Learn which diet, supplements, and lifestyle changes can help reverse fatty liver. Plus, we share all the research to back them up!
Note from Dena: This post was co-written with Sandra Johnson, Dietetic Intern, as part of a research partnership between Back To The Book Nutrition and post-graduate nutrition students from the University of Houston.
We’ve talked all about what causes fatty liver (sometimes and four options for getting tested, but today we’re focusing on natural solutions! The good news is that food, supplements, and lifestyle can significantly improve or even reverse fatty liver– read on to learn more.
Best Fatty Liver Diet
The goal of diet changes is to improve the underlying issues of insulin resistance, inflammation, choline deficiency, and poor gut health that cause fatty liver (2,3).
1. Avoid Overeating
What you eat definitely matters with fatty liver (more on that below!), but how much you eat is also important. When we eat or drink more calories than our body needs at a time, the excess is more likely to be stored as fat, both in the liver and around the body.
2. Reduce sugar intake, especially fructose
Fructose is a type of sugar found in high amounts in the foods and drinks listed below. Once consumed, fructose heads straight to the liver and increases fat production (3,8).
- High fructose corn syrup
- Fruit juice
- Canned fruits
- Packaged breads and sweets
- Invert sugar (ingredient in packaged foods)
3. Limit processed foods
Processed foods are foods that have been stripped of much of their bran, fiber and nutrient content, and they often have unhealthy preservatives and other chemicals added. Eating moderate amounts of these from time to time isn’t a problem for most people, but frequent or excessive intake increases fat production in the liver (3,8).
- Crackers, chips, and other packaged snack foods
- Breads, pastas, pizza, etc. made with white flour
- Convenience meals
- Sugary foods and drinks
4. Minimize alcohol
Fatty liver develops in over 90% of those who consume 4 or more drinks daily. Alcohol goes directly to the liver to be metabolized and even lower intake of alcohol can burden the liver and promote conditions associated with fatty liver such as insulin resistance and obesity (3). Ideally, limit yourself to 1-2 drinks per week.
5. Eat broccoli & other cruciferous vegetables daily
1-2 cups daily of cruciferous veggies like broccoli, cauliflower, Brussels sprouts, kale, cabbage, and arugula provides sulfur compounds called indoles, to support overall gut health, Phase I and II liver detoxification, and reduce liver inflammation(1,7).
6. Eat more egg yolks
High in choline and many studies have shown that diets high in choline can help prevent the accumulation of fat in the liver (2,3). Egg yolks are also a decent source of vitamin A, which is lower in fatty liver and other liver diseases. (12)
7. Choose high quality animal foods including organ meats
Animals raised on a pasture are more nutrient dense and have fewer hormones and toxins, which makes them easier to digest and adds less waste for the liver to filter. Organ meats are higher in choline and other supportive nutrients for liver health like vitamins A, D and B.
8. Eat more fish and seafood
Individuals with fatty liver have low levels of healthy omega-3 fats. Eating wild caught fish and seafood – especially fatty fish like salmon and sardines – can increase omega-3 levels, lowering inflammation and liver fat. Omega-3’s also help lower triglycerides, which is a challenge for many people with fatty liver.
9. Buy organic as much as possible
Organic foods have lower levels of pesticides and no manufactured herbicides and thus have fewer toxins, which makes them easier to digest and adds less waste for the liver to filter.
10. Eat probiotic rich foods
Probiotics help reduce inflammation, support overall gut health, reduce the liver enzymes ALT and AST and improve insulin resistance. Fermented vegetables, cultured dairy, and kombucha are all great sources of probiotics(1,5).
11. Drink Bone Broth often
Bone broth has an amino acid called glutamine which can help heal your gut and reduce inflammation within the liver. Sipping on broth daily or eating soups made with homemade bone broth are both great practices! Bone broth protein powder is a good backup option on days you can’t get bone broth in.
- Easy Homemade Bone Broth Recipe (Slow cooker)
- Bonafide Provisions Bone Broth – my favorite store bought bone broth! (beef or chicken)
- Bone broth protein powder – available in unflavored, vanilla, and chocolate:
12. Use fresh herbs daily
- Turmeric – anti-inflammatory, antioxidant, helps promote healthy blood pressure, and liver protective
- Garlic – antioxidant, liver protective, reduces cholesterol and triglycerides levels, and improve insulin resistance
- Rosemary – antioxidant, anti-inflammatory, liver protective, may help with triglycerides, blood sugar, blood pressure, and weight reduction
- Bitters – Bitters like artichoke root and leaf, dried dandelion root, dried chicory root, dried grapefruit peel, fennel seeds, cardamom seeds and ginger have been used for centuries to support liver function and help liver cells regenerate.
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Supplements for Fatty Liver
These specific supplements have been well studied and each have shown their ability to help combat fatty liver. Reputable brands and products are listed below, but always check with your own provider before supplementing.
1. Milk Thistle
Milk thistle (“Silymarin”)It helps lower insulin resistance and is a powerful antioxidant, meaning it helps prevent damage to the liver and it is used to help heal and rejuvenate your liver.
2. Resveratrol supplements
Has similar effects to milk thistle, it has antioxidant and anti-inflammatory properties to help reduce liver fat.
This herb helps lower blood sugar (one study showed it to be more effective than the diabetes medication Metformin!), reduce cholesterol, promote heart health, and decrease liver fat accumulation.
4. N-Acetl-L-Cysteine (NAC)
NAC converts to glutathione which is a powerful antioxidant and detoxifier. It has also been shown to lower ALT liver enzymes, which are often elevated in fatty liver.
This antioxidant lowers liver enzymes ALT and AST, and reduces inflammation.
L-Carnitine levels are lower in patients with fatty liver, and multiple studies have shown L-Carnitine supplements to lower liver enzymes ALT and AST, and to reduce liver fat accumulation. (11) The product below has therapeutic doses of both L-Carnitine and CoQ10.
7. Mervia Curcumin
Curcumin (from the turmeric root) has shown to improve liver health and reduce liver enzymes ALT and AST.
Choline (sometimes called phosphatidylcholine or lecithin) levels are low in fatty liver patients. Supplementing with choline can help prevent or reverse liver fat accumulation (4). Ideally, use a soy-free versions like the one below.
9. Vitamins C, E, and Selenium
These vitamins and minerals can be found in a good multivitamin-mineral. They serve as antioxidants and have been shown to lower inflammation, reduce liver enzyme levels (AST, ALT, GGT, etc.), and reverse fatty liver when used alone or in combination with choline and milk thistle (4).
10. Pantethenate (Vitamin B5)
This B vitamin helps to lower triglyceride levels and remove fat from the liver (6).
11. Fish Oil (omega-3)
Multiple studies have shown fish oil supplements to reduce liver fat on ultrasound. Fish oil can also significantly lower triglyceride levels and reduce inflammation in the body. (9)
It is a common mineral deficiency. It’s needed to help the body make more glutathione, an antioxidant that protects against liver damage.
13. Probiotic supplements
14. Rosemary tinctures
Rosmarinus officinalis – or rosemary – has been shown in many preliminary studies (petri dish and rat studies) to improve survival rate after heart attack, lower blood pressure, lower blood sugar, and decrease body weight as well as cholesterol and triglyceride levels. (8) Human studies are needed to confirm benefits and determine recommended doses, but rosemary can be purchased in liquid tincture form and is often recommended as part of a protocol for improving liver health.
TUDCA is a combination of taurine with ursodeoxycholic acid (UDCA), the same compound used in prescription medications to treat the autoimmune liver condition Primary Biliary Cirrhosis. TUDCA has been shown in some small human studies to significantly decrease levels of the liver enzymes AST and ALT. Mice studies have shown it to reduce liver damage, oxidative stress, and scar tissue in mice given fatty liver disease. (10)
Other Lifestyle Factors that Help Fatty Liver
If you’re overweight, one of the best things you can do is lose weight. Even 5-10% weight loss can significantly improve fatty liver.
In addition to how helpful exercise can be for weight loss, it also helps reduce blood sugar and insulin resistance, which improves fatty liver (3). A few shorter sessions of cardio daily (i.e., 10 minute brisk walk after meals three times daily) may be even more beneficial than one longer one!
Multiple studies have shown ultraviolet light (sunlight) can slow the progression of fatty liver disease, both related to the vitamin D it provides and independent of it. This level of protection isn’t the same when vitamin D supplements are used (13).
Fatty liver is common and on the rise. The good news is that it is extremely responsive to diet and lifestyle changes. If you want a personalized protocol to help reverse your fatty liver, consider working one-on-one with Dena! Schedule a Discovery Call to learn more.
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About the Co-Author
Sandra Johnson, Dietetic Intern has a B.S. in Human Nutrition and Foods from the University of Houston. When she started changing her eating patterns and improving her health to be a better influence for her children, she discovered her passion for nutrition and food.
Disclaimer: Information on this site is intended only for informational purposes and is not a substitute for medical advice. Always consult with a trusted healthcare provider before implementing significant dietary change. Read additional disclaimer info here.
4.Loguercio, C., Andreone, P., Brisc, C., Brisc, M.,Burgainesi,E., Chiaramonte, M.,…Federico, A.(2012). Silybin combined with phosphatidylcholine and vitamin E in patients with nonalcoholic fatty liver disease: A randomized controlled trial, Free Radical Biology and Medicine 52(9), 1658-1665.https://www.ncbi.nlm.nih.gov/pubmed/22343419
5.Ma, Y., Li, L., Yu,C., Shen, Z., Chen, L. & Li, Y. (2013). Effects of probiotics on nonalcoholic fatty liver disease: A meta-analysis. World J Gastroenterol, 19(40), 6911- 6918. doi: 10.3748/wjg.v19.i40.6911
6.Orono, Y., Hirose, N., Nakajima,K. & Hata, Y. (2000). The effects of pantethine on fatty liver and fat distribution. Journal of atherosclerosis and thrombosis, 7(1), 55-58. https://doi.org/10.5551/jat1994.7.55
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9. Lu, W., Li, S., Li, J., Wang, J., Zhang, R., Zhou, Y., Yin, Q., Zheng, Y., Wang, F., Xia, Y., Chen, K., Liu, T., Lu, J., Zhou, Y., & Guo, C. (2016). Effects of Omega-3 Fatty Acid in Nonalcoholic Fatty Liver Disease: A Meta-Analysis. Gastroenterology research and practice, 2016, 1459790. https://doi.org/10.1155/2016/1459790
11. Savic, D., Hodson, L., Neubauer, S., & Pavlides, M. (2020). The Importance of the Fatty Acid Transporter L-Carnitine in Non-Alcoholic Fatty Liver Disease (NAFLD). Nutrients, 12(8), 2178. https://doi.org/10.3390/nu12082178
12. Saeed, A., Dullaart, R., Schreuder, T., Blokzijl, H., & Faber, K. N. (2017). Disturbed Vitamin A Metabolism in Non-Alcoholic Fatty Liver Disease (NAFLD). Nutrients, 10(1), 29. https://doi.org/10.3390/nu10010029
13. Hoel, D. G., Berwick, M., de Gruijl, F. R., & Holick, M. F. (2016). The risks and benefits of sun exposure 2016. Dermato-endocrinology, 8(1), e1248325. https://doi.org/10.1080/19381980.2016.1248325