Diet for Fatty Liver Disease

Non-alcoholic fatty liver disease, NAFLD for short, is on the rise. It’s the most common form of liver disease in the developed world and afflicts 1 in 3 American adults. It’s on my radar because it tends to travel with other health problems I see a lot. Your risk is high if you have prediabetes, diabetes, metabolic syndrome or obesity. We’ll get to diet for fatty liver disease in a bit.

diet for fatty liver

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The number of cases of NAFLD has doubled in the last 20 years. Researchers say it may soon surpass hepatitis C infection to become the number one cause of liver transplantation in the US. This is an alarm bell that we really need to sound. Even about 10% of children over the age of 2 have NAFLD.

People are asking what is the best diet for fatty liver disease. Here are some things that will help.Click To Tweet

What is Non-Alcoholic Fatty Liver Disease?

Whether we are talking about alcoholic fatty liver disease or non-alcoholic fatty liver disease, it is the buildup of excess fat in the liver. The difference between the two is nothing more than the cause. One is caused by drinking too much alcohol. The other is usually the liver manifestation of insulin resistance or metabolic syndrome. About 90% of people with severe obesity and at least 50% of individuals with type 2 diabetes have NAFLD. Other less common causes of NAFLD include medications, dietary and herbal supplements, infections, genetic abnormalities, malnutrition and even rapid weight loss.

Keep in mind that excess weight often leads to insulin resistance and that both prediabetes and type 2 diabetes are characterized by insulin resistance. This is how obesity, prediabetes and type 2 diabetes are linked to NAFLD. Without lifestyle changes, NAFLD can progress to inflammation and scarring of the liver to cirrhosis and even liver cancer. By the way, there are no approved medications for NAFLD.

NAFLD is also related to heart disease. Heart disease is the #1 killer of people with NAFLD. It’s also the #1 killer of people with diabetes, which is why you hear me say ALL THE TIME that prediabetes and type 2 diabetes are more than blood sugar problems.

That’s all the bad news. Now comes the good news.

Lifestyle and Diet for NAFLD

The really good news is that the same lifestyle interventions that treat other conditions associated with insulin resistance are what you need to dial back fatty liver. In other words, a fatty liver disease diet plan isn’t some horribly difficult diet plan at all. A diet for fatty liver is just good, wholesome eating with a few specific guidelines, as you’ll see below.

Lose weight if necessary. Even moderate weight loss improves NAFLD, but the more excess weight you lose, the greater you can expect your results. If you’re overweight, aim to lose about 7 to 10% of your starting weight. Once you hit that, you can decide if you want to work on further weight loss.

A word of caution though: A lot of people get hyper-motivated with a new diagnosis and take drastic measures. It’s better to make gradual changes and to find diet and lifestyle changes that you can stick with. My experience tells me that drastic plans lead to only temporary results.

Eat wholesome foods. Don’t put your energies and time into following restrictive diet rules. Instead focus on eating health-boosting foods in the proper amounts for weight management. That’s the best diet for fatty liver disease. Some research suggests that a Mediterranean-style diet is helpful. In a small study, it led to improved insulin resistance and less fat in the liver even without weight loss. Here are 8 ways to Follow a Mediterranean Diet.

A few other things to think about for your fatty liver diet plan:

  • Avoid sugary beverages such as sodas, sweet tea and lemonade.
  • Some studies suggest that drinking coffee might help.
  • Alcohol is a bit tricky. In general, drinking small amounts of alcohol is associated with less insulin resistance, but research doesn’t clearly show if this helpful or harmful for people with NAFLD. It’s smart to discuss this with your healthcare provider.
  • healthy diet for fatty liverInstead of looking for a best diet, make your food choices based on nutrient density and wholesomeness. Check out my 3 key takeaways from the US News Best Diet rankings (I proudly sit on their expert panel, by the way). Please resist the temptation to carb count (unless you also have diabetes) or worry about macros. This is not what is most important. What I recommend about carbs is the same that I recommend with protein and fat. Choose wisely: Eat black beans, not jelly beans. Choose whole grain toast with peanut butter over toaster pastries. It’s not the carbs (or fat); it’s the food with its nutrients or lack of nutrients and the total amount that you eat. Balance your plate with a variety of food groups; aim for a variety of wholesome foods within food groups; and avoid eating too much. If you do this consistently, your macros will fall into place, and you’ll be in the position to dial back prediabetes, insulin resistance, fatty liver, and more.
    You might have fatty liver and not know it. Find out what it is and what you should eat.Click To Tweet

For specific meal ideas, check out Best Prediabetes Diet. Since both prediabetes and NAFLD are often characterized by insulin resistance, some of the meal planning strategies for your fatty liver diet plan are the same as the ones for prediabetes.

Get a move on. All types of exercise improve insulin resistance and nonalcoholic fatty liver disease. Try to be active everyday. Make time for regular sessions of strength training as well as aerobic exercise. Avoid sitting for long stretches at a time.

Since there are usually no symptoms associated with early NAFLD, ask your healthcare provider if you should be screened for it. Screening involves a blood test to measure liver enzymes, but diagnosis requires imaging, usually by ultrasound.

Bottom line about lifestyle: You already know that being active, eating nutrient-dense foods at least 90% of time, getting adequate sleep, and managing stress affect nearly every aspect of your life. They make a difference with NAFLD too. So the best diet for fatty liver disease is the wholesome diet you can stick with. More health-boosting foods, calorie control, and less nutrient-poor food.

Jill-Weisenberger_about-image-2
Jill Weisenberger

I'm Jill, and I believe simple changes in your mindset and health habits can bring life-changing rewards. And I don't believe in willpower. It's waaaay overrated. As a food-loving registered dietitian nutritionist, certified diabetes care and education specialist and certified health and wellness coach, I've helped thousands of people solve their food and nutrition problems. If you're looking for a better way to master this whole healthy eating/healthy living thing or if you're trying to prevent or manage diabetes or heart problems, you'll find plenty of resources right here.

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19 Comments

  1. رژیم غذایی on October 12, 2018 at 2:38 am

    hi. Thanks for your good article.

    • Jill Weisenberger on October 12, 2018 at 9:58 am

      So glad you stopped by. Thanks for reading.

    • Linda Borland on December 3, 2019 at 2:17 am

      Hi I was wondering if you could help me find a diet for fatty liver but I also have gastroparesis..I got hurt in a accident in June and have been pretty much in bed ..I’ve gained almost 30 lbs and I don’t know what to do anymore..please help I’m depressed in pain and getting bigger by the minute..I can’t see a solution and I don’t want to die..

      • Jill Weisenberger on December 3, 2019 at 9:10 am

        I’m sorry for your ordeal! Please work with a registered dietitian nutritionist who can get to know you and your health problems to help you craft a personalized diet plan that will help you meet your goals. If you are in the US, visit eatright.org to find a RDN near you. Best wishes!

  2. king on November 20, 2018 at 1:02 pm

    Your last several posts are great quality.

    • Jill Weisenberger on February 18, 2019 at 3:40 pm

      Why thank ya!

  3. mary on February 18, 2019 at 7:46 am

    I have fatty liver and diabetes 2. Can you help me to know what to eat for both problems please.

    • Jill Weisenberger on February 18, 2019 at 3:53 pm

      Thanks for asking this question Mary. Typically, when someone has both type 2 diabetes and nonalcoholic fatty liver disease, they are partly caused by the same problem: insulin resistance. Working to improve insulin resistance should then help both problems. Some strategies include moderate weight loss, strength training, cardiovascular exercise, and reducing sedentary time. Diet is also critical, but I can give you only general guidelines. Carbohydrate intake should be consistent and moderate and largely come from wholesome foods such as beans, lentils, vegetables, whole grains (like oats, barley and quinoa), fruit, nuts and seeds. Milk and yogurt also provide carbohydrates, and they are also good for you. I have no idea what will work for you (this depends on your health, medications, goals, etc), but many of my patients aim for 45-ish grams of carbs per meal. We know from research, and I know from experience, that it’s helpful to have a qualified professional work with you to create a personalized eating and lifestyle plan. You can go to eartight.org. On the upper right corner, there’s a place for you to enter your zip code to find a registered dietitian nutritionist in your area. I suggest that you look for one who is also a certified diabetes educator. Also, check out some of my posts on Mediterranean diet, diabetes, and prediabetes.

  4. Siri on February 24, 2019 at 7:33 pm

    Hi Jill. I’m going through a lot of problems. I was always average weight but all of a sudden I gained a lot of weight because of the birth control that my obgyn gave me when I lost my health insurance last year and somehow got hepatitis A and fatty liver disease when I went to India to visit family. Please tell me what I can do so I don’t have to keep going to doctors for blood tests.

    • Jill Weisenberger on February 25, 2019 at 6:43 pm

      Oh my, I’m sorry to hear about all of these troubles. There is no substitute for medical management for your health concerns, so I strongly encourage you to keep up with your doctor appointments. As far as other things you can do, all I can really suggest is the same kinds of healthy eating suggestions that I have on these pages. Without doing a full nutrition assessment, that’s the best I can offer. Other sites with healthy eating information are aicr.org, diabetes.org, and choosemyplate.gov.If you’d like to see a registered dietitian nutritionist for a personalized plan, please visit eatright.org where you can enter your zip code to search for someone near you. Best wishes!

      • Siri on August 7, 2019 at 11:01 pm

        Hi Jill,
        I’m happy to tell you that last month when I saw my doctor and got my eight week follow up blood work done, my results proved that I was doing something right because my liver enzymes that were high back in February are now back to normal.

        • Jill Weisenberger on August 8, 2019 at 9:34 am

          Great news! Thanks for sharing!

  5. Fred on March 17, 2019 at 10:12 pm

    Excellent! This is such helpful information tⲟ us, keеp it up.

  6. John on April 9, 2019 at 8:51 am

    Thanks for the great article. I suffered from fatty liver for years. My diet had caused my fatty liver, and it was slowly killing me. Then I learned about nutrition and I reversed my fatty liver naturally.

  7. Rahul on December 20, 2019 at 7:23 am

    Thank you for sharing these great tips!

  8. Julie on March 21, 2020 at 8:19 am

    where do u start ( recently diagnosed with fatty liver ) to make meals what can we eat how do we create a meal

    • Jill Weisenberger on March 27, 2020 at 8:26 pm

      I like the Plate Method of diabetic meal planning. It’s good for diabetes as well as NAFLD, which are closely related because they both deal with insulin resistance. It’s good to focus on simply choosing wholesome foods over highly processed foods, greasy foods and sweets.

  9. denise on June 3, 2020 at 3:41 pm

    Just diagnosed with fatty liver disease. I have been complaining about enlarged liver and I do not drink much. Need recipes for fatty liver diet that are not so bland. Vegetables get old day after day. Red meat is discouraged and I do not eat seafood. Any suggestions. besides chicken chicken chicken!

    • Jill Weisenberger on June 8, 2020 at 10:18 am

      You don’t have to stick to chicken, chicken, chicken. That does sound boring and frustrating. I really think your best plan will come from working with a registered dietitian nutritionist to help you individualize a healthy diet for your unique needs and preferences. Find one here

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Hi there! I'm Jill, a nutrition & diabetes expert and the author of 4 books.

Jill Weisenberger

I believe simple changes in health habits can bring you life-changing rewards.

And I believe willpower is way overrated.

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