
Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease globally, affecting about one-third of US adults. It is caused by a surplus of free fatty acids, which result from excessive lipolysis, de novo lipogenesis, dietary FFA, diminished export by very low-density lipoprotein, or impaired beta-oxidation. Lifestyle changes, including dietary interventions, are considered the cornerstone of NAFLD treatment. While there is no specific diet recommended for NAFLD, a nutritious diet rich in high-fibre foods and nuts is associated with a reduced prevalence of NAFLD. The Mediterranean diet, which emphasizes vegetables, fruits, whole grains, beans, legumes, and healthy fats, while limiting processed foods, sugary drinks, added sugars, saturated fats, and refined carbohydrates, is also beneficial for liver health. In addition to diet, regular exercise, weight loss, and managing cholesterol and blood sugar levels are crucial components of NAFLD management.
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What You'll Learn

The Mediterranean diet
There are no concrete rules for following the Mediterranean diet, but some general guidelines can help incorporate its principles into your daily routine. A sample menu for a week of meals on the Mediterranean diet includes Greek yogurt with strawberries and chia seeds for breakfast, a whole-grain sandwich with hummus and vegetables for lunch, and a tuna salad with greens and olive oil, as well as a fruit salad for dinner. Another dinner option could be Mediterranean pizza made with whole wheat pita bread and topped with cheese, vegetables, and olives.
Snacks are also important, and there are plenty of healthy options, such as nuts, which have been associated with a reduced prevalence of NAFLD. It is important to consume all food in moderation, and if you start feeling hungry between meals, you can always add a snack. Additionally, you can drink a low to moderate amount of red wine, in small servings and with a meal.
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Reduce saturated fats
Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease globally, affecting about a third of adults in the US. The rising rates of obesity and metabolic disease are to blame for the disease's global epidemic status.
A diet high in calories is fundamentally linked to obesity and is the initial trigger point for NAFLD through adipose tissue expansion, increased inflammation, and mitochondrial dysfunction. Therefore, it is important to limit your intake of fats, which are high in calories and increase your chance of developing obesity.
One way to do this is to reduce saturated fats and replace them with unsaturated fats, especially omega-3 fatty acids, which may reduce your chance of heart disease if you have NAFLD. To reduce saturated fats in your diet, you can:
- Choose leaner cuts of meat, such as chicken breast or turkey breast, and trim the fat and skin before cooking.
- Grill, bake, poach, or steam food instead of frying or roasting.
- Measure oil with a teaspoon to control the amount used, or use an oil spray.
- Choose lower-fat or reduced-fat dairy products or dairy alternatives, such as skimmed milk.
- Use reduced-fat spreads, such as those based on olive or sunflower oils, instead of butter.
- Compare food labels when shopping and choose products with low saturated fat content.
- Eat more fruits and vegetables, which are naturally fat-free and packed with heart-healthy nutrients.
- Choose fish and chicken over red meat, and opt for lean proteins.
By making these gradual adjustments to your diet, you can significantly impact your heart health and manage your cholesterol and triglyceride levels.
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Increase omega-3 fatty acids
Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease globally, affecting about one-third of adults in the United States. The condition is becoming a global epidemic due to rising obesity and metabolic disease rates.
If you have NAFLD, your doctor may recommend losing weight gradually if you are overweight or obese. They may also suggest dietary changes, such as limiting your fat intake and replacing saturated and trans fats with unsaturated fats, especially omega-3 fatty acids.
Omega-3 fatty acids are "healthy fats" that offer many health benefits. They are polyunsaturated fats, a type of “good” or “healthy” fat that supports heart health when consumed in moderation. Omega-3s are essential nutrients that perform crucial functions in the body. They are vital components of cell membranes, providing structure and facilitating interactions between cells.
There are three main types of omega-3 fatty acids:
- Eicosapentaenoic acid (EPA): A marine omega-3 found in fish.
- Docosahexaenoic acid (DHA): Also a marine omega-3 present in fish.
- Alpha-Linolenic acid (ALA): The form of omega-3 found in plants.
While ALA can be converted into EPA and DHA, the process yields only small amounts. Therefore, it is essential to obtain EPA and DHA directly from dietary sources, such as fish.
- Include fatty fish in your diet: Fatty fish, such as salmon and mackerel, are excellent sources of EPA and DHA. By incorporating these fish into your meals, you can effectively boost your omega-3 intake.
- Add flaxseed and chia seeds to your meals: Flaxseed and chia seeds are plant-based sources of ALA, providing a convenient way to increase your omega-3 levels, especially for those who follow a vegetarian or vegan diet.
- Consider omega-3 supplements: While it is generally recommended to obtain omega-3s from food sources, some individuals may benefit from omega-3 supplements, also known as fish oil pills. However, it is crucial to consult your healthcare provider before taking any supplements to ensure they are suitable for your specific needs and do not interfere with any medications you may be taking.
- Consume soy products: While evidence is mixed, some research suggests that soy may help protect the liver due to its ability to lower triglyceride levels and potentially guard against visceral fat buildup. Tofu, for example, is a low-fat, protein-rich food that can be a suitable choice when limiting fat intake.
- Explore the Mediterranean diet: Guidelines from the European Association for the Study of the Liver (EASL) recommend a macronutrient composition in line with a Mediterranean diet, which typically includes healthy fats, such as olive oil, and a variety of plant-based foods.
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Eat more legumes
Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide, affecting about one-third of adults in the United States. The condition is caused by a surplus of free fatty acids, which are stored as triglycerides in the liver. A diet rich in legumes can help prevent and manage NAFLD.
Legumes are a large family of plants, constituting about seven percent of flowering plant species. They are a good source of symbiotic bacteria called Rhizobia, which can fix nitrogen from the atmosphere into ammonia. This makes legumes a good source of nitrogenous amino acids and protein. Legumes are also nutritionally dense foods that contain resistant starches that help improve gut health.
Legumes such as lentils, chickpeas, soybeans, peas, and beans are a good source of protein and vegetable oil. They are also high in fibre, which has been shown to be effective in managing NAFLD. A 2019 study found that diets rich in legumes helped lower the likelihood of NAFLD. This is likely because legumes can help lower triglyceride levels and protect against visceral fat buildup.
In addition to their health benefits, legumes are also versatile in cooking. They can be used in a variety of dishes, including soups, salads, and curries. Legumes can also be ground into flour to make bread and other baked goods.
It is important to note that while legumes can be a healthy addition to the diet, they should be consumed in moderation as part of a balanced diet. It is also important to consult a healthcare professional before making any significant changes to your diet, especially if you have a medical condition.
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Drink coffee
Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide, affecting about a third of adults in the United States. The disease is becoming a global epidemic due to rising obesity and metabolic disease rates. A healthy diet, controlled portion sizes, and a healthy weight are all factors that can help prevent NAFLD. Doctors may recommend weight loss for overweight patients with NAFLD.
Drinking coffee may help protect your liver against NAFLD. A 2021 review found that regular coffee consumption is associated with a lowered risk of developing NAFLD. The review also found a decreased risk of the advancement of liver fibrosis in those already diagnosed with NAFLD. However, the roles of caffeine and non-caffeine components in coffee are unclear.
Several studies have been conducted to examine the relationship between coffee consumption and NAFLD. One study assessed coffee intake through a questionnaire and found no association between self-reported coffee intake and NAFLD parameters. However, urine caffeine metabolites were significantly higher in subjects without liver fibrosis compared to those with fibrosis. Another study found that regular coffee consumption, but not espresso, protected against fibrosis in a group of morbidly obese European women with NAFLD.
While the exact mechanisms are not fully understood, there are several plausible explanations for the potential benefits of coffee in NAFLD. Evidence from other liver diseases, such as hepatitis C and alcohol-related liver disease, suggests that caffeine consumption may reduce the risk of fibrosis and cirrhosis. Additionally, coffee contains antioxidants and other compounds that may have protective effects on the liver.
In summary, while more research is needed to fully understand the relationship between coffee intake and NAFLD, current evidence suggests that drinking coffee may help reduce the risk of developing NAFLD and slow the progression of the disease. However, it is important to note that maintaining a healthy weight, exercising regularly, and following a balanced diet are also crucial components of managing NAFLD.
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Frequently asked questions
Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide and affects approximately one-third of adults in the United States. It is caused by a surplus of free fatty acids and can be triggered by a high-calorie diet.
Diets that promote overall health and weight loss can help prevent NAFLD. This includes the Mediterranean diet, which emphasises vegetables, fruits, whole grains, beans, legumes, and healthy fats while limiting processed foods, sugary drinks, saturated fats, and refined carbohydrates. The DASH diet, which is low-glycemic and low-energy dense, has also been shown to be effective in reducing metabolic markers associated with NAFLD.
In addition to diet and exercise, specific foods that may help with NAFLD include:
- High-fibre foods like oats
- Nuts, especially walnuts
- Turmeric
- Spinach and other leafy greens
- Legumes like lentils, chickpeas, soybeans, and peas
- Coffee

















