Fatty liver
Fatty liver, or hepatic steatosis, is a term that describes the buildup of fat in the liver. It’s normal to have some fat in your liver, but too much can become a health problem.
The liver is the second largest organ in the body. Its function is to process everything we eat or drink and filter any harmful substances from the blood. This process is interrupted if too much fat is in the liver. Fatty liver is when fat accounts for more than 5 to 10 percent of your liver’s weight.
The liver commonly repairs itself by rebuilding new liver cells when the old ones are damaged. When there’s repeated damage to the liver, permanent scarring takes place. This condition is called cirrhosis.
Fatty liver is a reversible condition that can often be resolved with lifestyle modifications. In many cases, fatty liver has no symptoms. It doesn’t usually cause permanent damage unless it progresses.
Fatty liver is a common condition, affecting around 10 to 20 percent of Americans without cirrhosis or inflammation. Most cases of fatty liver are detected in people between ages 40 and 60, according to the American Liver Foundation.
Fatty liver can become harmful to the liver if its underlying cause isn’t recognized and treated.
Fatty liver, or hepatic steatosis, is a term that describes the buildup of fat in the liver. It’s normal to have some fat in your liver, but too much can become a health problem.
The liver is the second largest organ in the body. Its function is to process everything we eat or drink and filter any harmful substances from the blood. This process is interrupted if too much fat is in the liver. Fatty liver is when fat accounts for more than 5 to 10 percent of your liver’s weight.
The liver commonly repairs itself by rebuilding new liver cells when the old ones are damaged. When there’s repeated damage to the liver, permanent scarring takes place. This condition is called cirrhosis.
Fatty liver is a reversible condition that can often be resolved with lifestyle modifications. In many cases, fatty liver has no symptoms. It doesn’t usually cause permanent damage unless it progresses.
Fatty liver is a common condition, affecting around 10 to 20 percent of Americans without cirrhosis or inflammation. Most cases of fatty liver are detected in people between ages 40 and 60, according to the American Liver Foundation.
Fatty liver can become harmful to the liver if its underlying cause isn’t recognized and treated.
What are the symptoms of fatty liver?
Fatty liver typically has no associated symptoms. You may experience fatigue or vague abdominal discomfort. Your liver may become slightly enlarged, which your doctor can detect during a physical exam.
However, excess fat in the liver can cause inflammation. If your liver becomes inflamed, you may have symptoms such as:
- a poor appetite
- weight loss
- abdominal pain
- physical weakness
- fatigue
- confusion
If fatty liver progresses to cirrhosis and liver failure, symptoms can include:
- an enlarging, fluid-filled abdomen
- jaundice of the skin and yellowing of the eyes
- confusion
- a tendency to bleed more easily
Fatty liver typically has no associated symptoms. You may experience fatigue or vague abdominal discomfort. Your liver may become slightly enlarged, which your doctor can detect during a physical exam.
However, excess fat in the liver can cause inflammation. If your liver becomes inflamed, you may have symptoms such as:
- a poor appetite
- weight loss
- abdominal pain
- physical weakness
- fatigue
- confusion
If fatty liver progresses to cirrhosis and liver failure, symptoms can include:
- an enlarging, fluid-filled abdomen
- jaundice of the skin and yellowing of the eyes
- confusion
- a tendency to bleed more easily
What are the causes of fatty liver?
The most common cause of fatty liver is alcoholism and heavy drinking. In many cases, doctors don’t know what causes fatty liver in people who don’t drink much alcohol.
Fatty liver develops when the body creates too much fat or cannot metabolize fat fast enough. The excess fat is stored in liver cells where it accumulates to form fatty liver disease. Eating a high-fat, high-sugar diet may not directly result in fatty liver, but it can contribute to it.
Besides alcoholism, other common causes of fatty liver include:
- obesity
- hyperlipidemia, or high levels of fats in the blood
- diabetes
- genetic inheritance
- rapid weight loss
- side effect of certain medications, including aspirin, steroids, tamoxifen (Nolvadex), and tetracycline (Panmycin)
The most common cause of fatty liver is alcoholism and heavy drinking. In many cases, doctors don’t know what causes fatty liver in people who don’t drink much alcohol.
Fatty liver develops when the body creates too much fat or cannot metabolize fat fast enough. The excess fat is stored in liver cells where it accumulates to form fatty liver disease. Eating a high-fat, high-sugar diet may not directly result in fatty liver, but it can contribute to it.
Besides alcoholism, other common causes of fatty liver include:
- obesity
- hyperlipidemia, or high levels of fats in the blood
- diabetes
- genetic inheritance
- rapid weight loss
- side effect of certain medications, including aspirin, steroids, tamoxifen (Nolvadex), and tetracycline (Panmycin)
What are the types of fatty liver?
There are two basic types of fatty liver: nonalcoholic and alcoholic.
There are two basic types of fatty liver: nonalcoholic and alcoholic.
Nonalcoholic fatty liver disease
Nonalcoholic fatty liver disease (NAFLD) develops when the liver has difficulty breaking down fats, which causes a buildup in the liver tissue. The cause is not related to alcohol. NAFL is diagnosed when more than 10 percent of the liver is fat.
Nonalcoholic fatty liver disease (NAFLD) develops when the liver has difficulty breaking down fats, which causes a buildup in the liver tissue. The cause is not related to alcohol. NAFL is diagnosed when more than 10 percent of the liver is fat.
Alcoholic fatty liver
Alcoholic fatty liver is the earliest stage of alcohol-related liver disease. Heavy drinking damages the liver, and the liver cannot break down fats as a result. Abstaining from alcohol will likely cause the fatty liver to subside. Within six weeks of not drinking alcohol, the fat will disappear. However, if excessive alcohol use continues, cirrhosis may develop.
Alcoholic fatty liver is the earliest stage of alcohol-related liver disease. Heavy drinking damages the liver, and the liver cannot break down fats as a result. Abstaining from alcohol will likely cause the fatty liver to subside. Within six weeks of not drinking alcohol, the fat will disappear. However, if excessive alcohol use continues, cirrhosis may develop.
Nonalcoholic steatohepatitis (NASH) and alcoholic steatohepatitis
When enough fat builds up, it will cause the liver to swell. If the original cause is not from alcohol, it’s called nonalcoholic steatohepatitis (NASH). This disease can impair liver function.
Symptoms can be seen with this disease. These include:
- appetite loss
- nausea
- vomiting
- abdominal pain
- jaundice
If left untreated, steatohepatitis can progress to permanent scarring of the liver and eventual liver failure.
When enough fat builds up, it will cause the liver to swell. If the original cause is not from alcohol, it’s called nonalcoholic steatohepatitis (NASH). This disease can impair liver function.
Symptoms can be seen with this disease. These include:
- appetite loss
- nausea
- vomiting
- abdominal pain
- jaundice
If left untreated, steatohepatitis can progress to permanent scarring of the liver and eventual liver failure.
Acute fatty liver of pregnancy
Acute fatty liver is a rare, and potentially life-threatening, complication of pregnancy.
Symptoms begin in the third trimester. These include:
- persistent nausea and vomiting
- pain in the upper-right abdomen
- jaundice
- general malaise
Women who are pregnant will be screened for this condition. Most women improve after delivery and have no lasting effects.
Acute fatty liver is a rare, and potentially life-threatening, complication of pregnancy.
Symptoms begin in the third trimester. These include:
- persistent nausea and vomiting
- pain in the upper-right abdomen
- jaundice
- general malaise
Women who are pregnant will be screened for this condition. Most women improve after delivery and have no lasting effects.
Who’s at risk for fatty liver?
Fatty liver is the buildup of extra fats in the liver. It’s more likely to develop if you’re overweight or obese. Having type 2 diabetes also may increase your risk for fatty liver. Fat accumulation in the liver has been linked to insulin resistance, which is the most common cause of type 2 diabetes. Studies have shown that a high-choline diet is associated with a lower risk of fatty liver disease.
Other factors that may increase your risk for fatty liver are:
- excessive alcohol use
- taking more than the recommended doses of certain over-the-counter medications, such as acetaminophen (Tylenol)
- pregnancy
- high cholesterol
- high triglyceride levels
- malnutrition
- metabolic syndrome
Fatty liver is the buildup of extra fats in the liver. It’s more likely to develop if you’re overweight or obese. Having type 2 diabetes also may increase your risk for fatty liver. Fat accumulation in the liver has been linked to insulin resistance, which is the most common cause of type 2 diabetes. Studies have shown that a high-choline diet is associated with a lower risk of fatty liver disease.
Other factors that may increase your risk for fatty liver are:
- excessive alcohol use
- taking more than the recommended doses of certain over-the-counter medications, such as acetaminophen (Tylenol)
- pregnancy
- high cholesterol
- high triglyceride levels
- malnutrition
- metabolic syndrome
How is fatty liver diagnosed?
Physical exam
If your liver is inflamed, your doctor can detect it by examining your abdomen for an enlarged liver. Let your doctor know if you’ve been experiencing fatigue or loss of appetite. Also, tell your doctor about any history of alcohol, medication, and supplement use.
If your liver is inflamed, your doctor can detect it by examining your abdomen for an enlarged liver. Let your doctor know if you’ve been experiencing fatigue or loss of appetite. Also, tell your doctor about any history of alcohol, medication, and supplement use.
Blood tests
Your doctor may find that liver enzymes are higher than normal on a routine blood test. This doesn’t confirm a diagnosis of fatty liver. Further analysis is necessary to find the cause of the inflammation.
Your doctor may find that liver enzymes are higher than normal on a routine blood test. This doesn’t confirm a diagnosis of fatty liver. Further analysis is necessary to find the cause of the inflammation.
Imaging studies
Your doctor may use an ultrasound to detect fat in your liver. The fat will show up as a white area on the ultrasound image. Other imaging studies may also be done, such as CT or MRI scans.
Another imaging test similar to ultrasound is a FibroScan. Like an ultrasound, a Fibroscan utilizes sound waves to determine the density of the liver and the corresponding areas of fat and normal liver tissue.
Imaging studies can detect fat in the liver, but they cannot help your doctor confirm any further damage.
Your doctor may use an ultrasound to detect fat in your liver. The fat will show up as a white area on the ultrasound image. Other imaging studies may also be done, such as CT or MRI scans.
Another imaging test similar to ultrasound is a FibroScan. Like an ultrasound, a Fibroscan utilizes sound waves to determine the density of the liver and the corresponding areas of fat and normal liver tissue.
Imaging studies can detect fat in the liver, but they cannot help your doctor confirm any further damage.
Liver biopsy
In a liver biopsy, your doctor will insert a needle into the liver to remove a piece of tissue for examination. Your doctor will give you a local anesthetic to lessen the pain. This is the only way to know for certain if you have fatty liver. The biopsy will also help your doctor determine the exact cause.
In a liver biopsy, your doctor will insert a needle into the liver to remove a piece of tissue for examination. Your doctor will give you a local anesthetic to lessen the pain. This is the only way to know for certain if you have fatty liver. The biopsy will also help your doctor determine the exact cause.
How is fatty liver treated?
There isn’t a medication or surgery to treat fatty liver. Instead, your doctor will offer recommendations to reduce your risk factors. These recommendations include:
- limiting or avoiding alcoholic beverages
- managing your cholesterol and reducing your intake of sugar and saturated fatty acids
- losing weight
- controlling your blood sugar
If you have fatty liver because of obesity or unhealthy eating habits, your doctor may also suggest that you increase physical activity and eliminate certain types of food from your diet. Reducing the number of calories you eat each day can help you lose weight and heal your liver.
You can also reverse fatty liver disease by reducing or eliminating fatty foods and foods high in sugar from your diet. Choose healthier foods such as fresh fruits, vegetables, and whole grains. Replace red meats with lean animal proteins such as chicken and fish.
There isn’t a medication or surgery to treat fatty liver. Instead, your doctor will offer recommendations to reduce your risk factors. These recommendations include:
- limiting or avoiding alcoholic beverages
- managing your cholesterol and reducing your intake of sugar and saturated fatty acids
- losing weight
- controlling your blood sugar
If you have fatty liver because of obesity or unhealthy eating habits, your doctor may also suggest that you increase physical activity and eliminate certain types of food from your diet. Reducing the number of calories you eat each day can help you lose weight and heal your liver.
You can also reverse fatty liver disease by reducing or eliminating fatty foods and foods high in sugar from your diet. Choose healthier foods such as fresh fruits, vegetables, and whole grains. Replace red meats with lean animal proteins such as chicken and fish.
What is the long-term outlook for fatty liver?
Many cases of fatty liver don’t develop into liver disease. The liver can repair itself, so if you take the necessary steps to treat high cholesterol, diabetes, or obesity, you can reverse your fatty liver. If you’re a heavy drinker, stopping drinking or limiting your alcohol intake to 1-2 beverages a day may heal your liver completely. A liver biopsy can help your doctor identify permanent liver damage, as well as determine the severity of damage and the best way to treat it.
If fatty liver persists and is not reversed, it can progress into liver disease and cirrhosis. The progression to cirrhosis is dependent on the cause. In alcoholic fatty liver, continuing to drink alcohol in excess can lead to rapid development of cirrhosis and subsequent liver failure.
The progression of nonalcoholic fatty liver disease varies, but in most people it does not lead to liver scarring and cirrhosis. However, if you are diagnosed with steatohepatitis, you have a higher chance of developing scarring and liver disease. Twenty-five percent of people with steatohepatitis will develop cirrhosis within a decade.
If a fatty liver has progressed to cirrhosis, the risk of liver failure and death rises significantly. Half of those with cirrhosis from fatty liver disease will develop signs of liver failure. If this happens, the survival rate is often no more than two years.
Many cases of fatty liver don’t develop into liver disease. The liver can repair itself, so if you take the necessary steps to treat high cholesterol, diabetes, or obesity, you can reverse your fatty liver. If you’re a heavy drinker, stopping drinking or limiting your alcohol intake to 1-2 beverages a day may heal your liver completely. A liver biopsy can help your doctor identify permanent liver damage, as well as determine the severity of damage and the best way to treat it.
If fatty liver persists and is not reversed, it can progress into liver disease and cirrhosis. The progression to cirrhosis is dependent on the cause. In alcoholic fatty liver, continuing to drink alcohol in excess can lead to rapid development of cirrhosis and subsequent liver failure.
The progression of nonalcoholic fatty liver disease varies, but in most people it does not lead to liver scarring and cirrhosis. However, if you are diagnosed with steatohepatitis, you have a higher chance of developing scarring and liver disease. Twenty-five percent of people with steatohepatitis will develop cirrhosis within a decade.
If a fatty liver has progressed to cirrhosis, the risk of liver failure and death rises significantly. Half of those with cirrhosis from fatty liver disease will develop signs of liver failure. If this happens, the survival rate is often no more than two years.
How do I prevent fatty liver disease?
Protecting your liver is one of the best ways to prevent fatty liver and its complications. This includes drinking alcoholic beverages in moderation. According to the Centers for Disease Control and Prevention (CDC), “moderate alcohol consumption is defined as having up to one drink per day for women and up to two drinks per day for men.”
Follow your doctor’s instructions, and take medications for diabetes or high cholesterol as directed. Additionally, aim for at least 30 minutes of exercise most days of the week to maintain a healthy weight.
Treating fatty liver disease with food
Protecting your liver is one of the best ways to prevent fatty liver and its complications. This includes drinking alcoholic beverages in moderation. According to the Centers for Disease Control and Prevention (CDC), “moderate alcohol consumption is defined as having up to one drink per day for women and up to two drinks per day for men.”
Follow your doctor’s instructions, and take medications for diabetes or high cholesterol as directed. Additionally, aim for at least 30 minutes of exercise most days of the week to maintain a healthy weight.
There are two major types of fatty liver disease — alcohol-induced and nonalcoholic fatty liver disease. Fatty liver disease affects nearly one-third of American adults and is one of the leading contributors to liver failure. Nonalcoholic fatty liver disease is most commonly diagnosed in those who are obese or sedentary and those who eat a highly processed diet.
One of the main ways to treat fatty liver disease, regardless of type, is with diet. As the name suggests, fatty liver disease means you have too much fat in your liver. In a healthy body, the liver helps to remove toxins and produces bile, the digestive protein. Fatty liver disease damages the liver and prevents it from working as well as it should.
In general, the diet for fatty liver disease includes:
- lots of fruits and vegetables
- high-fiber plants like legumes and whole grains
- very little added sugar, salt, trans fat, refined carbohydrates, and saturated fat
- no alcohol
A low-fat, reduced-calorie diet can help you lose weight and reduce the risk of fatty liver disease. Ideally, if you’re overweight, you would aim to lose at least 10 percent of your body weight.
12 foods and drinks that you should eat for a fatty liver
Here are a few foods to include in your healthy liver diet:
1. Coffee to lower abnormal liver enzymes
Studies have shown that coffee drinkers with fatty liver disease have less liver damage than those who don’t drink this caffeinated beverage. Caffeine appears to lower the amount of abnormal liver enzymes of people at risk for liver diseases.
2. Greens to prevent fat buildup
Broccoli is shown to help prevent the buildup of fat in the liver in mice. Eating more greens, like spinach, Brussels sprouts, and kale, can also help with general weight loss. Try the Canadian Liver Foundation’s recipe for vegetarian chili, which lets you cut back on calories without sacrificing flavor.
3. Tofu to reduce fat buildup
A University of Illinois study on rats found that soy protein, which is contained in foods like tofu, may reduce fat buildup in the liver. Plus, tofu is low in fat and high in protein.
4. Fish for inflammation and fat levels
Fatty fish such as salmon, sardines, tuna, and trout are high in omega-3 fatty acids. Omega-3 fatty acids can help improve liver fat levels and bring down inflammation. Try this teriyaki halibut recipe, recommended by the Canadian Liver Foundation, that’s especially low in fat.
5. Oatmeal for energy
Carbohydrates from whole grains like oatmeal give your body energy. Their fiber content also fills you up, which can help you maintain your weight.
6. Walnuts to improve the liver
These nuts are high in omega-3 fatty acids. Research finds that people with fatty liver disease who eat walnuts have improved liver function tests.
7. Avocado to help protect the liver
Avocados are high in healthy fats, and research suggests they contain chemicals that might slow liver damage. They’re also rich in fiber, which can help with weight control. Try this refreshing avocado and mushroom salad from Fatty Liver Diet Review.
8. Milk and other low-fat dairy to protect from damage
Dairy is high in whey protein, which may protect the liver from further damage, according to a 2011 study in rats.
9. Sunflower seeds for antioxidants
These nutty-tasting seeds are high in vitamin E, an antioxidant that may protect the liver from further damage.
10. Olive oil for weight control
This healthy oil is high in omega-3 fatty acids. It’s healthier for cooking than margarine, butter, or shortening. Research finds that olive oil helps to lower liver enzyme levels and control weight. Try this liver-friendly take on a traditional Mexican dish from LiverSupport.com.
11. Garlic to help reduce body weight
This herb not only adds flavor to food, but experimental studies also show that garlic powder supplements may help reduce body weight and fat in people with fatty liver disease.
12. Green tea for less fat absorption
Data supports that green tea can help interfere with fat absorption, but the results aren’t conclusive yet. Researchers are studying whether green tea can reduce fat storage in the liver and improve liver function. But green tea also has many benefits, from lowering cholesterol to aiding with sleep.
6 foods to avoid if you have a fatty liver
There are definitely foods you should avoid or limit if you have fatty liver disease. These foods generally contribute to weight gain and increasing blood sugar.
Avoid
- Alcohol. Alcohol is a major cause of fatty liver disease as well as other liver diseases.
- Added sugar. Stay away from sugary foods such as candy, cookies, sodas, and fruit juices. High blood sugar increases the amount of fat buildup in the liver.
- Fried foods. These are high in fat and calories.
- Salt. Eating too much salt can make your body hold on to excess water. Limit sodium to less than 1,500 milligrams per day.
- White bread, rice, and pasta. White usually means the flour is highly processed, which can raise your blood sugar more than whole grains due to a lack of fiber.
- Red meat. Beef and deli meats are high in saturated fat.
What does a diet plan look like?
Here’s what your menu might look like during a typical day on a fatty liver diet plan:
| Meal | Menu |
| breakfast | • 8 oz. hot oatmeal mixed with 2 tsp. almond butter and 1 sliced banana • 1 cup coffee with low-fat or skim milk |
| lunch | • spinach salad with balsamic vinegar and olive oil dressing • 3 oz. grilled chicken • 1 small baked potato • 1 cup cooked broccoli, carrots, or other vegetable • 1 apple • 1 glass of milk |
| snack | • 1 tbsp. peanut butter on sliced apples or 2 tbsp. hummus with raw veggies |
| dinner | • small mixed-bean salad • 3 oz. grilled salmon • 1 cup cooked broccoli • 1 whole-grain roll • 1 cup mixed berries • 1 glass of milk |
Additional ways to treat liver disease
In addition to modifying your diet, here are a few other lifestyle changes you can make to improve your liver health:
- Get more active. Exercise, paired with diet, can help you lose extra weight and manage your liver disease. Aim to get at least 30 minutes of aerobic exercise on most days of the week.
- Lower cholesterol. Watch your saturated fat and sugar intake to help keep your cholesterol and triglyceride levels under control. If diet and exercise aren’t enough to lower your cholesterol, ask your doctor about taking medication.
- Control diabetes. Diabetes and fatty liver disease often occur together. Diet and exercise can help you manage both conditions. If your blood sugar is still high, your doctor can prescribe medication to lower it.
Takeaway
There are currently no drugs on the market that are approved by the U.S. Food and Drug Administration for fatty liver disease. While losing 10 percent of your weight is ideal, even just 3 to 5 percent can help. Ask your doctor to check your blood for the hepatitis A and B vaccines as well. These can help prevent viruses from causing liver damage.
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