It may come as no surprise to you that I often express gratitude for individual organs in my body. And 10 years ago, my liver never would have even entered into the consideration set. My brain, my heart, my lungs, my skin, sure … but my liver? I hardly even knew what it did, let alone how powerful it was.
Fast forward to today, and more and more of us are hearing about liver health, which is great, but the reason we’re hearing about it (that fatty liver is becoming an incredibly common affliction) is not great. Today, non-alcoholic fatty liver disease (or NAFLD) affects up to 75% of adults who are overweight, up to 2/3 of people with type 2 diabetes, and about 90% of adults who are obese (source). In fact, some estimates say that up to 40% of adults in Western countries will develop non-alcoholic fatty liver disease at some point.
So today, I’m going to tackle a huge topic in bite-sized pieces. I’m going to discuss why our liver is so important to our overall health, what non-alcoholic fatty liver disease is, how to prevent it, and how to manage it with lifestyle and nutrition. Get ready to learn!
What is the liver and what does the liver do?
Our liver is widely considered one of the hardest working organs in our bodies because it’s one of our main detoxification organs and is literally working around the clock to filter out any toxins that enter our bodies. Whether these are prescription medications, pollutants in the air we breathe, toxic items we put on our skin, or harmful chemical ingredients found in food, our liver takes care of every single one of them, converting them into harmless substances that can be excreted. The liver is also involved in metabolism, hormone balance, circulation, digestion, and energy balance.
The liver weighs about 3 pounds and is located under your rib cage on the right side of your body. And as I mentioned, it’s constantly working. Here are just a few functions of the liver:
- Filters blood from the digestive tract
- Produces bile, which helps digest fat
- Helps metabolize proteins and converts carbohydrates into glucose and glycogen
- Breaks down and removes excess hormones
- Stores some vitamins and minerals
- Manufactures triglycerides and cholesterol
- Produces components of blood and regulates blood clotting
The liver is so critical to our body that it can even regenerate itself! Have you ever heard of a living-donor transplant? That is when someone, who is still alive, donates a small portion of their liver to another human in need of a liver, and if there is even 25% of the new liver transplanted into the other body, it can fully regenerate into an entirely new liver! This sounds like science fiction, but in my mind, it’s the innate superintelligence of the body that prioritizes this essential organ.
What is non-alcoholic fatty liver disease (NAFLD)?
The short version is that when the liver is overburdened, it stores excess fat, and when excess fat accumulates in liver cells, we develop non-alcoholic fatty liver disease. It has a similar presentation to alcoholic fatty liver disease, which occurs when the liver becomes overburdened by processing alcohol rather than other things. In decades past, we were not exposed to the plethora of toxins, sugars, processed foods, low-quality fats, and refined carbohydrates that our livers need to deal with today, so liver issues were usually only seen in those who drank excessive quantities of alcohol. But today, because of the high number of these things that our livers need to deal with, non-alcoholic fatty liver disease is the more common variety.
The majority of clients that I treat who have non-alcoholic fatty liver had no symptoms prior to running bloodwork with me and discovering elevated liver enzymes (ALT and AST are two liver enzymes that are easy and routine to test, which I run nearly every time I run bloodwork on someone), or getting bloodwork from another practitioner, or getting testing like an ultrasound or CT scan for something else. This is one reason bloodwork is so important – we can catch things like non-alcoholic fatty liver disease at early stages when nutrition and lifestyle are far more impactful at managing, treating, and reversing them than when we catch them at later stages. However, those who do experience symptoms often describe fatigue, abdominal discomfort, nausea, decreased appetite, or feeling of fullness.
What causes non-alcoholic fatty liver disease?
- Being overweight or obese and being insulin resistant are the two most direct causes of non-alcoholic fatty liver disease (source).
- Having high blood sugar because of a high-refined-carbohydrate, high-sugar diet leads to insulin resistance, which directly causes fatty liver (source).
- Consuming a very high amount of fats, particularly low-quality fats like hydrogenated oils, vegetable oils, and trans fats also causes fatty liver.
- Being on many prescription medications, being exposed to many environmental toxins, or consuming many chemical preservatives in food may also contribute to fatty liver disease because the liver has to filter all of these and winds up overburdened, which causes it to store excess toxins in fat.
How to manage non-alcoholic fatty liver disease with nutrition and lifestyle
Unfortunately, I’ve had many clients come to me after having met with doctors, who told them, “there’s nothing you can do, so just try to lose weight and hope that helps.” This, honestly, makes me want to scream from the rooftops because there is something we can do. In fact, I’ve had many dozens of clients who have reversed their non-alcoholic fatty liver disease by managing their nutrition and lifestyle. It does make a difference!
It is true that weight loss of about 10% of body weight can often help reverse fatty liver disease, but this is a bit tricky for two reasons. First, very rapid weight loss causes toxins to be released by fat that needs to be reprocessed by the liver and can stall or reverse progress, so weight loss needs to be gradual but sustained. Second, if the individual loses weight on a low-quality diet, they are not fixing the underlying problem, and will not reverse fatty liver disease. A low-sugar, high-fiber, high-nutrient (vegetables!!) diet is essential for appropriate management.
Particularly helpful foods in reducing non-alcoholic fatty liver disease are those foods we always talk about as healthy foods here, which should reinforce the message that the body is all connected, and health of one part equals health of another part. Here are some of the top foods for managing fatty liver disease:
- A Mediterranean-style diet high in vegetables, fruits, polyunsaturated fats like olive oil and avocados, polyphenols from vegetables and fruits, and moderate animal protein is linked to significant improvements in non-alcoholic fatty liver disease (source)
- Bitter vegetables like mustard greens, leafy greens overall, arugula, dandelion, artichokes, and asparagus are all helpful for the liver
- Foods rich in omega-3 fatty acids (see this post for more!)
- Foods or supplements rich in vitamin E (see this post for more!)
- Green tea
Foods that need to be minimized or avoided to reverse fatty liver include:
- High-sugar foods, especially those high in added sugar, and more especially those containing high fructose corn syrup, which should be avoided completely in those with non-alcoholic fatty liver disease
- Alcohol (even though this isn’t the direct cause of non-alcoholic fatty liver, it still overburdens the liver)
- Ultra-processed foods, especially those with hydrogenated oils, food colorings, artificial sweeteners, and other harmful preservatives
- Low-quality meats (it is a good time to try to prioritize good quality as it is feasible/ accessible to you)
- Refined grains (like breads, pastas, and pastries, which contribute to insulin resistance)
- Anything that keeps blood sugar unstable (you can view this free Masterclass all about how to keep your blood sugar stable!)
Supplement-wise, my protocol for dealing with individual clients experiencing non-alcoholic fatty liver disease is very individualized based on our hypotheses for the primary root causes. That said, here are the top two most common I recommend:
- Milk thistle, which is by far the most studied and proven liver support supplement and has been shown to reverse NAFLD (source). I recommend (and take) this version from Thorne
- Berberine, which is fantastic for all things blood sugar control and insulin sensitivity and has been shown effective in NAFLD treatment (source). I recommend (and take!) the Integrative Therapeutics variety.
How to prevent non-alcoholic fatty liver disease and protect your liver now
Enjoying an overall healthy lifestyle is the best way to prevent non-alcoholic fatty liver disease. Here are a few more tips to keep in mind:
- Eating a diet that keeps your blood sugar stable is essential to preventing fatty liver disease. This means fewer refined carbohydrates and sugars, and more vegetables, protein, and healthy fat for most people. To learn how to combine your food, what order to eat food in, and sneaky blood sugar villains, watch this masterclass.
- Eating tons of vegetables, rich in polyphenols and antioxidants that reduce risk of NAFLD, is important.
- Drinking adequate water to support liver function is essential.
- Exercising in a way you enjoy on most days is great for preventing insulin resistance and thus, non-alcoholic fatty liver disease.
- Probiotics: research has shown the power of probiotics to “effectively prevent” diet-induced non-alcoholic fatty liver disease (source). For more on probiotics including my recommended brands, see this post.
- Managing stress plays a huge part here as well. I am not an expert in Chinese Medicine, but in Chinese Medicine, the liver controls the free flow of Qi, or energy, throughout the whole body, and excessive stress can prevent the appropriate function of this vital organ.
Now it’s your turn! Did you know how powerful the liver is? What changes can you make based on reading this that might support your liver?
Want more? In my Revitalize Health Accelerator, I walk you through every step of what it takes to be a well-rounded healthy person. The information, motivation, and accountability in this program is simply unmatched! You’ll learn everything from inflammation to emotional eating, from supplements to sleep quality, from macronutrient balance to meal planning – I’ll walk you through my proven system to teach you how to implement it. If you’re curious, set up a free call with me here to discuss!