Non-alcoholic fatty liver disease (NASH), or fatty liver disease, is affecting more and more people in France and Europe. Dietary changes can slow the progression of NASH and prevent lasting liver damage. There is no approved drug treatment for NASH. Methods of managing the condition include lifestyle and diet changes, including eating a nutritious diet rich in a variety of plant foods. A NASH-friendly diet will also limit or eliminate certain types of foods, such as animal products and processed foods.
Having NASH indicates that a person’s liver has excess fat and inflammation that can cause liver scarring, or fibrosis. The accumulation of scar tissue in the liver can affect its functioning and, if left untreated, this scarring can lead to cirrhosis and liver failure. A NASH-friendly diet can prevent or reduce further damage in someone with this disease.
Here’s what the NASH diet is all about, along with foods to eat, foods to avoid, and other lifestyle changes that people with this disease can benefit from.
Diet for fatty liver disease
A healthy NASH diet focuses on making changes to the diet by including various nutritious foods. The program may seem restrictive at first and may require significant changes in the daily eating habits of some people. However, a nutritious NASH diet still allows for a range of foods to be consumed.
Vegetables are essential for general health. Regular consumption of a wide range of vegetables ensures that the body receives a large amount of nutrients and vitamins. Adults should consume around 2 to 4 cups of vegetables per day, depending on their gender and age.
Here are some examples of vegetable groups:
– dark leafy green vegetables, such as kale, mustard greens and spinach
– root vegetables, such as yams, turnips and beets
– legumes, especially beans, peas and lentils
– cruciferous vegetables, such as Brussels sprouts, cabbage and broccoli
– alliums, such as onion, garlic and leek
– stem vegetables, such as celery, asparagus and fennel.
There are many vegetables to include in the diet. Perhaps most important is finding a wide variety and eating enough vegetables each day.
Fruit can be part of a NASH diet in moderation. Whole fruit can provide many nutrients and vitamins to the body and is a suitable snack or dessert.
Fruit may include
– citrus fruits, such as lemon, orange and grapefruit
– stone fruits, such as apricots, peaches and plums
– berries, especially raspberries, blueberries and blackberries
– melons and watermelon
– tropical fruits, such as pineapple, banana and papaya.
Whole grains can be an alternative to processed and refined grains and are high in fiber and nutrients.
Whole grains or their substitutes include:
– brown rice
Good sources of protein
A NASH diet will also include suitable protein sources. Here are some protein options that can fit into a healthy liver diet:
– fatty fish, such as cod, sardines and salmon
– cooked shellfish, such as shrimp, crab and lobster
– lean poultry, such as chicken or turkey
– lean red meats
– legumes and beans, such as soy products, lentils or chickpeas
– nuts, such as almonds, cashews or peanuts.
A healthy diet still leaves room for fat, but focuses on replacing saturated and trans fats with more nutritious unsaturated fats.
Here are some examples of nutritious fat sources:
– seeds, such as chia and flax
– extra virgin olive oil
– the lawyers
– fatty fish, such as sardines, herring and salmon.
Few diets follow the principles of healthy eating. However, with little modification, some eating plans may be easier to adapt than trying to create a new diet. Low-carb diets, which limit added sugars and refined carbohydrates, are among the types of diets that can follow a nutritious eating pattern similar to the NASH diet. Additionally, low-fat diets that limit trans and saturated fats may also work.
Foods to avoid with fatty liver disease
A NASH diet will also focus on modifying the diet by excluding or limiting certain foods, including the following.
Foods high in sugar can be a high calorie source with low nutritional value for many people. Many sweet foods also contain fructose, a fruit sugar that the liver breaks down during digestion. The body also breaks down other sugars, like sucrose or table sugar, into glucose and fructose during digestion, which means sugar is another source of fructose. Research from 2021 indicates that fructose in the diet stimulates the body to make more fat and contributes to insulin resistance. It also indicates that fructose consumption is a major possible dietary risk factor for fatty liver disease.
Here are some examples of sugary foods to limit or avoid:
– sugary drinks, such as sodas, fruit juices and fruit cocktails
– jams and jellies sweetened with sugars
– baked goods or packaged foods containing added sugars
– sweets and other sweets
– ice cream
– sauces and condiments containing added sugars.
Refined or processed carbohydrates
Processed carbohydrates can cause a similar increase in sugars in the body after digestion. An appropriate diet for NASH may limit or avoid refined or processed carbohydrates, such as:
– white bread
– white rice
– starches and starchy foods
– foods that are usually fried, such as fries and crisps
– fat food
Doctors may also recommend eliminating foods high in saturated fats, trans fats, or hydrogenated oils.
These fats are a source of high calories that increase the risk of obesity. Non-nutritive fats can also increase the risk of conditions such as heart disease. These two pathologies are risk factors for NASH.
There are several dietary sources of these fats to avoid, and doctors may recommend eliminating or drastically reducing the following sources:
– fatty red meats, such as beef, lamb and pork
– deli meats, cold meats and packaged sausages
– baked goods, cookies and cakes
– packaged foods containing saturated fats and hydrogenated oils
– dairy products, ice cream and yogurts full of fat.
Other Dietary Changes
Doctors may also recommend limiting or adding other foods depending on the person’s risk factors. This may include:
– limit sodium intake
– eliminate alcohol consumption
– eliminate dietary supplements that may affect the liver
– add coffee to the diet
– add green tea to your diet
– add a variety of spices to his diet
A NASH-friendly diet is one of many beneficial changes to help protect and reduce liver damage. Doctors also recommend other lifestyle changes:
Regular aerobic exercises
Active exercise that increases your heart rate benefits overall health and can help burn calories and maintain a moderate weight. Doing about 150 minutes a week of activity that gets your heart rate up is enough for most people. This is about 30 minutes a day of activities such as:
– brisk walking
– lifting weights
– the bike
– Martial Arts
Maintain a moderate weight
Maintaining a moderate weight is a key step in the treatment of NASH. Losing at least 3-5% of a person’s body weight can reduce fat in their liver. Larger increases, around 7-10% in a person’s total body weight, can also help reduce inflammation and scarring from NASH.
Controlling other factors is an important part of treating or preventing NASH. This may include:
– diabetes control
– keeping cholesterol within a healthy range
– avoid alcohol
– avoid smoking
– only use over-the-counter medications that can affect the liver under the supervision of a doctor
– consult a healthcare professional before taking dietary supplements
– consider vaccinations against diseases that can affect the liver, such as hepatitis.
Dietary changes can prevent lasting liver damage and slow the progression of nonalcoholic steatohepatitis (NASH). People with NASH tend to have fatty buildup and inflammation in their liver, which can damage the organ, in the form of scarring or fibrosis. Eating more fruits, vegetables and grains is a vital diet change for people with NASH. Avoiding or limiting sugary foods, fatty foods, and refined carbohydrates also helps slow the progression of the disease. People with NASH are also advised to exercise regularly and maintain a moderate weight.
Cardoso, AC, et al. (2021). Current management of NAFLD/NASH.
Chalasani, N., et al. (2017). The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases.
Nonalcoholic fatty liver disease (NAFLD) & NASH. (nd).