Introduction

Millions of people all over the world suffer from fatty liver disease. It occurs when excess fat accumulates in the liver, leading to inflammation and potential liver damage. Although it can be caused by a variety of factors, including alcohol consumption and certain medications, the most common form of fatty liver disease is non-alcoholic fatty liver disease (NAFLD), which is associated with lifestyle factors such as a poor diet and lack of exercise.

Fortunately, there are dietary interventions that can help to reverse the damage done to the liver. By making certain changes to your diet, you can reduce the amount of fat in your liver and improve liver function.

Let us dive into the world of fatty liver diets, exploring the best foods to eat and avoid, as well as some easy-to-follow tips for creating a liver-friendly meal plan.^1,2

What is Fatty Liver?

Fatty liver disease is a prevalent health condition that results from an excess buildup of fat in the liver. While some individuals may not experience any noticeable symptoms, the accumulation of fat can lead to severe liver damage in others. However, the good news is that fatty liver disease is often preventable and reversible through simple lifestyle modifications.¹

Grades of Fatty Liver?

Fatty liver disease is categorized into four grades based on the amount of fat buildup in the liver.

• Grade 0: It means no fat is present in the liver, and it appears normal. In other words, it is free from fatty liver disease
• Grade 1: This indicates mild fat accumulation in the liver with a slightly brighter appearance on imaging.
• Grade 2: It represents moderate fat accumulation in the liver with more pronounced changes on imaging.
• Grade 3: This indicates severe fat accumulation in the liver, making it difficult to see certain parts of the liver on imaging.³

What foods should you eat?

The following list gives you a gateway to eating foods that are good for you, if you have fatty liver disease:

• Doctors often recommend the Mediterranean diet to individuals with fatty liver disease.
• The Mediterranean diet emphasizes a high intake of vegetables, fruits, and healthy fats.
• Foods to include in a liver-friendly diet include whole grains, nuts, and legumes.
• Lean meats should be consumed in moderation and red meats should be totally avoided.
• Sweets and added sugars should be limited.^1,4

Certain drugs can cause harm to the liver. If you are diagnosed with a fatty liver, it is important that you let your doctor be aware about the medicines you take. Some medicines can aggravate your liver condition and make the condition worse.

Dr. Siddharth Gupta, B.A.M.S, M.D (Ayu)

What foods should you avoid?

Here is a list of foods to avoid if you have fatty liver disease: 

• Sugary beverages like soda, juice, lemonade, and sports drinks should be avoided.
• Red meats, cold cuts, bacon, and other processed meats should be limited in the diet.
• Butter should also be limited, and foods containing trans fats like fried foods, such as french fries, fried chicken, and doughnuts, processed snacks, such as crackers and chips and baked goods, such as cakes, cookies, and pastries should be avoided completely.⁵

Tips for Following the Fatty Liver Diet

• Focus on a whole-foods, plant-based diet: Include plenty of vegetables, fruits, whole grains, nuts, and legumes in your diet. These foods are rich in fibre, vitamins, and minerals, and low in saturated and trans fats, which can be beneficial for individuals with fatty liver disease.
• Limit or avoid processed foods: Processed foods, such as fast food, snacks, and baked goods, often contain high amounts of sugar, unhealthy fats, and additives that can worsen fatty liver disease. Processed foods often contain high levels of fructose, unhealthy fats such as trans fats and saturated fats, and additives like high fructose corn syrup, which can increase the amount of fat deposited in the liver and contribute to liver inflammation.
• Choose lean protein sources: Opt for lean protein sources such as skinless poultry, fish, beans, and lentils over red meats and processed meats, which are high in saturated fats. These foods are high in protein, iron, and fiber.
• Avoid sugary beverages: Sugary beverages such as soda, juice, lemonade, and sports drinks can contribute to the development of fatty liver disease. Sugary and carbonated beverages contain high amounts of fructose and other sugars. When consumed in excess, these sugars are processed in the liver and converted into fat, leading to the accumulation of fat in the liver cells. Instead, opt for water, unsweetened tea, or coffee.⁶
• Watch your portion sizes: Overeating can lead to weight gain and increase the risk of fatty liver disease. Be mindful of your portion sizes and consider using smaller plates or bowls to help control your portions. Large portion sizes can contribute to weight gain and obesity, which are risk factors for fatty liver disease. When we eat more calories than our body needs, the excess calories are stored as fat in the liver and other organs, leading to the development of fatty liver disease.
• Limit alcohol consumption: Drinking alcohol in excess can damage the liver and exacerbate fatty liver disease. If you choose to drink, do so in moderation and always consult with your healthcare provider first. It is important to note that the American Liver Foundation recommends complete abstinence from alcohol, especially for those with alcoholic fatty liver disease.⁷
• Exercise: Regular physical activity can aid in weight loss, improved insulin sensitivity, and a decreased risk of fatty liver disease. Try to exercise for at least 30 minutes, five days of the week, at a moderate level.

Remember, making simple lifestyle changes can go a long way in preventing and even reversing fatty liver disease. Always consult with your healthcare provider before making any significant changes to your diet or exercise routine.^1,4,5

Another important fruit that you can add to your diet is grapefruit. Grapefruits are rich in naringenin, a flavonoid that has liver-protective properties (as per several lab studies). Adding grapefruits to your diet might help you avoid further liver damage.

Dr. Rajeev Singh, BAMS

Also Read: How Long Does It Take to Reverse Fatty Liver: A Guide to Restoration and Recovery

Meal plan For Fatty Liver

Here are some suggestions for a meal plan when you are following a fatty liver diet:

Day 1:
Breakfast: Besan chilla made with gram flour, onion, tomato and capsicum, served with a side of green chutney.
Snack: Masala chaas (buttermilk spiced with cumin, coriander, and mint) with a handful of mixed nuts.
Lunch: Palak paneer made with spinach and cottage cheese, served with a side of brown rice and salad.
Snack: Roasted makhana (fox nuts) with chaat masala.
Dinner: Tandoori chicken with a side of roasted vegetables and dal.

Day 2:
Breakfast: Oats upma made with oats, vegetables and spices, served with a side of coconut chutney.
Snack: Dhokla made with besan and served with mint chutney.
Lunch: Baked fish curry made with tomato, onion and spices, served with a side of quinoa and salad.
Snack: Masala papad with chopped onions and tomatoes.
Dinner: Rajma (kidney bean) curry made with tomato, onion and spices, served with a side of brown rice and salad.

Day 3:
Breakfast: Poha made with flattened rice, vegetables and spices, served with a side of green chutney.
Snack: Roasted peanuts with a dash of chaat masala.
Lunch: Lauki (bottle gourd) kofta curry made with onion, tomato and spices, served with a side of brown rice and salad.
Snack: Boiled chana (chickpeas) chaat with chopped onions, tomatoes, and spices.
Dinner: Chicken tikka masala made with tomato, onion, and spices, served with a side of quinoa and salad.

Day 4:
Breakfast: Vegetable dalia (broken wheat porridge) with a side of mint chutney.
Snack: Fruit chaat made with mixed fruits and spices.
Lunch: Methi (fenugreek) chicken curry made with tomato, onion and spices, served with a side of brown rice and salad.
Snack: Roasted chana dal with spices.
Dinner: Dal tadka made with lentils, tomato, onion and spices, served with a side of brown rice and salad.

Day 5:
Breakfast: Upma made with semolina, vegetables and spices, served with a side of green chutney.
Snack: A glass of spiced buttermilk (chaas) with a handful of mixed nuts.
Lunch: Baingan (eggplant) bharta made with onion, tomato and spices, served with a side of quinoa and salad.
Snack: Roasted chana jor garam (spicy roasted chickpeas).
Dinner: Chicken biryani made with brown rice, chicken, and spices, served with a side of raita.

Remember to drink plenty of water throughout the day, and limit or avoid alcohol, sugary drinks, and processed foods. This meal plan is a suggested guideline for a fatty liver diet and should not be taken as medical advice. 

It is recommended that you consult with a healthcare professional or a registered dietitian to create a personalized meal plan that meets your specific nutritional needs and dietary restrictions. 

You can tailor it according to your diet, your specific needs and preferences, but try to focus on whole foods, lean protein sources, and plenty of fruits and vegetables while limiting your intake of processed foods, sugar, and unhealthy fats.⁵

Also Read: What is Milk Thistle Good For? Exploring its Research-Backed Benefits

Tips to manage Fatty liver disease

Here are some tips to help manage fatty liver disease:

• Consult with your doctor to take steps to control nonalcoholic fatty liver disease.
• Lose weight by reducing the number of calories you eat each day and increasing physical activity.
• Eat a healthy diet rich in fruits, vegetables, and whole grains, and keep track of all calories you take in.
• Aim for at least 30 minutes of exercise most days of the week, but get your doctor’s approval first and start slowly.
• Follow your doctor’s instructions to stay in control of diabetes and monitor blood sugar closely.
• Keep cholesterol and triglycerides at healthy levels through a plant-based diet, exercise, and medications.
• Avoid things that put extra stress on your liver, such as alcohol and over-the-counter drugs.
• Discuss the potential benefits of vitamin E supplements or coffee with your doctor, but do not rely on alternative medicine treatments that are not proven to cure fatty liver disease.²

Also Read: Grade 1 Fatty Liver: Causes, Symptoms, Diagnosis, and Reversal Strategies

FAQs

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References

1. Fatty liver disease: Risk factors, symptoms, types & prevention [Internet]. Cleveland Clinic. [cited 2023May4]. Available from: https://my.clevelandclinic.org/health/diseases/15831-fatty-liver-disease 
2. Nonalcoholic fatty liver disease (NAFLD) & Nash – NIDDK [Internet]. U.S. Department of Health and Human Services; [cited 2023 May 9]. Available from: https://www.niddk.nih.gov/health-information/liver-disease/nafld-nash 
3. Kang BK, Kim M, Shin SJ, Kim YJ. Correlation of clinical and histopathologic parameters with ultrasonographic grades in pediatric non-alcoholic fatty liver disease. Journal of Korean Medical Science. 2019 Dec 9;34(47). Available from: https://jkms.org/DOIx.php?id=10.3346/jkms.2019.34.e298 
4. Annie Guinane RD. What foods help prevent and reverse fatty liver disease? [Internet]. UChicago Medicine. UChicago Medicine; 2021 [cited 2023May4]. Available from: https://www.uchicagomedicine.org/forefront/gastrointestinal-articles/fatty-liver-disease-diet
5. Non-alcoholic fatty liver disease — a guide to — what how to eat – BCM [Internet]. [cited 2023May4]. Available from: https://www.bcm.edu/sites/default/files/a-guide-to-what-and-how-to-eat-non-alcoholic-fatty-liver-disease.pdf  
6. Nseir W, Nassar F, Assy N. Soft drinks consumption and nonalcoholic fatty liver disease. World journal of gastroenterology: WJG. 2010 Jun 6;16(21):2579. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2880768/ 
7. Alcohol-related liver disease: Risks & complications [Internet]. 2023 [cited 2023 May 9]. Available from: https://liverfoundation.org/liver-diseases/alcohol-related-liver-disease/