Non-alcoholic fatty liver disease is a chronic liver disease which is not due to alcohol abuse but rather metabolic syndrome. Many people who are overweight and/or have type 2 diabetes also have fatty liver disease. Fatty liver disease is a condition where more than 5 % of the liver consists of fat. The condition is reversible, which means that, with the right treatment, the liver can be healed. Without treatment, the condition can progress to steatohepatitis and later on also cirrhosis; conditions that cannot be treated. Therefore, it is important to initiate the right treatment when the condition ‘only’ involves increased deposit of fat in the liver.
However, the problem is that the disease rarely causes any signs and symptoms, and few people are aware that they have non-alcoholic fatty liver disease. Most of those who suffer from obesity and type 2 diabetes have fatty liver disease, and therefore this group has to be particularly aware about the risk of developing irreversible liver disease with severe symptoms if they do not receive the right treatment.
The treatment of fatty liver disease is based on weight loss, and for this reason, diet is of utmost importance to the patients. It is important to eat foods that fight cell damage, make it easier for the body to use insulin, and reduce inflammation. It is often difficult to completely change your eating habits to follow a diet, and this often brings along weight loss which does not last. It is therefore recommended to modify your current eating habits, so the daily number of calories is reduced. You should also introduce more nutritious, healthy foods into your diet.
The best advice for patients with fatty liver disease include:
A Mediterranean diet
The dominant diet in the Mediterranean area is often healthy to follow for a person with fatty liver disease as it reduces the deposit of fat in the liver. This diet mainly consists of healthy fats, protein and complex carbs, including fish, vegetables, fruits, grains, nuts and olive oil.
Usually, the body’s cells use glucose (sugar) for energy. Sugar is digested and absorbed from the blood by means of the hormone insulin. People with type 2 diabetes have cells that do not respond to insulin: they are insulin resistant, and they therefore absorb less sugar. This results in high blood sugar. The liver cells’ absorption of sugar is not dependent on insulin, and they will therefore receive high levels of sugar via the blood when the rest of the body’s cells do not take in sugar. The liver cells transform the sugar into fat, which is then stored in the liver cells.
Certain fats can improve the cells’ sensitivity to insulin and thereby their ability to take in sugar, so that the deposit of fat in the liver is reduced. These include:
- Omega-3 fatty acids: Especially found in fish (such as salmon), fish oil, vegetable oils, nuts (walnuts), flaxseed and flaxseed oil and leafy veggies. These fats can reduce liver damage and inflammation.
- Monounsaturated fats: Especially found in avocados, olives and nuts.
Avoid saturated fats especially found in meat and dairy products, and steer clear of deep fried foods.
It is important to avoid damage to the liver cells as this may lead to an increased deposit of fat in the liver. Fruits, especially berries, vegetables and other foods rich in antioxidants can help protect against cell damage. Vitamin E is an antioxidant, and several studies have shown that vitamin E helps with fatty liver disease in non-diabetic fatty liver patients, especially when combined with vitamin C and cholesterol-lowering medicine. Nuts, sunflower seeds, and plant-based oils are rich in vitamin E.
Other foods which contain antioxidants, and which are thought to reduce liver damage, include coffee, raw garlic, green tea and goji berries. Before you start taking supplements, it is important to consult your doctor as the supplements could affect your medical treatment.
Simple carbohydrates can increase the deposit of fat in the liver, whereas the complex carbohydrates are healthy for your liver. Simple carbohydrates are found in candy, pop, and other sweets – these should be limited or avoided altogether. Choose naturally sweet foods like fruits, dates, and honey instead.
The complex carbohydrates are rich in fibres and digest slower. They are said to have a low glycaemic index. By eating complex carbohydrates, you will not experience a sudden spike in blood sugar, but instead it will be more stable. This contributes to an increased insulin sensitivity and lower cholesterol levels. It is recommended that you eat whole grains, starchy vegetables, beans and lentils.
Other important elements in your diet
Low vitamin D levels are associated with more severe liver damage. Vitamin D is produced in the skin when it is exposed to sunlight, and in addition, it can also be found in dairy products. Stick with low-fat dairy products as saturated fats are bad for the liver. In addition, it is important to get plenty of potassium found in fish like salmon, vegetables such as broccoli, peas and sweet potatoes, fruits like bananas and kiwis, as well as milk and yoghurt.
Alcohol damages the liver in many ways, for instance by increasing the deposit of fat in the liver cells. It is therefore important to avoid alcohol altogether.