From the Guidelines
A Mediterranean-style diet is the most recommended diet for treating fatty liver disease, as it has been shown to reduce liver fat, improve insulin sensitivity, and decrease the risk of disease progression. This diet focuses on consuming plenty of fruits, vegetables, whole grains, lean proteins (especially fish), and healthy fats like olive oil and nuts, as suggested by the 2021 study published in Gastroenterology 1. The Mediterranean diet is characterized by 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.
Some key points to consider when following a Mediterranean-style diet for fatty liver treatment include:
- Limiting red meat consumption to once or twice a month, as high meat consumption has been associated with an increased risk of NAFLD 1
- Avoiding sugary beverages completely, as increased consumption of fructose is associated with postprandial hypertriglyceridemia and visceral adiposity contributing to insulin resistance and NAFLD 1
- Minimizing alcohol consumption, as it can worsen liver damage
- Including foods high in antioxidants and fiber, such as berries, leafy greens, and legumes, which help reduce inflammation and support liver health
- Staying well-hydrated with water, as it is essential for overall health and can help reduce liver fat
The Mediterranean diet has been shown to be effective in reducing liver fat and improving insulin sensitivity, even in the absence of weight loss, as demonstrated by the 2021 study published in Gastroenterology 1. Additionally, a 2020 study published in Liver International found that the Mediterranean diet is associated with a significant improvement in steatosis, even in the absence of weight loss 1. Regular physical activity of at least 150 minutes per week complements dietary changes and enhances their effectiveness in treating fatty liver disease.
It is essential to note that while other diets may be effective for weight loss, the Mediterranean diet has been the most studied and recommended for fatty liver treatment due to its high content of antioxidants, fiber, and healthy fats, which help reduce inflammation and support liver health, as suggested by the 2020 study published in Liver International 1.
From the Research
Diet for Fatty Liver Treatment
- The habitual diet plays a significant role in the pathogenesis of nonalcoholic fatty liver disease (NAFLD), with both risky and protective foods described 2.
- A hypocaloric diet to induce weight loss and subsequent improvement in liver enzymes and histology is supported by strong clinical evidence 3.
- The Mediterranean diet can lead to improvement in steatosis even in the absence of weight reduction 3.
- Omega-3 fatty acids may have beneficial effects in regulating hepatic lipid metabolism, adipose tissue function, and inflammation 4.
Weight Loss and Fatty Liver Treatment
- Weight loss is the most effective way to promote liver fat removal, with a 7%-10% weight loss associated with reduced liver fat, nonalcoholic steatohepatitis (NASH) remission, and reduction of fibrosis 2.
- A 5% body weight loss is effective in both obese and lean patients, resulting in a similar NAFLD remission 5.
- Intensive dietary and lifestyle interventions can lead to significant weight loss and improvement in liver function tests in both lean and obese patients with NAFLD 5.
Dietary Approaches for Fatty Liver Treatment
- A diet of 25-30 kcal/kg multiplied by ideal body weight daily, combined with aerobic and resistance exercise, can improve liver function tests and body weight in patients with fatty liver 6.
- Medical nutrition therapy (MNT) and intensive lifestyle interventions (ILIs) can lead to significant weight loss and improvement in liver function tests in patients with NAFLD 5.
- The role of omega-3 fatty acids in the treatment of NAFLD is promising, but further research is needed to establish the dose, duration of therapy, and benefit on different component features of NAFLD 4.