Diet for fatty liver: which foods are allowed and which to avoid?

Fatty liver, also known as hepatic steatosis, is a medical condition in which more than 5% of liver cells accumulate fatty acids, triglycerides, or cholesterol. Although many people with fatty liver do not experience symptoms, some may present with:

• Fatigue
• Discomfort or pain in the upper right side of the abdomen
• Elevated transaminase levels in a blood test

There are two types of fatty liver: Alcoholic Liver Disease (ALD), linked to excessive alcohol consumption, and Non-Alcoholic Fatty Liver Disease (NAFLD), associated with factors such as obesity, type 2 diabetes, metabolic syndrome, high triglyceride levels, and an unhealthy lifestyle.

Non-Alcoholic Fatty Liver Disease is primarily based on inflammation, caused by the consumption of harmful foods that increase insulin and disrupt liver metabolism, leading to changes in its morphology.

In addition to alcohol consumption, recent research suggests that the main cause of fatty liver is an excess of carbohydrates, especially refined ones that are also difficult to digest.

Fighting fatty liver requires adopting changes in eating habits and maintaining an active lifestyle. Keep reading!

What is the best diet for fatty liver?

‍Different scientific studies indicate that the Mediterranean diet is one of the best options for people with fatty liver. This diet is characterized by its low carbohydrate content, the absence of processed foods, and its richness in healthy fats, such as monounsaturated fats and omega-3 fatty acids.

In this diet, the main sources of protein are fish, seafood, eggs, and poultry. It also emphasizes the consumption of vegetables, fresh fruits, and legumes, which not only provide essential nutrients but also help reduce total cholesterol, thus benefiting liver health.

What can I eat if I have fatty liver?

‍Among the “friendly” or allowed foods in the fatty liver diet are:

Vegetables

‍Fill your plate with color, vitamins, minerals, and fiber by choosing vegetables you enjoy and tolerate—ideally, they should take up half your plate to give you greater satiety. Some vegetables you can include are:

• Brussels sprouts, cabbage, broccoli, and cauliflower: They contain a natural compound called indole, which may reduce inflammation and fat deposits in the liver, according to a study.
• Artichokes: Rich in essential acids, fiber, and other components such as cynarin, which support digestion and fat metabolism, protecting the liver and gallbladder.
• Raw spinach: High in antioxidants and polyphenols that have shown protective effects against liver diseases in experimental studies. It is important to eat them raw, since boiling them causes a loss of many properties and did not show the same results in the studies.

You can also include other vegetables such as carrots, pumpkin, celery, and beets, among others.

Lean Proteins

‍Even fatty cuts of meat can be consumed if you have fatty liver, as long as you tolerate them well and do not have food sensitivities. This is because proteins and fats do not spike insulin as much as carbohydrates. Some lean proteins you can include are:

• Fish: Especially those rich in omega-3, such as salmon, tuna, mackerel, among others. These fatty acids help prevent and control fatty liver.
• Eggs: They are high in choline, an essential substance for reducing bad cholesterol (LDL). You can eat them scrambled or boiled—avoid frying them.
• Chicken, skinless turkey, and tofu are other examples of proteins you can include in your meals.

Healthy Fats

‍The “friendly” or healthy fats are monounsaturated and polyunsaturated fats. They are recommended because they increase satiety and do not raise insulin levels as much. In addition, monounsaturated fatty acids have anti-inflammatory properties. You can find them in:

• Nuts and seeds: A rich source of healthy fats, antioxidants, protein, and nutrients. Some options include almonds, walnuts, hazelnuts, pistachios, flaxseeds, walnuts, and chia seeds.
• Olive oil: As long as it is extra virgin olive oil (meaning it has not gone through a refining process that alters its properties), it is one of the best sources of healthy fats and antioxidants.
• Avocado: A unique fruit rich in healthy fats, fiber, potassium, and antioxidants. It helps lower bad cholesterol (LDL) and increase good cholesterol (HDL).
  

What should you avoid eating with fatty liver?

Among the “enemy” or not-allowed foods in the fatty liver diet are:

Foods high in sugar

Eliminate sugary drinks, ice cream, jams, cookies, and other processed foods containing high fructose corn syrup. Fructose—the carbohydrate found in fruit—when consumed in excess and in its pure form, has a greater impact on the development of fatty liver since it is metabolized directly in this organ.

Flours or foods with gluten

Even whole grains, brown rice, or whole wheat bread contain gluten, a harmful protein that is difficult for your intestine to digest, where 70% of your immune system resides. When food digestion is incomplete, the intestine can become inflamed and permeable. As a consequence, during inflammatory reactions, insulin levels rise, which also promotes the internal production of triglycerides that, in excess, end up being deposited in liver tissue.

Dairy (including lactose-free products)

This group of foods contains a protein called casein which, like gluten, can be difficult for the intestine to digest and can trigger the entire inflammatory process at the liver level.

Fast food, frozen, and processed foods

This group includes French fries, chicken nuggets, frozen pizzas, ready-made sauces, or bouillon cubes. Avoid any “instant” food you find at the supermarket.

Alcoholic beverages

Alcoholic drinks are one of the liver’s main enemies. When metabolized, they raise triglyceride levels and release harmful substances that damage liver cells.

What nutritional supplements should be included in a fatty liver diet?

‍After evaluating each patient’s specific condition, a specialist may recommend some of the following nutritional supplements to help improve liver health:

• Omega-3 fatty acids: Research indicates that omega-3s may help reduce fat accumulation in the liver, raise HDL (good) cholesterol, and lower triglyceride levels.
• Milk thistle: This supplement is widely recognized for its liver benefits. Its active ingredient, silymarin, has been shown to protect and revitalize liver cells, as well as provide anti-inflammatory properties.
• Dandelion: Known for its diuretic and detoxifying properties, it is a natural option to support liver health.
• Vitamin E: This powerful antioxidant protects cells from oxidative damage. Studies suggest it may help reduce liver fat and optimize liver function.
• Turmeric: Curcumin, the active component of turmeric, has been observed to potentially improve serum ALT and AST concentrations in patients with NAFLD. However, more research is still needed to confirm these findings.

Example of a menu for fatty liver

Other recommendations for treating fatty liver

As you already know, adopting an appropriate diet is essential to prevent and treat fatty liver. However, knowing where to start can be overwhelming. Here are some tips:

• Evaluate how much sugar and processed carbohydrates you are consuming, especially refined flours.
• Assess your food sensitivities, since certain “enemy” foods can also trigger insulin spikes and increase inflammation.
• Personalize your 3R Immunonutrition Protocol — it’s much more than just a healthy weight-loss diet!
• Engage in physical activity for at least 30 minutes, 4 times per week.
• Drink enough water — ideally about 2 liters throughout the day. Water helps flush out toxins and cleanse the liver.

During your online nutrition consultation, you’ll receive recommendations for specific tests and supplements to help reduce liver inflammation and restore your liver health.

Frequently Asked Questions

What can be done to eliminate fat from the liver?

In summary, the best measures to reverse or prevent Non-Alcoholic Fatty Liver Disease (NAFLD) include:

• Adopting a diet rich in natural foods, low in saturated fats, carbohydrates, and refined sugars.
• Exercising regularly.
• Limiting alcohol consumption.
• Maintaining a healthy weight.
• Consulting a doctor or nutritionist for personalized guidance, taking into account other health conditions as well as your food sensitivities and intolerances.

Which drink is good for the liver?

The most important drink is pure water, essential for keeping the liver healthy and supporting its detoxification functions. Other recommended options include:

• Green tea: known for its antioxidant properties that may help reduce liver inflammation.
• Coffee (without sugar): can help reduce fat accumulation in the liver, inflammation, and oxidative stress.

How long does it take to heal fatty liver?

The time required to reverse fatty liver can vary depending on the severity of the condition, one’s commitment, and individual response to treatment. Generally, improvements can be seen within 6 months, depending on lifestyle changes and the removal of inflammatory foods such as sugars and processed products (Ludovico Abenavoli et al., 2020).

Are there any fruits that are bad for the liver?

Although fruits have many health benefits, people with fatty liver should reduce their sugar intake. For this reason, it is recommended to limit the consumption of very sweet or high-fructose fruits such as grapes, mango, figs, pineapple, and pomegranate.
It is also important to avoid dried fruits, as they tend to be high in simple sugars and can promote fat accumulation in the liver.

What can be taken on an empty stomach to cleanse the liver?

Drinking warm water with lemon on an empty stomach can help stimulate the liver and support its detoxifying function. Green tea or dandelion tea infusions are also popular options for this purpose.

What happens to the liver if I don’t drink water?

Lack of water can hinder the liver’s ability to eliminate toxins from the body. Proper hydration helps the liver function optimally, while prolonged dehydration can increase the risk of liver damage.

How can a nutritionist help a patient with fatty liver?

A nutritionist or dietitian can play a key role in treating fatty liver by personalizing the meal plan according to the patient’s preferences, needs, tolerances, and food sensitivities. They can also prescribe nutritional supplements and recommend specific tests.

If you want to start transforming your health, schedule a consultation plan with our NutriWhite Ambassadors, experts in Immunonutrition, and join the more than 20,000 people who have regained their well-being through NutriWhite.

References:

• Raúl Carrillo Espera, Jimena Muciño Bermejo, 2011: “Hígado graso y esteatohepatitis no alcohólica”. Revista de la Facultad de Medicina de la UNAM Vol. 54, N.o 3.
• Pilar Buil Cosiales, 2015: ¿Existe relación entre el hígado graso y la diabetes mellitus tipo 2?
• Guías de la Organización Mundial de Gastroenterología Enfermedad del hígado graso no alcohólico y esteatohepatitis no alcohólica Junio de 2012.
• Metin Basaranoglu, y col 2015: Carbohydrate intake and nonalcoholic fatty liver disease: fructose as a weapon of mass destruction. Hepatobiliary Surg Nutr. 2015 Apr; 4(2): 109–116.
• Yaron Ilan, 2012: Leaky gut and the liver: A role for bacterial translocation in nonalcoholic steatohepatitis
• Sid Victoria y col, 2015: Folic acid supplementation during high-fat diet feeding restores AMPK activation via an AMP-LKB1-dependent mechanism. Am J Physiol Regul Integr Comp Physiol. 2015 Nov 15; 309(10): R1215–R1225.
• Cole Laura y col, 2012: Phosphatidylcholine biosynthesis and lipoprotein metabolism. Biochimica et Biophysica Acta (BBA) - Molecular and Cell Biology of Lipids Volume 1821, Issue 5, May 2012, Pages 754–761.
  
• Abenavoli L, Boccuto L, Federico A, Dallio M, Loguercio C, Di Renzo L, De Lorenzo A. Diet and Non-Alcoholic Fatty Liver Disease: The Mediterranean Way. Int J Environ Res Public Health. 2019 Aug 21;16(17):3011. doi: 10.3390/ijerph16173011. PMID: 31438482; PMCID: PMC6747511.