With over 500 functions, the liver is one of the most important organs in our bodies. The liver plays a critical role in carbohydrate, lipid, vitamin and mineral, protein, and enzyme metabolism. Understanding how to fuel our bodies to best support our liver function can lead to a reduced risk of chronic diseases.
This blog will investigate two prevalent forms of liver disease and their nutrition therapy and prevention methods.
NAFLD and NASH
- Non-alcoholic fatty liver disease (NAFLD): is a condition in which excess fat is stored in your liver. Unfortunately, it often goes undiagnosed as the symptoms can be very mild or silent. In some cases, if left untreated NAFL can develop in NASH.
- Non-alcoholic steatohepatitis: is a condition where there is inflammation of the liver and liver damage, in addition to fat in your liver. The inflammation and liver damage of NASH can cause fibrosis, or scarring, of the liver. NASH may lead to cirrhosis, in which the liver is scarred and permanently damaged.
It is estimated that 25%–30% of all adults in the United States likely have underlying non-alcoholic fatty liver disease (NAFLD)1. However, liver disease can be reversible in the early stages through nutrition and physical activity.Risk Factors
Before discussing liver healthy nutrition, it is important to understand your risk of liver disease as the beginning stages often go undetected or are silent.
- Being overweight
- Having high blood fat levels, either triglycerides or LDL (“bad”) cholesterol
- Having diabetes or prediabetes
- Having high blood pressure
NAFLD, without other medical comorbidities, does not require specific treatments of medications. The good news is that working on nutrition and exercise can control or even reverse fatty liver. Working on the below categories, may reduce risk of progressing to NASH.
- Losing weight
- Lowering your cholesterol and triglycerides
- Controlling your diabetes
- Limiting or avoiding alcoholic beverages such as wine, beer, liquor
With NASH, no medication is available to reverse the fat buildup in your liver. In some cases, the liver damage stops or even reverses itself2. But in others, the disease continues to progress. Treatments and lifestyle changes may include:
- Losing weight
- Medication to reduce cholesterol or triglycerides
- Medication to reduce blood pressure or medications to control diabetes
- Limiting OTC drugs as much as possible. Such as pain relievers, antihistamines, and cough suppressants
- Limiting or avoiding alcoholic beverages such as wine, beer, liquor
- Seeing a liver specialist
As read above, treatment for NAFLD and NASH accentuates the importance of nutrition when it comes to fatty liver. Lifestyle interventions, namely optimizing nutrition and increasing physical activity, remain the cornerstone of therapy for NAFLD, as this can lead to the significant improvement or resolution of disease1.
Studies have shown that losing at least 3% to 5% of your body weight can reduce fat in the liver3. Furthermore, in a meta-analysis of eight randomized, controlled trials, those adults who were able to lose at least 5% of body weight had improvement in fatty liver, whereas ≥7% body weight reduction was associated with NASH improvement4.Nutrition Recommendations:
- Reduce simple sugar and refined carbohydrates food choices
- Not only are these foods high in calories, but they are not as nutritionally dense! Choose whole grains, fruits, and vegetables for your carbohydrate choices.
- Some studies have shown that reducing carbohydrate intake to <45% of your daily intake can lead to improvements in NAFLD5,6.
- Fructose is a simple sugar of concern. Based on its specific metabolism, on its lipogenic potential, and on its high consumption in modern diets, fructose appears as one major factor not only of the initiation of hepatic steatosis (fatty liver), but also of its progression to NASH and more severe stages of the disease7. However, this could be in contribution with caloric dense diets.
- Weight loss and increase in physical activity
- Weight loss can have a tremendous effect on liver health. Slowly increasing physical activity can you obtain weight loss goals.
- Increase dietary fiber intake (goal 20-40g per day)
- Many Americans fall short on dietary fiber recommendations. Fiber helps your liver perform at optimal levels.
- Focus on healthy fat intake (Omega-3, monounsaturated and polyunsaturated)
- Diets enriched with omega-3 polyunsaturated fatty acids may also reduce steatosis (fat accumulation). A 2016 analysis found that omega 3 fatty acids helped lower liver fat and triglycerides in those with NAFLD or NASH8.
- Studies have found similar effects of olive oil consumption in humans, including less fat accumulation in the liver, improved insulin sensitivity, and improved blood levels of liver enzymes
- Avoidance of alcohol
- Depending on the state of your liver, you should avoid alcohol. If you’re allowed alcohol, limit it to no more than one drink a day if you’re a woman and two drinks a day if you’re a man9.
- Vitamin E – 800 IU/day
- AGA suggests the use of 800 IU/day of vitamin E in nondiabetic patients with NASH to improve histological liver patterns and delay disease progression10.
- Food sources of vitamin E include sunflower seeds, almonds, sunflower or safflower oil, hazelnuts, and peanut butter.
- A 2019 study found a diet higher in nuts to be associated with a decreased risk of NAFLD11.
- A meta-analysis of 11 studies found that regular coffee consumption is significantly associated with a reduced risk of NAFLD12. It is also significantly associated with decreased risk of liver fibrosis development in already diagnosed NAFLD patients12.
- Consider adding a liver support supplement
- Nafliva Liver Health Supplement contains a unique and tested combination of herbals to support liver health and support the reduction of fatty deposits.
Due to the many important roles the liver has, it is critical understand your risk of liver disease, and to understand how to best reduce fat deposits. Studies have found that nutrition and physical activity can be extremely beneficial to those with liver disease or those worried about their risk of disease.
If you have NAFLD or NASH, consider talking to your healthcare provider about nutrition to aid reduce the fat deposits on your liver.References:
- Saeed N, Nadeau B, Shannon C, Tincopa M. Evaluation of Dietary Approaches for the Treatment of Non-Alcoholic Fatty Liver Disease: A Systematic Review. Nutrients. 2019;11(12):3064. doi:10.3390/nu11123064
- Nonalcoholic Fatty Liver Disease. Accessed August 16, 2021. https://www.hopkinsmedicine.org/health/conditions-and-diseases/nonalcoholic-fatty-liver-disease
- Treatment for NAFLD & NASH | NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases. Accessed August 16, 2021. https://www.niddk.nih.gov/health-information/liver-disease/nafld-nash/treatment
- Chalasani N, Younossi Z, Lavine JE, et al. The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases. Hepatology. 2018;67(1):328-357. doi:10.1002/hep.29367
- Browning JD, Baker JA, Rogers T, Davis J, Satapati S, Burgess SC. Short-term weight loss and hepatic triglyceride reduction: evidence of a metabolic advantage with dietary carbohydrate restriction123. Am J Clin Nutr. 2011;93(5):1048-1052. doi:10.3945/ajcn.110.007674
- Weight and Metabolic Outcomes After 2 Years on a Low-Carbohydrate Versus Low-Fat Diet. Accessed August 17, 2021. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2949959/
- Jegatheesan P, Bandt J-PD. Fructose and NAFLD: The Multifaceted Aspects of Fructose Metabolism. Nutrients. 2017;9(3). doi:10.3390/nu9030230
- Effects of Omega-3 Fatty Acid in Nonalcoholic Fatty Liver Disease: A Meta-Analysis. Accessed August 17, 2021. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5019889/
- Liver Disease Diets. American Liver Foundation. Accessed August 17, 2021. https://liverfoundation.org/for-patients/about-the-liver/health-wellness/nutrition/
- Europe PMC. Accessed August 17, 2021. http://europepmc.org/article/PMC/4685119
- Chen B bing, Han Y, Pan X, et al. Association between nut intake and non-alcoholic fatty liver disease risk: a retrospective case-control study in a sample of Chinese Han adults. BMJ Open. 2019;9(9):e028961. doi:10.1136/bmjopen-2019-028961
- Hayat U, Siddiqui AA, Okut H, Afroz S, Tasleem S, Haris A. The effect of coffee consumption on the non-alcoholic fatty liver disease and liver fibrosis: A meta-analysis of 11 epidemiological studies. Ann Hepatol. 2021;20:100254. doi:10.1016/j.aohep.2020.08.071