I do get a lot of young patients complaining of fatty liver, saying they do not drink at all. But the fact of the matter is NAFLD (Non-Alcoholic Fatty Liver Disease), a condition where too much fat is stored in liver cells even when you do not drink a drop, is increasingly becoming common around the world, more so in India, as we battle conditions like genetics, insulin resistance, cholesterol and obesity, all of which stress out the liver. That’s why non-alcoholic fatty liver disease (NAFLD) is now called the metabolic dysfunction-associated steatotic liver disease (MASLD).
Some individuals with NAFLD can develop non-alcoholic steatohepatitis (NASH), an aggressive form of fatty liver disease, which is marked by liver inflammation and may progress to advanced scarring (cirrhosis) and liver failure. This damage is similar to the damage caused by heavy alcohol use. NAFLD affects approximately 20 per cent to 30 per cent of adults in the general population, and more than 70 per cent of patients with obesity and diabetes.
Although there aren’t any medications to treat NAFLD, a good diet and regular exercise can reverse it. Losing 10 per cent of your current body weight can dramatically decrease the amount of fat in the liver as well as reduce inflammation. This is where the role of diets becomes important in disease management. So what are the foods you should avoid and what should you include?
WHAT TO AVOID
1) No added sugar please: Forget instant sugar rush items like cookies, biscuits, candy, sodas, sports drinks, packaged juices, sweets and chocolates, pre-mixed tea and coffee.
2) No fried and processed foods: Try to steam or boil your fish and lean meats instead of deep-frying them. Avoid red meat cold cuts, bacon and any other processed meats as they are rich in saturated fats. Forget butter and foods with trans fats like French fries, fried chicken, doughnuts, chips, burgers and any other form of fast food. Processed foods often contain high levels of fructose or additives like high fructose corn syrup, which can increase fat deposition in the liver and trigger liver inflammation. Do away with instant meal mixes.
3) No added salt: This means you should do away with any form of packaged food, which are laden with salt. Limit sodium intake to less than 2,300 milligrams per day. Those with high blood pressure should take no more than 1,500 mg per day
4) No white bread, milled rice or pasta: Since they break down easily in the body, they can lead to sugar spikes. Remember whole grains slow this very process because they are high in fibre.
5) No big meal indulgences: Watch your portion sizes as overeating may pile up more calories than you can use that get easily accumulated as fat and increase the risk of fatty liver disease. Use smaller plates and have meals in bowls to control your portions.
WHAT SHOULD YOU EAT?
1) First and foremost, practise time-restricted eating, trying to eat in the diurnal window of eight to ten hours. Eat a good breakfast, a moderate lunch and a light dinner of soup or salad, that too by 7 pm.
2) You can have black coffee, which many studies have shown lowers the risk of fatty liver and abnormal liver enzymes.
3) Have plenty of leafy greens as plant compounds fight fatty liver disease because of the presence of nitrate and polyphenols.
4) Apportion half a plate for fibre-rich fruits, vegetables and whole grains.
5) Include legumes such as lentils, chickpeas, soybeans and peas, which are non-fat and nutrient-dense.
6) Fish rich in Omega-3 fatty acids reduce triglycerides.
7) Include garlic in your diet: A study in 2019 found that its consumption reduces liver fat and improves enzyme levels.