What You Need to Know About Fatty Liver Disease

What do you think of when you hear the term fatty liver disease? While heavy drinking may be the first thing that comes to mind, alcohol-related fatty liver disease is just one form of the disease. There is another form that can leave you wondering if your lifestyle is making your liver fat, even if you’re a committed teetotaler—and it’s more common than you may think. In fact, nonalcoholic fatty liver disease (NAFLD) affects about 25 percent of all people worldwide. (1)

What is fatty liver disease?

NAFLD is a disease marked by the accumulation of fat inside your liver cells. While tiny amounts are naturally found in the liver, the condition occurs when fat makes up more than five percent of the liver. (2) There are two forms of NAFLD: (3)

Simple nonalcoholic fatty liver

Technically known as liver steatosis, simple NAFLD means you have some fat buildup in your liver but there is little or no inflammation or damage to your liver cells. 

Nonalcoholic steatohepatitis (NASH)

More serious than simple NAFLD, NASH signifies that there is inflammation, excess fat, and cell damage in the liver. Over time, ignoring NASH can cause fibrosis, cirrhosis, and liver cancer. (4)(5)

What causes nonalcoholic fatty liver disease?

Many factors contribute to the development of NAFLD. Most of these are tied to lifestyle:


Obesity is one of the most common causes of NAFLD, as well as it’s more serious cousin, NASH. (6) It’s estimated that as many as 74-98 percent of those who are obese have NAFLD. (7)

Excess belly fat

Even people at a normal weight who carry excess abdominal fat are at an increased risk of NAFLD. According to one study review, people with higher waist circumference and waist-to-hip ratio had an even greater risk of NAFLD than those who were generally obese. (8)

Insulin resistance

Insulin resistance and diabetes don’t simply increase your risk of developing NAFLD, these conditions can also speed it’s progression to NASH. People with type 2 diabetes have a five-fold higher incidence of NAFLD compared to people without the disease. (9)

Trade in refined sugar and ultra-processed carbs for minimally processed whole foods to discourage the buildup of fat in your liver cells.

A diet high in ultra-processed carbohydrates

A diet filled with bread, pasta, and other simple carbohydrates increases your odds of developing NAFLD. (10) Even if you don’t indulge in these types of foods regularly, binging on carbs for just three weeks can increase liver fat ten fold. (11)

Sugary drinks

Sugar-sweetened drinks like soda or sports drinks can increase the risk of NAFLD by as much as 40 percent. (12) When you consume a sugar-sweetened drink, the high fructose corn syrup it contains causes fat to accumulate in the liver, even if you aren’t insulin resistant. (13)

A gut imbalance

Recent studies suggest that an imbalance in your microbiota can contribute to NAFLD. Research has also found that a compromised intestinal barrier—a condition commonly known as leaky gut syndrome—can up your chances of developing a fatty liver. (14)

High blood pressure

Even if you aren’t overweight or have insulin resistance, you may be susceptible to NAFLD. A cohort study of more than 5,300 otherwise healthy people found a link between high blood pressure and a higher risk of developing NAFLD. (15)

High triglycerides

High triglyceride levels and low high-density lipoproteins (HDL) can be a clue that you have NAFLD. Some studies have concluded that elevated triglycerides, by themselves, are an independent indicator of fatty liver, even if you’re not overweight. (16)(17)


NAFLD can affect people of any age, even children. But your odds of developing the condition become greater as you age. According to a study involving more than 8,300 men and women, men have the highest risk between the ages of 40 and 49 while women’s risk peaks between the ages of 60 and 69. (18)

Did you know? 
As prevalent as NAFLD is, there are no drugs or medical treatments that have been approved to treat the condition. (19)

Signs of fatty liver disease

Fatty liver disease is considered a “silent” condition since there are often few or no symptoms. But when symptoms do occur, they can be subtle or mistaken for other health problems. 

  • Fatigue (20)
  • Weakness and muscle loss (21)
  • Pain in the upper right abdomen (22)

Because NAFLD can often fly under the radar, it’s smart to get regular checkups. A routine blood test called a liver function test can help uncover liver problems in the early stages when NAFLD can be readily reversed. (23)  

5 natural ways to prevent or reverse fatty liver disease

The liver has the remarkable ability to regenerate itself, which is why the following strategies can be so effective in preventing and reversing NAFLD, especially in the early stages. (24

1. Minimize or avoid alcohol

People who have been diagnosed with NAFLD are typically advised to avoid drinking alcohol since research  suggests that even small amounts can accelerate disease progression. However, some studies have concluded that light to moderate drinking may actually have a protective effect for some people who are at a higher-than-normal risk for developing NAFLD. (25)(26)

2. Use over-the-counter pain relievers wisely

It’s no secret that non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin and ibuprofen can damage the gastrointestinal tract. However, overuse can also increase the risk of NAFLD. (27)

Adding a High-intensity interval training (HIIT) routine to your regular workouts can significantly reduce liver fat.

3. Get regular exercise

Studies show that participating in regular aerobic and resistance training reduces the amount of fat stored in your liver cells. (28)(29) High-intensity interval training (HIIT) workouts are among the most effective for preventing and improving NAFLD. One small clinical trial found that people with type 2 diabetes who participated in HIIT three times per week for 12 weeks experienced a significant 39 percent reduction in liver fat. (30) But, whatever exercise you choose, make sure it’s something you enjoy. This can help you stick with it long term. 

4. Lose weight

Weight loss can also reduce the amount of fat and inflammation in your liver. Studies show that losing just five percent of your body weight can help improve NAFLD. (31) One study published in the journal African Health Sciences reported that a 15 percent reduction in body mass index (BMI) can also improve both liver function and insulin resistance in type 2 diabetics with the disease. (32)

Adding liver-supporting supplements like ginger to healthy lifestyle changes can reduce inflammation and the accumulation of liver fat while also improving your liver function

5. Include liver-friendly supplements

Adding supplements that have clinically-studied benefits is important for those with a compromised liver. A liver-specific protocol that includes artichoke leaf, milk thistle, turmeric, and vitamin E is a good place to start. These nutrients have been shown to support healthy liver function, reduce inflammation, and neutralize damaging free radicals. (33)(34)(35)(36) In addition to these core nutrients, berberine—a powerful antioxidant found in barberry, goldenseal, and Oregon grape—paired with lifestyle changes has been shown to reduce fatty liver significantly more than lifestyle factors alone. (37) Another herb of note is ginger. One clinical trial involving 44 patients with NAFLD found that ginger supplementation beneficially modified many markers of liver function and improved the condition.(38)

The best diet for fatty liver disease

A healthy low-carb, nutrient-packed diet like the Mediterranean or Paleo diet can help improve insulin sensitivity and liver function in people with NAFLD. (39)(40)(41) Both of these diets revolve around plenty of antioxidant-rich fresh fruits and vegetables, fatty fish high in omega-3 fatty acids, and healthy oils like avocado and olive oil. What’s missing? Ultra-processed foods high in salt, sugar, and refined carbohydrates that can increase the odds of developing NAFLD. (42)(43)(44)

Did you know?
Excess carbohydrates are converted to fat in the liver. Studies report that a diet low in carbs may help reverse NAFLD. (45)

The bottom line

Cases of NAFLD are on the rise in the developed world and are closely linked to the rise of two other lifestyle-related conditions: obesity and type 2 diabetes. (46) To date, there aren’t any drugs or medical procedures that have been developed to treat fatty liver. But adopting these liver-supportive lifestyle tips may help to prevent and even treat the condition, effectively putting the power to defeat NAFLD in your hands.   

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