The liver is a remarkable organ. It breaks down alcohol and other toxins and processes sugars and fats. It even produces bile for digestion. But when there is too much fat in the liver, it can lead to a common condition called non-alcoholic fatty liver disease (NAFLD).
Non-alcoholic fatty liver disease occurs when fat builds up in your liver, despite drinking no alcohol. In some cases, the fat build-up can progress to inflammation and scarring that permanently damages the liver, requiring a liver transplant. NAFLD also increases the risk of developing liver cancer.
Between 2% and 5% of people with NAFLD develop NASH (non-alcoholic steatohepatitis), active inflammation of the liver. A small portion of these people will develop more serious complications such as scarring.
Anyone can develop non-alcoholic fatty liver disease, but it’s more likely to occur if you have:
- Obesity or being overweight (having a body mass index [BMI] over 30)
- Type 2 diabetes
- High cholesterol levels
Between 36.6% and 42% of people with NAFLD have no symptoms, so it’s important to talk to your healthcare provider about your risk. Fortunately, lifestyle changes can slow or prevent the progression of non-alcoholic fatty liver disease and lower the risk of complications. Let’s look at some lifestyle changes, backed by science, that can improve non-alcoholic fatty liver and lower your risk of developing it if you don’t already have it.
Weight loss is an effective treatment for non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH). Studies have shown that there is a dose-response relationship between the magnitude of weight loss and improvements in NAFLD, losing more weight leads to greater improvements in liver function. The goal is to bring your body mass index (BMI) into the normal range for your height.
Why is weight loss beneficial? Achieving a healthy weight reduces liver fat accumulation, inflammation, and helps reverse insulin resistance, a driving force behind NAFLD. If you have severe nonalcoholic fatty liver disease, you’ll need to lose at least 10 percent of your body weight to reduce the risk of progression. If you are overweight or obese, talk to your doctor about healthily losing weight. There are no quick fixes. Losing weight responds to consistent sustainable changes to your diet and lifestyle.
Dietary changes are a must for maximizing weight loss and reducing the insulin resistance that drives NAFLD.
Some dietary changes that may be beneficial for reducing liver fat:
- Eating a low-carbohydrate diet with less than 50 grams of carbohydrates per day reduces insulin resistance and improves insulin sensitivity but isn’t appropriate for everyone.
- Limiting saturated fats and trans fats in processed foods, fried foods, and fast food.
- Consuming plant-based sources of protein high in fiber such as soy products, lentils, beans, nuts, and seeds, and less meat.
- Eliminating added sugar and sugar-sweetened beverages, especially those that contain fructose.
- Consuming more foods rich in long-chain omega-3s (fatty fish) and sources of vitamin E.
The most moderate approach is to eat a well-balanced diet that includes fruits, vegetables, whole grains, and lean proteins such as fish or poultry. Limit your intake of red meat, sweets, and fried foods. Talk to your doctor about which dietary approach is best for you.
Make sure you get enough vitamin E in your diet. Some research shows vitamin E reduces liver inflammation. Vitamin E is naturally found in various foods, including nuts, seeds, avocados, and legumes. Vegetable and seed oils contain vitamin E, but these aren’t healthy because they’re overly processed. Vitamin E is an antioxidant that acts as a free radical scavenger, helping prevent damage to cells.
Exercise is also a must for managing NAFLD. Exercise can help you lose weight if you’re overweight or obese. One way it helps is by reducing insulin resistance, which plays a key role in NAFLD. Plus, exercise helps reduce inflammation, including liver inflammation. The type of exercise that helps manage NAFLD depends on your fitness level.
Low-intensity aerobic activity (such as walking) is best if you’re just starting an exercise program because it causes less stress on joints, muscles, and bones than higher-intensity exercise. However, high-intensity exercise may be more beneficial once you’ve built up your fitness level. Plus, strength training improves insulin sensitivity for better blood sugar control and less liver inflammation.
If you have NAFLD, talk to your healthcare provider about how much exercise is right for you. And remember, it all counts! A ten-minute walk several times a day can have benefits if you’re consistent about it.
If you have NAFLD, avoid alcohol consumption. Alcohol itself is toxic to liver cells. Plus, alcoholic beverages contain large amounts of sugar, which contributes to the development of NAFLD. Alcoholic beverages are also high in calories, contributing to weight gain and obesity — another risk factor for NAFLD. It’s safest to avoid alcohol entirely if you have NAFLD as alcohol increases fat accumulation in the liver.
Lifestyle changes are key in the management of non-alcoholic fatty liver disease. These changes can help you treat and prevent NAFLD, as well as improve your overall health. Why not begin working on lifestyle changes that will benefit your liver today?
- “Nonalcoholic fatty liver disease – Symptoms and causes.” mayoclinic.org/diseases-conditions/nonalcoholic-fatty-liver-disease/symptoms-causes/syc-20354567.
- “Nonalcoholic Fatty Liver Disease | Johns Hopkins Medicine.” hopkinsmedicine.org/health/conditions-and-diseases/nonalcoholic-fatty-liver-disease.
- “Nonalcoholic Fatty Liver Disease: Symptoms, Causes, and More – Healthline.” 07 Sept. 2021, healthline.com/health/nonalcoholic-fatty-liver-disease.
- Bhan I. Weight loss can help head off lasting damage caused by fatty liver – Harvard Health. Harvard Health. Published April 30, 2020. Accessed January 2, 2023. https://www.health.harvard.edu/blog/weight-loss-can-help-head-off-lasting-damage-caused-by-fatty-liver-2020043019664.
- Rafiq N, Younossi ZM. Effects of weight loss on nonalcoholic fatty liver disease. Semin Liver Dis. 2008 Nov;28(4):427-33. doi: 10.1055/s-0028-1091986. Epub 2008 Oct 27. PMID: 18956298.
- Aboubakr A, Stroud A, Kumar S, Newberry C. Dietary Approaches for Management of Non-Alcoholic Fatty Liver Disease: A Clinician’s Guide. Curr Gastroenterol Rep. 2021 Oct 15;23(12):21. doi: 10.1007/s11894-021-00827-0. PMID: 34654976.
- Lee I, Cho J, Park J, Kang H. Association of hand-grip strength and non-alcoholic fatty liver disease index in older adults. J Exerc Nutrition Biochem. 2018 Dec 31;22(4):62-68. doi: 10.20463/jenb.2018.0031. PMID: 30661332; PMCID: PMC6343763.
- Riazi K, Azhari H, Charette JH, Underwood FE, King JA, Afshar EE, Swain MG, Congly SE, Kaplan GG, Shaheen AA. The prevalence and incidence of NAFLD worldwide: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2022 Sep;7(9):851-861. doi: 10.1016/S2468-1253(22)00165-0. Epub 2022 Jul 5. PMID: 35798021.