Mediterranean Diet for Fatty Liver: Does it Help?

The Mediterranean diet consists of the dietary habits of countries bordering the Mediterranean Sea. With slight variations from region to region, the diet encourages healthy dietary habits while limiting sodium, processed foods, saturated fats, refined carbohydrates, and sugar.

Key takeaways:
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    Fatty liver disease is characterized by having too much fat accumulation in the liver. Healthy eating habits and physical activity are recommended for managing NAFLD.
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    The Mediterranean diet consists of lots of plant-based foods and healthy fats with moderate amounts of animal-based foods. People with fatty liver may benefit from the Mediterranean diet, which can improve liver function tests, insulin sensitivity, blood cholesterol, and triglyceride levels.
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    Always check with your doctor before you follow a special diet or take unprescribed medication, food supplements, and herbal remedies since the liver breaks them down.

Therefore, it can help to maintain healthy blood glucose and lipid. Studies have shown that the Mediterranean diet can prevent and manage non-alcoholic fatty liver commonly caused by obesity, high blood glucose, insulin resistance, and high levels of blood lipids.

What is the Mediterranean diet?

The Mediterranean diet consists of lots of plant-based foods and healthy fats with moderate amounts of animal-based foods. Is it the best diet to reduce fatty liver? Whole grains, beans, lentils, vegetables, fruits, olive oil, fish, and seafood constitute a great portion of the diet. It also limits unhealthy fats, sodium, and refined sugars. These healthy eating patterns are recommended in fatty liver patients as well.

The Mediterranean diet has been shown to reduce blood sugar, lipids, and pressure. Thus, it lowers the risk of metabolic and cardiovascular diseases besides NAFLD. Extensive literature analysis on lifestyle modifications improving NAFLD has shown that the Mediterranean diet improved liver function tests ALT, AST, and fatty liver grades. It also contributed to more than 5% weight loss compared to standard care. It also reduced total cholesterol, triglycerides, blood pressure, and HOMA-IR levels.

In conclusion, the Mediterranean diet can reduce fatty liver by improving liver function tests, blood lipids, and insulin sensitivity and promoting weight loss.

What is fatty liver?

Fatty liver disease – hepatic steatosis – is characterized by having too much fat accumulation in the liver. Having a small amount of fat in the liver is normal. If fat reaches 5 to 10 % of the liver's weight, it is called fatty liver. Fatty liver diseases can be caused by metabolic and chronic diseases, medication, genetics, alcohol, and malnutrition (lack of proper nutrition for good health). Two main forms of fatty liver diseases: alcohol-induced fatty liver disease and non-alcohol-related fatty liver disease (NAFLD).

How to know if you have a fatty liver? In the early stages, NAFLD generally doesn't show any symptoms. If you're concerned about NAFLD, you should see your doctor for a proper diagnosis. NAFLD is usually diagnosed by a blood test; in some cases, an ultrasound scan may be needed.

Will the Mediterranean diet improve fatty liver?

Adopting a healthy and balanced diet and physical activity is recommended for managing NAFLD. Being overweight, obese, and having metabolic and chronic conditions such as high blood lipid and glucose levels, metabolic syndrome, insulin resistance, and type 2 diabetes increases the risk of NAFLD. Thus a healthy and balanced diet along with weight management can be helpful to prevent, manage and reverse the early stages of NAFLD.

Can the Mediterranean diet prevent fatty liver?

Healthy eating habits are crucial for liver health since the liver is the center of metabolism. It metabolizes nutrients. Whether your blood glucose or lipids are high, your liver has to deal with it. A healthy and balanced diet includes whole grains, fruits, vegetables, healthy fats, oily fish, moderate amounts of meats, and dairy.

Foods to include in your diet to reduce or prevent fatty liver

Olive oil

Fats are not bad altogether. Your body needs healthy fats to support cell function, absorb certain nutrients, synthesize hormones, and keep you warm. Olive oil is extensively used in the Mediterranean diet. Other healthy fats sources are avocados, nuts, oily fish and seafood, and seeds such as chia, flaxseed, and sunflower.

Fruits and vegetables

Eating antioxidant-rich foods such as fruits and vegetables improve overall and liver health. Antioxidants capture harmful compounds that occur as a result of metabolic processes, environmental pollutants, and toxins. Antioxidant foods protect liver cells as well by minimizing toxic substances.

Fatty fish

Fatty fish contains a good amount of omega-3 fatty acids, which can help reduce blood cholesterol and triglyceride levels. Eating fish twice weekly is recommended for healthy adults to get the omega-3 fatty acids they need.

Whole grains

Whole grains such as legumes, beans, lentils, and oats are a great source of fiber that helps you maintain healthy blood glucose and lipid levels. They improve cardiovascular health and gut microbiota. Reaching healthy blood glucose and lipid levels may improve fatty liver disease.

Keep in mind that portion control is as important as food choices. Managing the calories you take may help you to stay at a healthy weight.

The foods that should be avoided to maintain healthy liver

Unhealthy food choices may accelerate fatty liver. Let's learn about foods that you should limit in your diet.

Refined sugars

Most packaged and processed foods and drinks contain lots of sugar, and fructose, especially in the form of high-fructose corn syrup. Refined sugar, also known as table sugar, consists of sucrose which is broken down into glucose and fructose in digestion. Excess sugar is transformed to fat in the liver. Gradually fat accumulates and shows toxic effects on liver cells, causing inflammation and liver diseases such as cirrhosis.

Saturated and trans fats

Saturated fats are found in meats but fish, full-fat dairy, eggs, and some cooking oils such as coconut and palm oil. These foods are not unhealthy, but they should be consumed in moderation, especially by people with high blood lipid levels.

Trans fats are present in foods both artificially and naturally. Naturally-occurring trans fat is found in small amounts in animal products such as milk and meat. However, most people consume high amounts of trans fat, eating packaged and highly processed foods. Avoid highly processed foods and foods that contain 'partially hydrogenated oils. Trans fats increase LDL 'bad cholesterol and decrease HDL' good cholesterol levels.

Replacing unhealthy fats with unsaturated fats, including omega-3 fatty acids, may help reduce the risk of heart disease in NAFLD patients.

High glycemic index foods

The glycemic index ranks carbohydrate-containing foods based on their effects in increasing blood glucose levels compared to a reference food. High glycemic index foods contribute to insulin resistance.

In insulin resistance, tissues can not take up glucose efficiently. Because tissues lack energy, your body breaks down fat for energy, resulting in increased blood-free fatty acid levels, which travel to the liver and accumulate over time, causing damage and inflammation.

Whole grains and vegetables are low glycemic index foods compared to white rice, bread, and potatoes, high glycemic index foods.


Even fatty liver is not caused by excess alcohol consumption. Alcohol may still worsen the symptoms of NAFLD. People with fatty liver are advised to minimize alcohol.

Added salt

Eating high salt is not good for overall health, including liver health. High salt (high sodium) foods can increase blood pressure, resulting in an increased risk of heart disease. A healthy diet should contain a maximum of 6g of salt a day (2.4g sodium) – equivalent to a teaspoon. Some high-salt foods are bacon, cheese, pickles, salted nuts, soy sauce, smoked meat, and fish.

What else can help to combat fatty liver?

Reaching healthy weight

The most common causes of NAFLD are dietary factors, obesity, glucose intolerance, and diabetes. If you have excess weight, healthy losing weight by 7 to 10% can reverse the fatty liver in the early stages.

Physical activity

Exercise and healthy eating habits improve insulin sensitivity, besides contributing to a healthy weight. 150 to 200 minutes of physical activity per week is recommended for the general population.

Be careful with medication and over-the-counter drugs

Other ways to protect your liver:

Take medications and over-the-counter drugs if they are only prescribed by your doctor.

Consult your doctor before taking dietary supplements. Higher doses of some vitamins, such as iron, vitamin A, and niacin, may harm your liver.

Be cautious about herbal remedies. Natural doesn't mean safe or healthy. Always check with a doctor before using any herbal products.


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