Dante Carrillo
Nonalcoholic fatty liver disease (NAFLD) is a common condition in which excess fat is stored in the liver, and it can lead to serious health problems. A more severe form of NAFLD is nonalcoholic steatohepatitis (NASH), where there is inflammation in the liver, which can cause scarring and lead to cirrhosis and liver failure. While NAFLD is often reversible through weight loss, a healthy diet, and exercise, NASH does not have any approved drug treatments. However, dietary changes can slow its progression and prevent lasting liver damage. So, will dieting reverse NASH liver?
| Characteristics | Values |
|---|---|
| Will dieting alone reverse NASH liver? | No, a combination of diet and exercise is required to reverse NASH liver. |
| What is NASH liver? | Nonalcoholic steatohepatitis (NASH) is a progressive form of nonalcoholic fatty liver disease (NAFLD). |
| What is NAFLD? | NAFLD is the buildup of fat in the liver that can cause health problems. |
| What foods to eat to reverse NASH liver? | A NASH-friendly diet includes a variety of plant foods, fruits, vegetables, whole grains, and healthy fats. It also includes suitable protein sources. |
| What foods to avoid to reverse NASH liver? | Foods high in added sugar, salt, refined carbohydrates, saturated fat, and alcohol. |
| What else can help reverse NASH liver? | Losing 3-10% of body weight can help reduce fat in the liver and improve liver health. Regular exercise is also recommended. |
| Are there any medications to treat NASH liver? | Rezdiffra is a prescription drug used to treat NASH liver. Vitamin E supplements may also be helpful. |
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What You'll Learn
Weight loss is key to reversing NASH liver
Nonalcoholic fatty liver disease (NAFLD) is a common condition in which excess fat is stored in the liver. NAFLD is often reversible, especially if caught early, and can be treated through weight loss, a healthy diet, and exercise. Nonalcoholic steatohepatitis (NASH) is a more severe form of NAFLD, where a fatty liver is accompanied by inflammation, which can lead to cirrhosis and liver failure.
Dietary changes are an important aspect of managing NASH. A NASH-friendly diet includes a wide variety of nutritious foods, with a focus on plant-based sources of protein and healthy, unsaturated fats. It is recommended to eat more fruits, vegetables, whole grains, legumes, nuts, and seeds, while limiting or cutting out animal products, processed foods, and foods high in added sugar, salt, refined carbohydrates, and saturated fat. Coffee consumption is also associated with a lowered risk of developing NAFLD.
In addition to dietary changes, regular exercise that raises the heart rate is beneficial for overall health and can help burn calories and maintain a moderate weight. Maintaining a healthy weight is crucial in treating NAFLD and NASH, as it can reduce fat and inflammation in the liver and prevent lasting liver damage.
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A NASH-friendly diet includes plant-based foods
Nonalcoholic steatohepatitis (NASH) is a progressive form of nonalcoholic fatty liver disease (NAFLD). A NASH-friendly diet includes plant-based foods and limits or cuts out animal products and processed foods. Eating more fruits, vegetables, and whole grains are vital dietary changes for people with NASH. A NASH-friendly diet can help protect and reduce damage to the liver.
A NASH-friendly diet includes a variety of plant-based foods, such as vegetables, fruits, whole grains, legumes, nuts, and seeds. Vegetables are essential for overall health, and adults should aim for around 2-4 cups per day. Whole fruits provide many nutrients and vitamins and make healthy snacks or desserts. Legumes, such as lentils, chickpeas, soybeans, and peas, are nutritionally dense and contain resistant starches that improve gut health. Nuts and seeds, such as almonds, walnuts, and pistachios, are high in protein and healthy fats.
In addition to plant-based foods, a NASH-friendly diet includes suitable protein sources. Some healthy protein options include fish, such as salmon and tuna, poultry in smaller portions, and plant-based sources like tofu. Red meat should be limited, as it can increase the likelihood of fatty buildup in the liver.
A NASH-friendly diet also focuses on replacing saturated and trans fats with more nutritious unsaturated fats. Healthy fat sources include plant-based oils, avocado, and nuts and seeds. It is important to limit or avoid processed foods, sugary foods, and refined carbohydrates, as these can lead to more fat buildup in the liver and worsen inflammation.
Overall, a NASH-friendly diet includes a variety of plant-based foods, lean protein sources, and healthy fats. It limits or cuts out animal products, processed foods, and sources of saturated and trans fats. By making these dietary changes, individuals with NASH can improve their liver health and slow the progression of the disease.
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Exercise can help reverse NASH liver
Non-alcoholic steatohepatitis (NASH) is a progressive form of non-alcoholic fatty liver disease (NAFLD). NAFLD is a common chronic liver disease, and NASH is its inflammatory form. It is caused by excess fat and inflammation in the liver, which can lead to scarring, or fibrosis, and, if left untreated, cirrhosis and liver failure.
Lifestyle interventions, including exercise, are the current treatment of choice for NASH. Exercise can help to reduce hepatic fat content and improve fatty liver disease. Both aerobic and resistance exercises have been shown to be effective in reducing hepatic fat content. A moderate exercise regimen of 20- to 60-minute routines, 4–7 days a week, including both resistance and aerobic training, has been shown to be beneficial. Additionally, intensive lifestyle interventions, including moderate-intensity exercise for more than 200 minutes per week, have led to a significant reduction in the NASH Activity Score (NAS) on post-intervention liver biopsies.
Exercise has been shown to reduce expression levels of fatty acid synthesis enzymes in fatty livers, resulting in decreased levels of FFA and reversal of steatosis. Exercise also increases phosphorylation of acetyl-CoA carboxylase (ACC), resulting in its inactivity. This can help to reduce the excess delivery of free fatty acids and glucose for fatty acid synthesis to the liver.
In addition to exercise, dietary changes are also important in managing NASH. A NASH-friendly diet includes a variety of plant foods, legumes, fruits, vegetables, and grains, while limiting or cutting out animal products, processed foods, high-sugar foods, fatty foods, and refined carbohydrates. These dietary changes can help to improve gut health, lower blood glucose and triglyceride levels, and reduce the risk of NAFLD.
Overall, exercise, along with dietary changes, can be an effective treatment for NASH by reducing fat content in the liver and improving overall liver health.
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Supplements may help reverse NASH liver
Nonalcoholic steatohepatitis (NASH) is a progressive form of nonalcoholic fatty liver disease (NAFLD). While dietary and lifestyle changes are the first line of treatment for NAFLD and NASH, some supplements may also help in managing the condition and reducing liver damage.
Probiotics
Research shows that probiotics, which contain healthy bacteria and fungi, can improve various aspects of NAFLD and liver function. Probiotics can improve blood sugar, insulin levels, insulin sensitivity, cholesterol levels, liver stiffness, and body mass index in people with NAFLD. They can also reduce liver enzyme levels that are typically elevated in people with NAFLD.
Vitamin E
Some evidence suggests that vitamin E supplements may be beneficial for people with liver damage due to NAFLD and NASH. Vitamin E is an antioxidant that works by reducing or neutralizing the damage caused by inflammation.
Caffeine
Studies indicate that consuming more than two cups of caffeinated coffee per day may reduce the risk of liver fibrosis in people with several liver diseases, including NAFLD. Coffee consumption is associated with a lowered risk of developing NAFLD and a decreased risk of the advancement of liver fibrosis in those already diagnosed with NAFLD.
It is important to note that certain vitamins and minerals, such as vitamins A, iron, and niacin, can be harmful to the liver in higher doses than necessary or prescribed. Therefore, it is always advisable to consult a healthcare professional before taking any supplements or making significant dietary changes.
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Prescription drugs can treat NASH liver
Nonalcoholic steatohepatitis (NASH) is a progressive form of nonalcoholic fatty liver disease (NAFLD). NAFLD is a condition in which excess fat is stored in the liver, and it is one of the most common causes of liver disease in the United States. NASH is a subtype of NAFLD, characterised by inflammation of the liver, which can lead to liver scarring (fibrosis) and, in its most advanced stage, cirrhosis and liver failure.
Previously, there were no approved drug treatments for NASH, and doctors recommended lifestyle and dietary changes to slow the progression of the disease and prevent lasting liver damage. However, in March 2024, the U.S. Food and Drug Administration (FDA) approved the first medication for NASH, called Rezdiffra (resmetirom). Rezdiffra is a prescription drug specifically designed to treat adults with noncirrhotic NASH who have moderate to advanced liver scarring. It is meant to be used in conjunction with a healthy diet and exercise.
In clinical trials, Rezdiffra showed promising results in improving liver scarring in patients with NASH. Approximately 23% to 28% of subjects who received 80 to 100 milligrams of Rezdiffra experienced an improvement in liver scarring and no worsening of NASH, compared to 13% to 15% of those who received a placebo. The most common side effects of Rezdiffra include diarrhoea and nausea, and it carries certain warnings, such as the risk of drug-induced liver toxicity and gallbladder-related side effects.
While Rezdiffra is a significant advancement in the treatment of NASH, it is important to note that the drug is intended for patients with moderate to advanced liver scarring. For those with early-stage NASH, weight loss and healthy lifestyle changes can help reverse the condition. Maintaining a moderate weight is crucial in treating NAFLD and NASH. Losing 3% to 5% of body weight can reduce fat in the liver, while losing 7% to 10% can help decrease inflammation and scarring associated with NASH.
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Frequently asked questions
Nonalcoholic steatohepatitis (NASH) is a progressive form of nonalcoholic fatty liver disease (NAFLD). It is a condition where there is excess fat and inflammation in the liver, which can cause scarring or fibrosis. If left untreated, NASH can lead to cirrhosis and liver failure.
A NASH-friendly diet includes a variety of plant-based foods such as fruits, vegetables, whole grains, legumes, and nuts. It is important to consume suitable protein sources and healthy fats while limiting or cutting out animal products, processed foods, and foods high in added sugar, salt, refined carbohydrates, and saturated fat.
Rezdiffra is a prescription drug that has been approved in the United States for the treatment of NASH. Additionally, some evidence suggests that vitamin E supplements, omega-3s, and ensuring adequate choline intake may be beneficial in reversing NAFLD and improving liver health. However, it is important to consult with a healthcare provider before taking any supplements.
Losing 3% to 5% of body weight can help reduce fat in the liver. Losing 7% can also decrease inflammation. If you have NASH, losing 7% to 10% of your body weight is recommended to see improvements in liver health. Slow and gradual weight loss is best, as rapid weight loss through crash diets or fasting can worsen liver disease.
