From the Guidelines
The recommended diet for non-alcoholic fatty liver disease (NAFLD) is the Mediterranean diet, which emphasizes daily consumption of fresh vegetables, fruit, legumes, minimally processed whole grains, and fish, along with omega-3-fatty acids, such as olive oil, nuts, and seeds as the primary fat sources, with minimal to low consumption of dairy and red and processed meat 1.
Key Components of the Mediterranean Diet
- High consumption of fresh vegetables, fruit, legumes, and whole grains
- High intake of omega-3-fatty acids, such as olive oil, nuts, and seeds
- Low consumption of dairy and red and processed meat
- Limited intake of saturated fatty acids, such as meat, and commercially produced fructose
Benefits of the Mediterranean Diet
- Reduces liver fat content and improves insulin sensitivity 1
- Decreases the risk of and progression of NAFLD through the nutraceutical effect of bioactive compounds and phytochemicals with their antioxidant and anti-inflammatory capacity 1
- Associated with a decrease in overall mortality and a reduction in the risk of multiple metabolic conditions, including CVD and diabetes mellitus 1
Foods to Limit or Avoid
- Red and processed meat, which are associated with NAFLD and should be limited to 0.33 portions/d or 2.3 portions/wk and 0.10 portions/d or 0.7 portions/wk, respectively 1
- Commercially produced fructose, which is associated with postprandial hypertriglyceridemia and visceral adiposity contributing to insulin resistance and NAFLD, but fructose contained in fruits is not associated with NAFLD and should not be restricted 1 The Mediterranean diet has been the most studied for those with NAFLD/NASH and is thought to be beneficial in the prevention and treatment of multiple metabolic conditions, including CVD and diabetes mellitus, and is associated with a decrease in overall mortality 1.
From the Research
Dietary Recommendations for Non-Alcoholic Fatty Liver Disease (NAFLD)
The recommended diet for NAFLD involves lifestyle modification, including calorie restriction and increased physical activity to enable weight loss 2. The dietary pattern and composition are critical in NAFLD management, with high consumption of certain foods associated with an increased risk of developing NAFLD and hepatocellular carcinoma.
Foods to Limit or Avoid
- Red and processed meat
- Saturated fat
- Added sugar
- Sweetened beverages
- Soft drinks
- Fructose
- Meat and saturated fatty acids
- Ultra-processed foods 2, 3, 4, 5
Beneficial Foods and Compounds
- Fish
- Olive oil
- Polyphenols
- Nuts
- Fruits
- Vegetables
- Whole grains
- Unsaturated fats
- Alpha linolenic acid (found in nuts)
- Vegetable protein (e.g., soya) 2, 3, 4, 5
Dietary Interventions
- Low calorie diets, regardless of fat and carbohydrate composition, are efficient for liver enzyme reduction 6
- Low fat diets seem to be markedly successful in reducing transaminase levels 6
- The Mediterranean diet has been proposed as the diet of choice for the treatment of NAFLD, with established superiority in long-term weight reduction and improvement of metabolic status and steatosis 3
- Time-restricted eating diet and low carbohydrate/low-fat diet have also been studied as potential dietary interventions for NAFLD 2