybeans. 

Diets rich in legumes can improve gut health and reduce the risk of NAFLD. They can also lower blood sugar and fats in people with obesity.^{12, 18}

8. Nuts

Eating nuts is highly associated with a lower risk of NAFLD, inflammation, diabetes, and cell damage. 

This is because nuts are rich in vitamin E, fiber, and unsaturated fats. They are also rich in chemicals that can prevent fat build-up and cell damage.¹¹

Walnuts are especially helpful. Like fish, the nut is also rich in omega-3 fatty acids.^{8, 11, 19} 

However, walnut’s omega-3 is different from that of fatty fishes. Walnuts contain ALA, which the body still needs to convert to DHA and EPA.¹³

9. Garlic

In one study involving Chinese men, frequent consumption of raw garlic lowered the occurrence of NAFLD.²⁰ 

In other studies, garlic powder reduced body weight and fats in people with fatty liver disease.^{21, 22} 

10. Coffee

Coffee contains various chemicals with antioxidant and anti-inflammatory properties.¹¹ 

Regular coffee consumption is linked with a lower risk of NAFLD. It also reduces liver scarring in people who are already diagnosed with NAFLD.^{23, 24}

11. Green Tea

Green tea is rich in catechins and other antioxidants. These components can help improve symptoms of fatty liver disease.²⁵ 

One meta-analysis reported green tea’s preventative effect against liver cancer.¹²

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5 Food to Avoid in a Fatty Liver Diet

Avoid these foods if you have fatty liver disease:

1. Saturated Fats

Saturated fats are unhealthy fats that are often solid at room temperature. They can increase fat build-up around organs, including the liver. 

Some dietary sources of saturated fats include:

• Animal products (like pork, beef, butter, and dairy products)
• Vegetable oils
• Processed foods 
• Deli meat
• Fried foods
• Baked goods made with saturated oils 

People should swap these foods for unsaturated fat sources, like fish, olive oil, avocados, and nuts.⁸

2. Sugar 

High blood sugar levels can lead to fat build-up in the liver. 

People with fatty liver disease should avoid candies, sodas, fruit juices, and other sugary foods. 

Avoiding other types of sugars (like fructose and corn syrup) will also minimize liver fat.²⁶

3. Refined Grains

White rice, bread, and pasta can raise blood sugar. Replace them with legumes or whole grains. 

In a study involving 73 adults with NAFLD, those who consumed fewer refined grains had lower sugar levels, fewer fats, and smaller waistlines.⁴

4. Salt

Too much salt can increase the risk of NAFLD. 

With cirrhosis, too much salt can cause further complications like swelling of the abdomen, arms, and legs.²⁷ 

5. Alcohol

Alcohol harms the liver. It can cause fatty liver disease and more severe complications like alcoholic hepatitis and cirrhosis. 

A person with fatty liver disease should reduce their alcohol intake or safely quit the habit.⁹

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Other Ways to Treat Fatty Liver Disease

Here are some other ways to treat fatty liver disease.

1. Consider Supplements

The best supplements for liver health include:

Vitamin D

Low levels of this vitamin are associated with NAFLD and other metabolic conditions. 

While your body can make Vitamin D from sunlight, ensure you get enough through diet or supplements.²⁸

Milk thistle 

A popular liver cleansing supplement. It contains silymarin, a potent antioxidant and anti-inflammatory. 

Silymarin has been used in treating several liver disorders, like cirrhosis and liver cancer.¹²

Berberine 

A herb used in Chinese medicine. It’s said to have a positive effect against blood glucose, fats, diabetes, and fatty liver disease.²⁹

Resveratrol 

A chemical in the skin of red grapes. It may help control inflammation and blood sugar levels.^{9, 11}

Turmeric 

A potent anti-inflammatory and antioxidant. It contains curcumin, which decreases liver enzymes that are abnormally high with fatty liver disease.¹²

Licorice 

An herb with anti-inflammatory and antiviral properties.¹²

2. Maintain a Healthy Weight

There are currently no approved medicines for NAFLD. Instead, doctors will recommend people to keep a healthy weight. 

When paired with diet, exercise can help people lose weight and keep their livers healthy. In obese patients, dropping just 5% of their body weight could make a big difference.^{2, 5, 30}

3. Control Your Blood Sugar

Diabetes and fatty liver disease often go together. Diet and exercise can help you manage both conditions. 

If your sugar level is still high even after diet and exercise, your doctor may prescribe medication.

4. Lower Your Cholesterol Levels

Another way towards a healthy liver is to keep cholesterol at healthy levels. You can also do this through diet and exercise. 

If these aren’t enough to lower your cholesterol, your doctor may prescribe medication.

Summary

• There are two types of fatty liver disease: alcoholic and non-alcoholic. 
• Non-alcoholic fatty liver disease (NAFLD) is more common in people with obesity and type 2 diabetes.
• Not all fats are bad. Some fats are healthy, like unsaturated fats. Their typical sources include avocados, olive oil, nuts, and fatty fish.
• Vitamin E is an antioxidant often used in NAFLD treatment. You can find it in olive oil and nuts.
• Fiber-rich foods are associated with reducing NAFLD, obesity, type 2 diabetes, and cardiovascular diseases. 
• People with fatty liver disease should avoid alcohol, refined grains, saturated fats, sugar, and salt.
• There are no approved medications for NAFLD. Doctors usually recommend people to maintain a healthy weight.