Metabolic dysfunction-associated steatotic liver disease (MASLD, formerly known as nonalcoholic fatty liver disease or NAFLD) is a condition where excess fat is stored in the liver, but the cause is not alcohol. When fatty liver is caused by heavy alcohol use, it is called alcohol-associated liver disease.
There are two types of MASLD. When you just have excess fat stored in your liver, it is referred to as nonalcoholic fatty liver (NAFL). When there is both fat storage and inflammation leading to liver damage, it is referred to as metabolic dysfunction-associated steatohepatitis (MASH, formerly known as nonalcoholic steatohepatitis or NASH).
In some cases, MASH can cause inflammation and extensive scarring (cirrhosis) that is so severe it leads to liver failure and liver transplant. Fortunately, there are some fatty liver home remedies that may help to slow progression of the illness and reverse some of the damage, even if they do not cure it.
In June 2023, the American Association for the Study of Liver Diseases, along with several other liver research societies and patient advocacy groups, announced new names for the conditions NAFLD and NASH. The names were changed to more accurately reflect the causes of the conditions and to reduce the usage of stigmatizing language.
Maintain a Healthy Weight
Sticking to a healthy, plant-based diet and getting regular exercise can keep fat from building up in your liver. That’s because the major risk factors for MASLD are obesity and diabetes, both of which are tied to our weight.
It’s estimated that rates of MASLD may be 90% in obese people and 50% in people with diabetes. Because obesity and diabetes are so prevalent in developed countries, approximately 30% of adults in the developed world have MASLD. Fortunately, some of this damage appears to be reversible if you take off the extra pounds.
If you are overweight or obese, the American College of Gastroenterology (ACG) advises that losing 10% of your body weight will have a positive impact on your liver.
Eat a Healthy Diet
In 2018, nutritional researchers summarized over 100 studies on diet in relation to MASLD, coming up with five recommendations supported by the literature:
- Eat a traditional diet like the Mediterranean diet, which is high in healthy fats, fish, and vegetables, and low in red meat. (The Mediterranean diet is also endorsed by the ACG.)
- Limit fructose in processed foods and avoid sweetened drinks.
- Increase consumption of omega-3 polyunsaturated fats and monounsaturated fats, which includes using olive oil, eating oily fish like salmon and sardines two to three times a week, and eating nuts and seeds daily.
- Increase consumption of high-fiber foods like eating lots of vegetables, whole grains, nuts, and seeds, and reduce consumption of highly processed foods like fast food, commercial bakery goods, and sweets.
- Avoid excess alcohol consumption.
Get Regular Exercise
The American Association for the Study of Liver Diseases notes in their 2018 recommendations that moderate exercise helps to sustain weight loss over time, but increasing strenuous exercise may help even more. But exercise appears to help MASLD and MASH, even without significant weight loss.
In the context of studies on MASLD, moderate exercise is often considered to be five exercise sessions per week of 30 minutes at your target heart rate, with a 10-minute warm-up and a 5-minute cool-down at 30% to 40% of your target heart rate.
Calculating Your Target Heart Rate
A popular way to calculate target heart rate is to find your maximum heart rate by subtracting your age from 220. If you are 50 years old, for example, a ballpark maximum heart rate is 220 minus 50, which equals 170. Often, a target heart rate is 60% to 80% your maximum heart rate, so it would be 102-136 for the 50 year-old in the example.
Because medications and fitness level can impact your heart rate, ask your healthcare provider for advice about calculating this number if you have fitness challenges or take medications.
If you are new to exercise, start with a shorter duration and lower intensity and work up gradually. Talk to your healthcare provider before starting any exercise program. They can guide you on what to set for your initial fitness goals, based upon your health status and medications.
Multiple studies have shown that coffee may protect against metabolic syndrome, which seems to go hand-in-hand with MASLD. This may be because of its anti-inflammatory effects or because it inhibits the deposition of fat in the liver. More research is needed, but both animal and human experiments have shown a lower prevalence of MASLD in coffee drinkers.
Try Milk Thistle
A traditional remedy for liver problems, milk thistle may boost the production of enzymes that help the liver knock out toxins.
Multiple studies have shown that milk thistle (or its active ingredient, silymarin) may help lower the liver enzymes AST and especially ALT. AST and ALT are important markers of liver damage, so lower levels of liver enzymes indicate a healthier liver. Other studies have shown that milk thistle may help to reduce the fibrosis that MASH causes in the liver.
The Food and Drug Administration (FDA) regulates health claims about both supplements and medications. It’s important to note that the FDA has not approved the claim that milk thistle improves liver health. Before you begin taking any kind of herb, you should talk to your healthcare provider or pharmacist about taking supplements safely and whether there are any interactions with your current medications.
Get Your Antioxidants
Vitamins E and C—both antioxidants—may help promote liver health.
The American Association for the Study of Liver Diseases has recommended 800 IU/day of vitamin E for non-diabetic people with biopsy-proven MASH. The efficacy and safety of long-term vitamin E use has not been evaluated in people with diabetes or people without MASH confirmed in a biopsy.
There is less research supporting vitamin C for liver health, but one 2013 study in Japan showed that taking vitamin C and vitamin E together helped to minimize liver damage due to MASH.
Avoid Added Sugar
Adding refined sugar to our diets adds extra calories, without providing nutritional benefits. High levels of sugar such as fructose increase the enzymes that make fat in our livers, a process already enhanced in people with MASLD. Even though fructose is naturally present in fruit, the high levels implicated in liver disease are usually from consumption of sugary soft drinks and other highly processed foods.
Ditch Liver Irritants (When Possible)
Exposure to toxins (found in industrial chemicals, some medications, and even your food) can weaken liver function and may contribute to the development of fatty liver. In addition to keeping away from toxic substances, consider flushing toxins from your system with the help of a “detox” diet.
But beware: Many fad detox diets are highly restrictive and may only use smoothies, juices, or other gimmicks. Nutritionists warn that these detox diets haven’t been shown to work, and that they may even backfire or be dangerous.
If you want to detox, try taking a week to reset your eating habits by eating only whole, unprocessed foods including lots of fresh fruits and vegetables, whole grains, healthy oils, lean proteins, and low-fat dairy. The recommendations for the Mediterranean diet discussed above are a good place to start.
Even though some medications may be hard on your liver, you should not stop any of your prescribed medications suddenly without talking to your healthcare provider.
Always Ask Your Healthcare Provider
Ask your healthcare provider before stopping any medication, starting a supplement, or starting an exercise plan.
What Causes Fatty Liver?
Often occurring in people who are overweight or obese, fatty liver has been linked to diabetes, high levels of blood fats, and insulin resistance. Fatty liver is closely linked with metabolic syndrome, and may be present in one third to two thirds of people with diabetes.
Standard blood tests at your healthcare provider’s office should indicate whether you have high levels of certain liver enzymes, a marker of fatty liver and other causes of liver damage.
Although there is no way to treat fatty liver medically, losing weight and lowering your levels of blood fats could help manage the condition. Keeping fatty liver in check is crucial to your overall health; excess liver fat can make you more vulnerable to cardiovascular disease, in addition to liver disease and diabetes.
A Word From Verywell
Due to a lack of supporting research, it’s too soon to recommend alternative medicine for any health condition. If you’re considering the use of any form of alternative medicine for fatty liver, make sure to consult your healthcare provider first. Self-treating a condition and avoiding or delaying standard care may have serious consequences.
Frequently Asked Questions
Can fatty liver be reversed?
Yes, fatty liver can be reversed or at least controlled, but the treatment will vary based on the cause. For metabolic dysfunction-associated steatotic liver disease (MASLD, formerly NAFLD), you can reduce liver fat buildup by losing weight, lowering cholesterol and triglycerides, and avoiding alcohol. If you have diabetes, controlling its symptoms can also reverse liver fat buildup.
What foods contribute to fatty liver disease?
Foods with high amounts of sugar or alcohol can contribute to fatty liver disease. Foods high in calories, sugar, and fat can lead to weight gain and diabetes, which are major risk factors for fatty liver disease. Whole foods that promote weight loss are beneficial for fatty liver.
How do I improve liver health?
Here are a few key things you can do to keep your liver healthy.
- Maintain a healthy weight.
- Eat a balanced diet that includes fiber and “good” fats, such as those found in nuts, seeds, and fish.
- Drink plenty of water daily.
- Be physically active.
- Limit alcohol consumption.