Nonalcoholic fatty liver disease (NAFLD) and its more severe form, nonalcoholic steatohepatitis (NASH), are increasingly prevalent conditions characterized by the accumulation of excess fat in the liver. Affecting nearly 1 in 3 adults and 1 in 10 children in America, NAFLD signifies the accumulation of fat deposits in liver cells, inhibiting this essential organ from functioning properly. This fat buildup and consequent inflammation and swelling can cause cirrhosis - scarring of the liver. Fortunately, nutrition plays a starring role in treating, and even possibly reversing, non-alcoholic fatty liver disease (NAFLD), a gastrointestinal disease caused by fat build-up in the liver. An effective fatty liver diet menu often consists of minimally processed whole foods, with plenty of fiber and lean protein. In fact, adopting healthy lifestyle changes, including following a nutritious diet and making meals at home using healthy recipes, can help safeguard your liver.
Understanding Fatty Liver Disease
A fatty liver can be categorized into two subgroups:
- Non-alcoholic fatty liver disease (NAFLD): fat cells are inside the liver, which might enlarge the organ and cause mild pain to the touch (but usually, there are no symptoms).
- Steatosis and non-alcoholic steatohepatitis (NASH): fat cells in the liver, inflammation, and damage to liver cells.
Researchers confirmed that NAFLD is more common, and they estimate the condition affects approximately 24% of US adults, compared to 1.5-6.5% who have NASH. It’s unclear why NAFLD is more common in the two subgroups. A primary intervention to treat both types of fatty liver disease is dietary and lifestyle changes. Physicians must closely monitor people with NASH because they’re at higher risk for liver complications, including cirrhosis or liver cancer.
Risk Factors for Fatty Liver Disease
Fatty liver is prevalent in people living with metabolic syndrome, obesity, and conditions affected by weight-such as type 2 diabetes. Certain ethnic groups are also at higher risk, including Hispanic individuals, non-Hispanic whites, and Asian Americans (including East and South Asian descent). People who drink large amounts of alcohol may develop alcohol-associated liver disease. After years of high alcohol intake, the liver may become permanently damaged. People living with this condition must follow a closely outlined care plan by their physician.
The Liver's Role in Weight Loss and Overall Health
Your liver is responsible for over 500 different functions in the body. This means that an unhealthy liver can mean poor health overall. The liver filters blood and breaks down harmful substances (such as drugs and alcohol) into smaller, manageable molecules the body can more easily eliminate through waste. It also produces bile-which helps with fat digestion, synthesizes protein, aids with blood sugar control, and stores vitamins and minerals. In some people, fat can accumulate inside the liver, impairing function and possibly injuring the organ. Fortunately, many people can improve liver health by making diet and lifestyle changes, including eating fiber-rich foods, following the Mediterranean eating pattern, and increasing physical activity.
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General Nutrition Tips for Liver Health
You can eat plenty of foods while healing a fatty liver. Enjoy various vegetables, fresh fruits, whole grains, beans, lean cuts of protein, nuts, seeds, most plant-based oils, and foods rich in omega-3 fatty acids (salmon, trout, etc.) The Mediterranean diet is frequently recommended to improve liver health because it includes many foods listed above. Other general nutrition tips for liver health include:
- Filling half your plate with vegetables (cooked or fresh).
- Choosing whole grains as often as possible (oats, quinoa, bulgur, wheat berries, amaranth, etc.)
- Limiting your intake of saturated and trans fats (bacon, deli meats, marbled meats, etc.)
- Increasing your intake of unsaturated fats (salmon, trout, mackerel, walnuts, pecans, avocado, olive oil, etc.)
- Reducing your intake of foods high in added sugars (juices, sweets, candies, etc.)
- Drinking water or unsweetened tea and coffee.
The American Liver Foundation recommends eating more home-cooked meals instead of takeout to decrease your intake of high-fat foods that could aggravate your liver.
Foods to Embrace
- Plantiful and Protein Rich Foods: Veggies, fruits, beans, nuts, healthy oils and whole grains can be extremely beneficial in the fight against NAFLD. They prevent buildup of fat in the liver and accelerate weight loss.
- Healthy Fats: We believe in putting healthy fats on our plates to combat unhealthy fat in our bodies.
- Omega-3 Fatty Acids: Recent studies testing effects of this fatty acid in people with NAFLD show promising findings suggesting omega-3s may have potential in treatment of this liver disease. You probably already know by now that your best sources of omega-3s are fatty fish like salmon, mackerel and tuna. That’s why we’re suggesting something new: omega-3 fortified eggs. These eggs are from chickens fed a diet containing flaxseed.
- Probiotics and Prebiotics: You’ve heard of probiotics, which are good bacteria that promote gut flora diversity. You’ve likely also heard of prebiotics, a type of dietary fiber that feeds your friendly gut bacteria. A synbiotic is the combination of probiotics and prebiotics. You can purchase synbiotics in supplement form, but here, we suggest a delicious dietary source.
- Herbs: Herbal supplements have shown to have a strong antioxidant effect in people with NAFLD. These herbs include milk thistle, turmeric, ginger and ginseng. However, herbal supplements contain highly concentrated amounts of herbs which can potentially be dangerous for people with liver disease or interact with other medications. That’s why we suggest this dietary source.
- Vitamin E: This essential vitamin is an antioxidant, and one studied most in relation to NAFLD.
- Vitamin D: Vitamin D deficiency has been established as a risk factor in NAFLD and the severity of liver disease. Studies have linked vitamin D to having a direct role in reversing liver inflammation. The good news? It’s super easy to get this essential vitamin dietarily, in the form of highly accessible and budget-friendly canned tuna.
Foods to Limit or Avoid
Guidelines suggest limiting your intake of high-sugar foods because they increase fat buildup in the liver. These include candies, cookies, frozen treats, and baked goods. Research also recommends limiting your intake of high-fructose foods that can stimulate liver fat production. These products include sodas and juices. Other refined carbohydrates, such as white flour products (pasta, bread, cereal, etc.), should be limited while your liver heals. They tend to be lower in fiber and are rapidly digested into simple sugar molecules (glucose), which your liver can store as fat. You don’t need to avoid all carbohydrates to heal your liver, but monitoring your portion sizes may be helpful. If you have NAFLD or NASH, you should limit your alcohol intake while the liver recovers. If you have questions about alcoholic intake, speak with your physician.
The Mediterranean Diet and Fatty Liver Disease
“For those with non-alcoholic fatty liver disease (NAFLD), the Mediterranean diet is strongly recommended,” says Dr. In addition to the nutrient-dense foods included, this diet also advises “limiting red meat, saturated fats, and added sugars like fructose found in sugary drinks,” Dr. Purohit continues.
The Mediterranean diet focuses on delicious fruits, vegetables, whole grains, and heart-healthy protein each day.
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- Vegetables: Eat at least three servings of vegetables daily. Try eating vegetables that are in season for extra flavor and nourishment.
- Fruit: Eat at least two servings of fruit each day.
- Protein: Choose a good source of protein, like fish, shellfish, legumes or beans, white meat, lean red meat or eggs, with every meal.
- Grains: Choose whole grains such as 100% whole-grain or whole wheat bread, 100% whole grain cereals, brown or wild rice. Experiment with grains such as quinoa, barley, bulgar, farro and whole-grain pastas.
- Dairy and Dairy Alternatives: Choose up to 3 servings of dairy or dairy alternatives daily. Choose low fat or fat free milk, yogurt and cheese. Pass on sugar-sweetened dairy products such as yogurt or flavored milks or sweetened milk alternatives.
- Healthy fats: Eat healthy fats daily, like walnuts, hazelnuts and almonds. Be sure to count your calories for added fats and nuts into your daily allotment.
Sample 7-Day Meal Plan for Fatty Liver
Below is an example of a 7-day meal plan that supports liver health. The serving sizes may vary depending on your needs, and a registered dietitian can help you build an eating plan that satisfies your nutrition requirements.
Day 1
- Breakfast: Egg omelet with mushrooms, diced tomato, shredded kale, black pepper, and a spoonful of feta cheese. Serve over whole grain toast.
- Lunch: Chicken breast served over wild rice, topped with mixed greens, green onion, fresh raspberries, cucumber, and tomato. Sprinkle on toasted sunflower seeds and dress with olive oil and balsamic vinegar.
- Dinner: Sheet pan dinner with baked salmon, asparagus, and acorn squash. Season your baked foods with your favorite spice blend (we recommend a simple mix of black pepper and paprika). Serve with a fresh salad of sliced tomato, cucumber, sweet onion, and dill. Dress with olive oil and a squeeze of fresh lemon juice.
- Snacks: Fresh carrot sticks with hummus; air-popped popcorn with olive oil and garlic powder.
Day 2
- Breakfast: Oatmeal (made with water or milk) with mixed berries, ground cinnamon, and a handful of mixed nuts. Nuts are rich in monounsaturated and polyunsaturated fats, which are beneficial to your liver and can be enjoyed in moderation.
- Lunch: Tuna salad mixed with olive oil, fresh basil and parsley, sundried tomato, and green onion. Serve with a whole grain bun and a slice of cheese. Add fresh vegetable sticks on the side for additional fiber.
- Dinner: Three-bean chili with kidney, black, and white beans. Add diced tomatoes, onions, green bell pepper, corn, and garlic. Season with chili powder and serve with a whole grain dinner roll. You can freeze chili in an airtight container for up to six months.
- Snacks: Plain Greek yogurt cup topped with fresh fruit; fresh red pepper with hummus.
Day 3
- Breakfast: Whole grain English muffin with ½ avocado. Top with sliced cherry tomatoes, lemon juice, and chili flakes. Serve with a boiled egg on the side.
- Lunch: Leftover chili salad-make a bed of leafy greens and sliced red onion. Top with warmed bean chili and a tablespoon of shredded cheese.
- Dinner: Turkey meatloaf (to make, mix, and bake: ground turkey, diced mushrooms, garlic powder, dijon mustard, rolled oats, and an egg) served with shredded kale salad with cucumber, tomato, and green onion. Dress with olive oil and balsamic vinegar.
- Snacks: Apple slices with nut butter; cucumber sticks with avocado dip.
Day 4
- Breakfast: Whole grain wrap with scrambled egg, fresh tomato, lettuce, and a slice of cheese.
- Lunch: Chicken noodle soup with whole grain pasta, carrots, onion, celery, garlic, low-sodium stock, and fresh parsley. Serve with a fresh side salad for extra fiber.
- Dinner: Loaded baked sweet potato with baby arugula, shredded carrot, diced red bell pepper, and tomato. Top with olive oil, lemon juice, and a soft-boiled egg.
- Snacks: Orange slices and a handful of mixed nuts; celery sticks with avocado dip.
Day 5
- Breakfast: Overnight oats with chia seeds. To make, put ½ cup of quick oats and one tbsp chia seeds in a small jar and top with milk. Before eating, add fresh fruit to garnish, such as diced apple or berries, and sprinkle with ground cinnamon for extra flavor.
- Lunch: Hearty chickpea salad with fresh pomegranate, mint, lemon zest, cucumber, red onion, and orange bell pepper. Top with grilled chicken breast slices.
- Dinner: Grilled thin pork chops with a side of sweet potato and grilled zucchini and bell peppers. Add a grilled pineapple ring if you like natural sweetness with your pork.
- Snacks: Air-popped popcorn dressed with olive oil and garlic powder; fresh apple slices with nut butter.
Day 6
- Breakfast: Whole grain toast with nut butter and fresh fruits.
- Lunch: Baked bean burger (mix mashed black beans, Montreal steak spice seasoning, ½ diced onion, and egg) served on a whole grain bun. Add lettuce, fresh tomato, red onion, and olive oil-based mayo. Enjoy a side of fresh fruit.
- Dinner: Baked tofu with broccoli, served with a fresh garden salad. Dress with olive oil and apple cider vinegar.
- Snacks: Carrot sticks with avocado dip; fresh pear, and a handful of mixed nuts.
Day 7
- Breakfast: Boiled millet with diced plum and a pinch of nutmeg and cinnamon. Serve with a dollop of plain Greek yogurt for additional protein and calcium.
- Lunch: Flatbread with whole grain pita, sliced tomato, yellow onion coated in curry powder, goat cheese, and chickpeas. Garnish with fresh mint and basil before serving.
- Dinner: Grilled trout with whole wheat couscous, steamed Swiss chard, and garlicky grilled eggplant. Sprinkle toasted sesame seeds onto your vegetables for extra flavor and crunch.
- Snacks: Whole grain crackers with boiled egg; fresh peach with a handful of mixed nuts.
Delicious and Nutritious Recipes for a Fatty Liver Diet
Following a fatty liver diet is much easier when you have some go-to meals and snacks. Here are a few ideas:
- California Poke Bowl: This delicious, satiating bowl is made using sashimi-grade salmon, avocados and sesame oil, all sources of healthy fats.
- Mango Mint Iced Green Tea: Green tea is rich in antioxidants linked to decreased fat absorption. Green tea also contains caffeine, as do coffee and other types of tea. Because some studies show that people with NAFLD who consume caffeine experience less liver damage than those who don’t.
- Swiss Chard & Curried Chickpea Salad with Orange Vinaigrette: This swiss chard salad is not only overflowing with color, but with nutritional benefits, too - including vitamin E.
- Tuna Poke Bowl: It’s super easy to get this essential vitamin dietarily, in the form of highly accessible and budget-friendly canned tuna.
- Persian-Style Spinach & Herb Sauté with Eggs: We’re omega-obsessed, and for good reason. Recent studies testing effects of this fatty acid in people with NAFLD show promising findings suggesting omega-3s may have potential in treatment of this liver disease.
- Spicy Kimchi Fried Quinoa: You’ve heard of probiotics, which are good bacteria that promote gut flora diversity. You’ve likely also heard of prebiotics, a type of dietary fiber that feeds your friendly gut bacteria. A synbiotic is the combination of probiotics and prebiotics. You can purchase synbiotics in supplement form, but here, we suggest a delicious dietary source.
- Lentil Kebab Bowl With Turmeric Tahini Sauce: It’s not as if you need another reason to load up on flavorful herbs, but we’re giving you one anyways. Herbal supplements have shown to have a strong antioxidant effect in people with NAFLD. These herbs include milk thistle, turmeric, ginger and ginseng. However, herbal supplements contain highly concentrated amounts of herbs which can potentially be dangerous for people with liver disease or interact with other medications. That’s why we suggest this dietary source.
- Burger (grilled turkey or chicken) with lettuce and tomato on top and a side of sweet potato fries.
- Breakfast: Fuel Up With Oats and Berries: Oatmeal is nourishing and filling, which helps prevent obesity. This recipe’s ingredients also support liver health and overall well-being. Oats are high in beta-glucan, a type of fiber that can help reduce cholesterol levels and improve liver function. Berries are rich in antioxidants, which can help protect liver cells from damage and reduce inflammation.
- Lunch: Build a Balanced Bowl of Protein: This bowl - a variety of ingredients piled on a base of quinoa - is a balanced and nutritious lunch option. Lean protein, whole grains, and plenty of vegetables support liver health. Quinoa is a complete plant protein that’s high in fiber, which helps regulate blood sugar levels and reduce fat accumulation in the liver. Avocado and olive oil are rich in healthy monounsaturated fats to help lower liver inflammation. For an entirely plant-based meal, leave out the chicken.
- Dinner: Fix Flavorful Fish and Veggies: This baked cod recipe is a light, nutritious dinner option that’s ideal for managing obesity and MASLD. It’s full of lean protein, healthy fats, and fiber-rich vegetables, all of which support liver health. Cod is a lean source of protein, a nutrient essential for repairing and maintaining tissues, including the liver. Brussels sprouts are part of the cruciferous vegetable family, known for their liver-protective compounds such as sulforaphane.
- Snacktime: Amp Up Apple Slices’ Nutrition: This quick and easy snack is ideal for managing liver health. Apples are high in pectin, a specific type of fiber that helps support digestion and reduce cholesterol levels to benefit liver health. Chia seeds are rich in omega-3 fatty acids and fiber, which are known to support overall health and decrease inflammation, helping to ease symptoms of liver disease. This recipe’s mix of fiber, healthy fats, and antioxidants provides a nourishing choice for any time of day.
Additional Tips for Managing Fatty Liver Disease
- Meal Preparation: Stay organized in the kitchen by implementing meal preparation techniques like menu planning, batch cooking, and grocery planning. These methods allow you to buy items that fit your health goals and budget. Dedicate a weekly time to meal preparation. Invest in kitchen equipment that keeps cooking simple: sharp knives, Tupperware, mixing bowls, mandolin, etc. Wash and cut your vegetables before storing them in the fridge. Start with easy recipes, and recycle your favorites in the future. Keep it fun by playing music, turning on a show, or inviting friends to cook.
- Gradual Dietary Changes: Slowly switching to this diet might mean adding in a few meals each week that follow the Mediterranean diet or cutting out one sugary snack at a time. “Even modest sugar reduction and time-restricted eating (like an 8-12 hour window) can help,” advises Dr.
- Food Log and Reflection: An easy way to reflect on nutritional changes is to keep a food log where you track what you eat, how you felt after (mentally and physically), and how much you enjoyed the meal.
- Regular Physical Activity: Regular physical activity is just as important as your nutrition, adds Dr. Purohit. This doesn’t mean you have to join an intense CrossFit class or register for a 100 mile cycling race. 150 minutes of moderate exercise a week, such as walking, yoga, or swimming, is the minimum recommended amount.
- Weight Loss: If you have NASH, losing weight and becoming more active are currently the primary treatments for a fatty liver. Even modest reductions in weight (5-10% of total body weight) can help decrease the amount of fat deposited in the liver.
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