Fatty liver disease is caused by a build-up of fat in the liver.

There are two types of fatty liver disease: alcoholic and nonalcoholic. Alcoholic fatty liver disease is caused by heavy alcohol use. Nonalcoholic fatty liver disease (NAFLD) isn’t related to alcohol use.

Although researchers are still unsure of what exactly causes a build-up of fat in an individual’s liver, it’s more common in people who are living with:

There are currently no drugs available to treat NAFLD. Diet and lifestyle changes are among the most effective ways to manage this condition.

So, what types of diet and lifestyle changes can be helpful? Read on to learn more.

If you have NAFLD, keep in mind that not all diets and supplements are healthy for your liver. It’s important to discuss any alternative treatments with your doctor before trying them.

The American Association for the Study of Liver Diseases (AASLD)’s 2017 guide identifies weight loss as a critical part of improving NAFLD progression and symptoms.

The guide recommends that people living with obesity and NAFLD lose between 3 and 5 percent of their body weight to reduce fat buildup in the liver.

It also states that losing between 7 and 10 percent of body weight can improve other symptoms of NAFLD, such as inflammation, fibrosis, and scarring

The best way to lose weight and maintain it is to take small steps toward your goal over time. Fasting and extreme diets are often unsustainable, and they can be hard on your liver.

Before beginning any weight loss program, it’s important to speak with your doctor to see what the right plan is for you. A dietitian can develop an eating plan to help you reach your weight loss goals and make nutritious food choices.

Research from 2017 suggests that the Mediterranean diet may help to reduce liver fat, even without weight loss.

The Mediterranean diet also helps conditions commonly associated with NAFLD, including high cholesterol, high blood pressure, and type 2 diabetes.

This eating plan focuses on a variety of plant-based foods and healthy fats. Here’s a brief overview of foods to focus on:

Fruits and vegetables

Aim to eat a variety. Try adding more:

  • berries
  • apples
  • oranges
  • bananas
  • dates
  • figs
  • melons
  • leafy greens
  • broccoli
  • peppers
  • sweet potatoes
  • carrots
  • squash
  • cucumbers
  • eggplant
  • tomatoes

Legumes

Try to include:

  • beans
  • peas
  • lentils
  • pulses
  • chickpeas

Healthy fats

Use healthy oils, such as extra virgin olive oil. High concentrations of healthy fats can also be found in:

  • nuts
  • seeds
  • avocados
  • olives

Fish and lean meats

Opt for fish twice per week. Eggs and lean poultry, like skinless chicken and turkey, are fine in moderation.

Whole grains

Consume unprocessed grains and cereals, such as:

  • whole-wheat bread
  • brown rice
  • whole oats
  • couscous
  • whole-wheat pasta
  • quinoa

According to research from 2016, coffee offers a number of protective benefits for the liver. In particular, it stimulates the production of liver enzymes believed to fight inflammation.

The same research reported that among people with NAFLD, regular coffee consumption reduces overall liver damage.

Two to three cups of coffee per day seems to be the amount that best lowers the risk of liver disease. Black coffee is the best option, as it doesn’t contain any added fat or sugar.

Because coffee contains caffeine, it’s always a good idea to be mindful of your consumption. If two or three cups make you feel jittery or anxious, it may not be the best option for you.

According to research from 2017, NAFLD is often associated with a sedentary lifestyle. In addition, inactivity is known to contribute to other conditions associated with NAFLD, including heart disease, type 2 diabetes, and obesity.

It’s important to stay active when you have NAFLD. According to the Physical Activity Guidelines for Americans, a good goal to shoot for is at least 150 minutes of moderate-intensity exercise per week.

That’s around 30 minutes, 5 days per week. You don’t necessarily have to play a sport or even go to the gym to get exercise, though. You can take a brisk 30-minute walk, 5 days a week.

Or, if you’re pressed for time, you can even break it down into two brisk 15-minute walks, 5 days a week.

To start exercising, try integrating moderate physical activity into your daily routine. Walk to the grocery store, walk the dog, play with your kids, or take the stairs instead of the elevator whenever you can.

If you’re interested in starting a new exercise routine, talk with your doctor about your best options.

Dietary sugars such as fructose and sucrose have been linked to the development of NAFLD. Research from 2017 describes how these sugars can contribute to fat buildup in the liver over time.

Major culprits include store-bought and commercially processed foods, such as:

  • baked goods, like cakes, cookies, doughnuts, pastries, and pies
  • candy
  • ice cream
  • sugary cereals
  • soft drinks
  • sports drinks
  • energy drinks
  • sweetened dairy products, like flavored yogurts

To identify whether a packaged food contains added sugar, read the ingredients list on the product packaging. Words that end in “ose,” including sucrose, fructose, and maltose, are sugars.

Other sugars commonly added to food products include:

Another way to tell how much sugar is in a food item is to read the nutrition facts label and to look at the number of grams of sugar that are in a serving for that item — the lower, the better.

According to research from 2012, NAFLD can make it harder for your body to manage cholesterol on its own. This can worsen NAFLD and increase your risk of heart disease.

Try to limit your intake of certain types of fats to help manage your cholesterol and treat NAFLD. Fats to limit include:

  • Saturated fats. These are found in red meats and full-fat dairy products.
  • Trans fats. Trans fats are often found in processed baked goods, crackers, and fried foods.

Many of the lifestyle changes listed above — including losing weight, staying active, and adopting a Mediterranean diet — can also help you manage your cholesterol. Your doctor might also prescribe medication for high cholesterol.

While certain fats should be limited for overall health, other types of fats can actually be beneficial. Omega-3 fatty acids are polyunsaturated fats found in foods such as oily fish and some nuts and seeds. They’re known to have benefits for heart health, and are often recommended for people with NAFLD.

A 2016 review of studies suggests that taking an omega-3 supplement may reduce liver fat and improve cholesterol levels.

In the review, daily omega-3 doses ranged from 830 to 9,000 milligrams. Talk with your doctor about how much you should take, and if they believe the supplement route is better than the food route for you.

Certain substances can put excess stress on your liver. Some of these substances include alcohol, over-the-counter (OTC) medications, and some vitamins and supplements.

According to research from 2019, even moderate consumption of alcohol can lead to disease progression in individuals with NAFLD.

If you’re currently living with NAFLD, talk with your doctor or a pharmacist before taking any OTC medication, vitamins, or supplements, as many of them can affect your liver.

Vitamin E is one antioxidant that may reduce inflammation caused by NAFLD. According to a 2018 review of studies, while some research is promising, more studies are needed to understand who can benefit from this supplement and how.

In their 2017 guide, the AASLD recommends a daily dose of 800 international units of vitamin E per day for people with NAFLD who don’t have diabetes and have confirmed nonalcoholic steatohepatitis (NASH), an advanced form of NAFLD.

Like many supplements, there are some risks associated with taking a high dose of vitamin E. Talk with your doctor to find out if vitamin E is right for you and whether it could help with your NAFLD.

A 2018 review of studies identified certain herbs, supplements, and spices that have been used as alternative treatments for NAFLD. Compounds shown to have positive effects on liver health include turmeric, milk thistle, resveratrol, and green tea.

Keep in mind that these aren’t approved medical treatments for NAFLD, and they may have side effects. It’s important to talk with your doctor before taking any herbs and supplements for NAFLD.

There are currently no approved medical treatments for NAFLD, though there are some in development.

One such treatment is pioglitazone, a medication typically prescribed for type 2 diabetes. The AASLD’s 2017 guide suggests that pioglitazone may help improve liver health in people with and without type 2 diabetes.

More research needs to be done to understand the long-term safety and effectiveness of this treatment. As a result, this medication is only recommended for people with confirmed NASH.

Lifestyle and dietary changes are currently the most effective options for managing NAFLD. Losing weight, being physically active, cutting back on sugar, eating a nutrient-dense diet, and drinking coffee (if you can tolerate it) are some of the methods that may help improve symptoms associated with NAFLD.

If you have this condition, be sure to work closely with your doctor to develop a personalized treatment plan that’s right for you.