Reversing Non-Alcoholic Fatty Liver Disease with Food

August 25, 2020 5:00 AM

A registered dietitian explains how less sugar is key, offering a recipe to try at home.

The supersized, high-fat, high-carbohydrate American diet isn’t gentle on the liver, and can result in non-alcoholic fatty liver disease, or NAFLD, which leads to inflammation or even organ failure from scarring over time.

Thirty percent of the American population has this buildup of fat in their liver cells, according to Lorraine Bonkowski, R.D., a dietitian in hepatology at Michigan Medicine.

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“Of that group, 20% will develop inflammation that causes damage and scarring, referred to as non-alcoholic steatohepatitis, or NASH,” Bonkowski says. “Twenty percent of those with inflammation will advance to irreversible organ damage.”

Unfortunately, NAFLD often goes undetected until organ damage has occurred. The symptoms, if there are any, can be easily downplayed.

A patient might have a dull ache or discomfort in the right abdomen or feel fatigued, Bonkowski says. But even if they seek out a blood test, liver enzyme levels don’t always show as being elevated, which is a sign that the liver is sick.

The silent nature of the disease makes knowing risk factors even more important, like obesity, high cholesterol and type 2 diabetes or prediabetes.

SEE ALSO: The Risk Factors That Mean You Need a Test for Liver Disease

Although there aren’t any medications to treat NAFLD, a good diet and regular exercise can reverse it. Losing 10% of your current weight can dramatically decrease the amount of fat in the liver as well as reduce inflammation.

But what does a “good diet” mean? One common misconception about a fatty liver is that a low-fat diet will solve the problem.

According to Bonkowski, there are healthy and non-healthy fats and the healthy ones – such as those found in nuts, seeds and olive oil – can be welcome additions to a nutritious diet. The key to reversing NAFLD is actually to eat less simple carbohydrates and other sugars.

“It takes a special attention to nutrition labels to find the hidden sugars found in foods like yogurt, granola bars, cereals, protein shakes, ketchup and salad dressing,” Bonkowski says.

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She adds that women should limit added sugars to no more than 24 grams a day, or 6 teaspoons worth of sugar. For men, no more than 36 grams a day, or 9 teaspoons of sugar.

So, what should you eat?

Like for many others conditions, a Mediterranean diet full of whole grains, lean proteins, healthy fats and vegetables is the perfect remedy to fight NALFD, or prevent the development of risk factors.

Quinoa Tabbouleh Salad Recipe

Quinoa Tabboulet Salad on a dish on table

This plant-based salad serves a family of four and is packed with liver-friendly ingredients.

“Quinoa is technically a seed but considered a whole grain and complex carb, making for a healthier diet,” Bonkowski says. “This recipe also has fiber, protein, unsaturated fat from the olive oil and fresh ingredients like cucumbers, carrots and tomatoes.”

What you’ll need

  • 1 cup of quinoa, rinsed and dried

  • 2 cups of water

  • 1 bunch of fresh parsley, finely chopped

  • 1⁄2 bunch of fresh mint, finely chopped

  • 2 carrots, shredded

  • 1 pint of cherry tomatoes

  • 1⁄2 cucumber, diced

  • 3 green onions, sliced

  • 2 tablespoons of olive oil

  • 3 tablespoons of fresh squeezed lemon juice (can substitute with a lemon)

  • 1⁄2 teaspoon of onion powder

  • 1⁄2 teaspoon of salt

  • A dash of black pepper


  1. Add one cup of washed quinoa and two cups of water in a pot until boiling and then reduce to a simmer for 10-15 minutes.

  2. While the quinoa is cooking, prep the parsley, mint, carrots, cherry tomatoes, cucumbers and green onion and set aside.

  3. After the 15-20 minutes, spread the quinoa out on a large plate to cool.

  4. In a small bowl, combine the olive oil, lemon juice, onion powder, salt and black pepper to make a dressing.

  5. Finally, combine all the ingredients and dressing together in a large bowl. Toss to mix thoroughly.

This recipe is endorsed by Lorraine Bonkowski, R.D., and can be found at the University of Michigan’s MHealthy with additional nutritional information.