Which Food Is Good For Fatty Liver?— Fatty liver, also known as nonalcoholic steatohepatitis (NASH) can be caused by nutrient and metabolic disorders. It is a serious health problem as it can lead to end-stage liver disease, type 2 diabetes and cardiovascular event. The way of life has been greatly impacted. Nutrition education is quite challenging issue. It requires a comprehensive understanding of both science and nutrition to bridge the gap between what researchers know in the lab, and the information that the public eats.
Why is the Mediterranean diet the best diet for fatty liver disease?
The Mediterranean diet is a well-known diet that gained popularity in the 1990s, known more as an eating pattern rather than a structured diet. It emphasizes eating fruits, veggies, whole grains, beans, nuts, legumes, olive oil, and flavorful herbs and spices; fish and seafood at least a couple of times a week; and poultry, eggs, cheese and yogurt in moderation, while saving sweets and red meat for special occasions.
In addition to being good for people with non-alcoholic fatty liver disease, the Mediterranean diet has been associated with a decreased risk of heart disease, and it’s also been shown to reduce blood pressure and bad LDL cholesterol. And it can be in line with the American Diabetes Association’s nutrition guidance. That’s important because both heart disease and diabetes are strongly associated risk factors for fatty liver disease.
How can a dietitian help patients with fatty liver disease?
A key role the dietitian plays is individualizing the nutrition plan for each patient. Every patient is unique and everyone has different needs.
Adapting to a Mediterranean diet is hard for patients because we are surrounded by convenience foods and junk on a daily basis. This diet is focused. It is important for patients to be able to sit down and learn about the benefits of the recommended diet and ask questions. Then they can set realistic and attainable goals with a nutrition expert, rather than something that sets them up to fail.
How to manage fatty liver with diet
To combat fatty liver disease, it’s essential to make strategic and lasting changes to your diet, rather than just avoiding or integrating random foods here and there. “The most important part of these changes is that they should be sustainable,” says Aymin Delgado-Borrego, MD, pediatric and young adult gastroenterologist and public health specialist at Kidz Medical Services in Florida. Generally, the best diet for fatty liver includes:
- Adequate fiber
- Lots of fruits, vegetables, and nuts
- Whole grains
- Very limited saturated fats from animal products
- Very limited salt and sugar
- No alcohol
The American Liver Foundation recommends restricting calorie intake and modeling your eating habits after the Mediterranean diet. Dr. Delgado-Borrego says half of any plate of food you are eating should be fruits and vegetables, one quarter should be protein, and the other quarter should be starches. You can always reference the foods to eat and avoid, or just remember these two main rules to improve fatty liver:
- Opt for low-calorie, Mediterranean-style choices. Eat lots of plant-based foods, whole grains, extra virgin olive oil, and fish—with poultry, cheese, and other dairy in moderation.
- Avoid added sugars, processed meats, and refined grains.
“The best way to ensure significant resolution or even cure [fatty liver disease] is losing approximately 7%–10% of your body weight,” explains Sanaa Arastu, MD, a board-certified gastroenterologist with Austin Gastroenterology in Texas.
8 foods to eat
Experts recommend these foods in particular for a healthy liver:
- Almond milk or low-fat cow’s milk: Dr. Delgado-Borrego says adults and children with fatty liver disease need to pay attention to calcium consumption. “There is some emerging evidence over the last couple of years that adequate calcium and vitamin D intake may help to prevent the development of fatty liver disease,” she explains and adds that further investigation is needed. “In addition, patients with advanced liver disease have problems due to multiple nutritional complications and can develop early osteopenia and osteoporosis. Fatty liver disease does not necessarily diminish calcium absorption. Calcium is simply important to all.” Drink up to three glasses of either of these kinds of milk per day.
- Coffee: Without added sugar or creamers, coffee has been shown to be one of the most effective ways at present to improve fatty liver. “It appears that coffee may reduce permeability of the gut, making it more difficult for people to absorb fats,” explains Dr. Delgado-Borrego. “However, this is still under investigation and the answer to this question is not yet completely known. Nevertheless, there is growing evidence that coffee has beneficial effects in helping to reduce fatty liver disease.” Multiple cups of coffee might be recommended, depending on the patient.
- Foods rich in vitamin E, including red bell peppers, spinach, peanuts, and nuts: Dr. Delgado-Borrego recommends these types of foods, rich in vitamin E, as beneficial to people with fatty liver. While more studies are needed, one concludes that the vitamin shows modest improvement for people who have NAFLD or NASH.
- Water: Experts recommended sticking to this beverage as much as possible over sugary and high-calorie alternatives. The average person, with no medical conditions that would limit fluid intake, should drink between a half ounce and an ounce of water for every pound of body weight daily to avoid dehydration and its negative effects on the liver.
- Olive oil: Certain oils can provide healthy fats, such as olive oil and avocado oil. These help with feelings of satiety and reduce liver enzyme levels. Other types of oil that are high in monounsaturated fats include sesame, peanut, sunflower, canola, and safflower oil.
- Flax and chia seeds: These are plant sources of omega-3 acids. Registered dietician Sandy Younan Brikho, MDA, RDN, recommends these acids for both nonalcoholic and alcoholic fatty liver, as they reduce the fat content in the liver.
- Garlic: One study suggests that upping your garlic intake (specifically through garlic powder but other forms work, too) over a 15-week period led to decreased body fat mass in people with NAFLD and also reduced the fat in the liver and prevented progression of the disease.
- Soy: Some evidence suggests that soy products, such as soy milk or tofu, may improve fatty liver. One study says that research has shown improvements in the metabolic effect in people with NAFLD.
- Whole grains: oats, 100% stone-ground wheat, barley, bulgur, farro, wheat berries, brown rice
- Legumes: beans, lentils, chick peas (preferably dried and not canned)
- Starchy vegetables: sweet potato, turnips, yams
- Nonstarchy vegetables: broccoli, spinach, kale, onions, leeks, asparagus, artichokes, peppers, onions, mushrooms, carrots, tomatoes, cauliflower
- Nuts and seeds: walnuts, sunflower seeds, almonds, cashews, pistachios
- Healthy fats: extra virgin olive oil, avocado
- Lean protein: white meat chicken, turkey, eggs, pork, vegetarian protein
- Fatty fish: salmon, tuna, sardines
- Fruit: berries, kiwi, apple, orange, lemon
- Low-fat dairy: low-fat Greek yogurt, low fat kefir
- Herbs: basil, cilantro, parsley, rosemary, thyme, oregano, lemongrass, lavendar
- Refined carbohydrates: white bread, white rice, bagels, white pasta, prepared boxed foods
- Sweeteners: high fructose corn syrup, maple syrup, sugar
- Trans fat and saturated fat: margarine, processed baked goods, fried foods, pastries, high-fat beef, full-fat cheese, packaged/boxed foods
- Refined snack foods: chips, pretzels, crackers, rice cakes
- Sugary beverages: soda, juice, sports drinks
- Sweets: cookies, cakes, ice cream, donuts, desserts
- Processed high-fat meats: sausage, bacon, bologna, liverworst, prosciutto
Antioxidants and Supplements for Liver Health
Cells get damaged when nutrients don’t break down properly. This can lead to fat buildup in your liver. But compounds known as antioxidants can help protect cells from this damage. Where do you get them?
- Green tea
- Raw garlic
- Fruits, especially berries
- Vitamin E. You can find it in:
- Sunflower seeds
- Liquid plant-based oils with monounsaturated fats, like olive or canola oil.
Scientists are studying supplements to see if they may be good for your liver:
- Goji berry (wolfberry), a plant often used in Chinese medicine, may slim your waist size. But we need more research to see if this is true.
- Resveratrol, which comes from the skin of red grapes, may help control inflammation. Conflicting studies suggest that how well it works depends on how much you take.
- Selenium is a mineral found in Brazil nuts, tuna, and oysters. (Most people get enough in their diet.)
- Milk thistle. You might hear it called silymarin, which is the main component of its seeds. Results are mixed on whether it really works.
- Berberine, a plant used in Chinese medicine. In early studies, it does appear to help with cholesterol, liver function, and blood sugar control. But we need more research to see if it works.
Check with your doctor before you take any supplements. They could change how your medicines work, or they might cause other health problems. They may not be helpful if you don’t take the right amount in the right way.
Other ways to reverse fatty liver disease
In addition to changing the way you eat, these lifestyle modifications can help to reverse fatty liver disease.
1. Exercise more
Weight loss, nutrition, and other healthy practices can improve liver disease drastically, and work best when you implement them together. Dr. Delgado-Borrego recommends 60 minutes of physical activity each day, but encourages people who find this intimidating to split the sessions into smaller increments, such as four 15-minute walks. The U.S. Department of Health and Human Services calls for 150 minutes per week of moderate-intensity aerobic activity, and also recommends strength training at least twice per week.
2. Get more ZZZ’s
While sleep is important for everyone, it can be even more so for people with liver diseases. “Conditions such as obstructive sleep apnea are common and can worsen liver disease by diminishing oxygen supply to the liver,” Delgado-Borrego says. “People with possible sleep problems should be formally evaluated for them.” The Sleep Foundation recommends seven to nine hours per night for adults. Try gradually going to bed a few minutes earlier each night instead of trying to alter your morning schedule, which might be tougher.
3. Discuss supplements with your doctor
All of our experts recommend consulting with a healthcare provider first before starting any supplements. This is especially true for vitamin E, a commonly used supplement for people with liver issues, because taking too much can result in other health complications such as cardiovascular issues. Supplements should also be used in conjunction with a healthy diet and lifestyle changes for maximum efficacy.
4. Try medication
There are currently no FDA-approved medications for fatty liver disease, according to Harvard Health. The most effective treatment is Pioglitazone (commonly used to treat diabetes), sometimes used off label for liver problems.
With persistence and consistency, fatty liver can be reversed and even cured. The length of time often depends on how long it takes a patient to safely lose weight, if necessary. It also depends on how consistent they are with diet and exercise changes. Also consider lifestyle changes that reduce your stress, as one study suggested cellular stress in the brain contributes to fatty liver.
Additional ways to treat fatty liver disease
In addition to modifying your diet, here are a few other lifestyle changes you can make to improve your liver health:
- Get active. Exercise, paired with diet, can help you lose weight and manage your liver disease. Aim to get at least 30 minutes of aerobic exercise on most days of the week.
- Lower blood lipid levels. Watch your saturated fat and sugar intake to help keep your cholesterol and triglyceride levels under control. If diet and exercise aren’t enough to lower your cholesterol, ask your doctor about medication.
- Control diabetes. Diabetes and fatty liver disease often occur together. Diet and exercise can help you manage both conditions. If your blood sugar is still high, your doctor can prescribe medication to lower it.