Nonalcoholic Fatty Liver Disease Diet: A Beginner’s Guide

Nonalcoholic fatty liver disease (NAFLD) is a condition where fat accumulates in your liver.

It’s a progressive disease that can lead to more severe forms of liver disease such as hepatitis and cirrhosis.

Fortunately, you can reverse NAFLD or reduce its progression with your diet.

This article explains what to eat and avoid with nonalcoholic fatty liver disease and provides a sample nonalcoholic fatty liver disease diet. 

What is nonalcoholic fatty liver disease?

Nonalcoholic fatty liver disease (NAFLD) is a condition where fat becomes deposited within the liver.

As the name implies, it doesn’t result from excessive alcohol use — the most common cause of liver disease.

Instead, the disease commonly occurs as a consequence of other conditions, mainly type 2 diabetes and obesity.

The prevalence of NAFLD in America and other Western countries is 20–30%, and an estimated 50–70% of people with diabetes have the condition (1, 2).

NAFLD is a chronic condition, meaning it takes years to develop.

Over time, however, NAFLD can progress to more severe forms of liver disease, including nonalcoholic steatohepatitis (NASH) and liver cirrhosis (2).

People with NAFLD commonly experience fatigue but generally have no other symptoms.

Symptoms such as nausea, vomiting, yellowing of the skin and whites of the eyes (jaundice), and loss of appetite occur as the condition advances.

A liver biopsy is the gold standard for diagnosing NAFLD, but an ultrasound of the abdomen is routinely used (1, 3).

Despite its progressive nature, you can reverse mild forms of NAFLD or halt its advancement to more severe forms of liver disease with diet.

Nonalcoholic fatty liver disease diet

While the evidence for specific diets for the treatment of NAFLD remains limited, a diet that resembles the Mediterranean diet has been shown to promote weight loss and decrease fat buildup within the liver, helping to shrink the liver (4, 5, 6, 7).

It has also been shown to reduce the progression of NAFLD by decreasing liver inflammation (8, 9).

The Mediterranean diet consists of fruits and vegetables, whole grains, nuts, seeds, beans, fish, and healthy fats like olive oil.

Consuming these foods can help you lose weight and maintain a healthy weight, while also lowering inflammation and supporting healthy blood vessel function (10).

Here are foods to eat and limit with nonalcoholic fatty liver disease.

Foods to eat

• Fruits: apples, bananas, berries, grapes, kiwifruit, mangos, melons, nectarines, oranges, pears, etc.
• Vegetables: arugula, asparagus, beets, broccoli, cabbage, carrots, kale, mushrooms, peppers, etc.
• Whole grains: brown rice, quinoa, oatmeal, whole-grain bread, tortillas, and pasta
• Nuts and seeds: almonds, brazil nuts, chia seeds, flaxseeds, pecans, pistachios, pumpkins seeds, walnuts
• Legumes: black beans, black-eyed peas, chickpeas, kidney peas, lima beans, pinto beans
• Fish and shellfish: tuna, herring, salmon, sardines, shrimp
• Poultry: eggs, chicken, duck, turkey
• Dairy: cheese and Greek yogurt
• Oils: olive oil and avocado oil
• Herbs and spices: basil, bay leaf, black pepper, cloves, garlic, oregano, paprika, turmeric
• Beverages: black coffee, tea, water

Foods to limit

Limit foods that tend to promote liver inflammation, such as:

• Sugars items: Sugar-sweetened drinks like soda, energy drinks, and specialty coffee drinks.
• Refined grains: White bread, rolls and bagels, crackers, cakes, cookies, and most breakfast cereals.
• Red and processed meats: Ham, sausages, bacon, hot dogs, pepperoni, beef, and deli meats.
• Solid fats: Butter, coconut, and palm oil.
• Alcohol: Beer, wine, whiskey, and vodka.

Sample nonalcoholic fatty liver disease diet

Here is a one-day sample NAFLD diet plan.

Breakfast: Oatmeal topped with blueberries, scrambled eggs, and black coffee.

Snack: Greek yogurt, almonds, and apple slices.

Lunch: Mediterranean-style wrap made with chicken, feta cheese, Greek yogurt, roasted red peppers, black olives, and baby spinach.

Snack: Avocado toast topped with cherry tomatoes and feta cheese.

Dinner: Grilled salmon, roasted garbanzo beans, and grilled asparagus.

Exercise for nonalcoholic fatty liver disease

While diet is essential for treating NAFLD, exercise can also help — especially when combined with a Mediterranean-style diet (11, 12).

A review of 20 studies involving more than 1,000 people with NAFLD found that exercise decreased the amount of fat within the liver, even in the absence of significant weight loss (13).

The same review found no significant difference between aerobic exercise like brisk walking, running, or cycling and resistance training or weight lifting.

The Physical Activity Guidelines for Americans recommend doing at least 150 minutes per week of moderate-intensity exercise, 75 — 150 minutes a week of high-intensity exercise, or a combination of both (14).

Here are examples of moderate- and high-intensity activities (15):

Moderate-intensity activities:

• walking briskly (3 – 4.5 miles per hour)
• hiking
• bicycling (5 to 9 miles per hour)
• weight training
• recreational swimming

High-intensity activities:

• jogging or running
• climbing briskly up a hill
• bicycling (faster than 10 miles per hour)
• circuit weight training
• competitive sports like football, basketball, and soccer

The same guidelines also recommend performing muscle-strengthening exercises that involve all major muscle groups at least twice per week.

The bottom line

NAFLD or fatty liver is a condition that occurs when fat builds up within your liver.

It’s a common condition and most often occurs in people who are overweight or have type 2 diabetes.

Left untreated, NAFLD can progress to more severe forms of liver disease like NASH and cirrhosis.

Following a Mediterranean-style diet rich in fruits, vegetables, beans, nuts, and fish can help reverse NAFLD or prevent its progression.

Combine exercise with a Mediterranean-style diet for the best results.