Fatty liver disease: foods to eat and avoid

Fatty liver disease, commonly referred to as fat in the liver, develops when excessive fat builds up in the organ’s cells. Although it often causes no symptoms at first, it can progress to inflammation, fibrosis and further complications without appropriate monitoring and treatment. Recognising the condition and making lifestyle changes are therefore important steps.

According to medical nutrition specialist Dr Mariana Wogel, the liver is directly affected by dietary patterns. Diets high in sugar, ultra-processed foods, sweetened drinks and excessive fat encourage fat to accumulate in the liver and worsen insulin resistance, one of the mechanisms most closely linked to the condition.

The doctor says diet plays a central role in this process and can be decisive in improving the condition. “Treatment begins with daily eating habits. There is no single formula capable of reversing fat in the liver if someone continues to eat in a disorganised way and maintains metabolic overload,” she says.

Diet as an ally in controlling the condition

In the specialist’s view, the foundation of the diet should consist of foods that are in natura or minimally processed. Leafy greens, vegetables, fruit, beans and wholegrains help manage blood glucose levels, promote fullness and provide fibre, vitamins, minerals and antioxidants that support liver health.

Protein is also an important part of managing fatty liver disease. Eggs, fish, chicken and lean cuts of meat help preserve muscle mass during weight loss and provide nutrients involved in fat metabolism, including choline and methionine. According to the doctor, this balance is vital because treating fat in the liver depends not only on weight loss, but also on improving body composition.

Fats that can be included in the diet

While excessive saturated fat should be avoided, this does not mean removing all fat from the diet. Extra-virgin olive oil, avocado, almonds, sardines and salmon can be included in appropriate portions because they provide better-quality fats with a more favourable metabolic profile.

“When properly adjusted, some sources of fat help balance the diet and may contribute as part of a structured eating plan. The issue is excess consumption and the frequent choice of ultra-processed products,” explains Dr Mariana Wogel.

Foods to avoid with fatty liver disease

Items that should be reduced include fizzy drinks, commercially produced fruit juices, sweets, filled biscuits, fried foods, processed meats, very fatty meats, hard yellow cheeses and alcohol. These foods can promote inflammation, spikes in blood glucose, insulin resistance and greater fat deposition in the liver.

The specialist stresses that alcoholic drinks require particular attention. For patients with fatty liver disease, intake is generally reduced as much as possible or stopped altogether, depending on the clinical assessment.

Physical activity is also important

Alongside diet, regular physical activity is an important part of the strategy to reverse fat in the liver. Aerobic exercise, such as walking, running and cycling, supports better metabolic health and may reduce fat stored in the liver. When paired with strength training, it also helps maintain muscle and improve metabolism.

Gradual weight loss, when appropriate, is another factor that can produce significant improvements. Even modest reductions can positively affect the liver and other metabolic markers. “This is not about a one-off change, but a combination of adjustments that need to be sustainable. Liver improvement follows improvements in lifestyle as a whole,” says Dr Mariana Wogel.

Medical follow-up is essential

Fatty liver disease is frequently identified during routine tests, with no symptoms at the outset. When it is associated with excess weight, diabetes, high cholesterol or raised triglycerides, a broader investigation is required, according to the doctor.

Dr Mariana Wogel highlights that the key point is understanding that fat in the liver is often a sign of metabolic imbalance. Treatment must therefore consider diet, body composition, physical activity and personalised medical follow-up.

By Paulo Novais