donate now The Fatty Liver Foundation

There is a lot of information below.

If you would like a short summary click this link.



Your liver is like a very complex factory

There are many diets being advocated but most of them do not talk to you about specific liver health issues like how their program impacts your liver.  The assumption is that weight loss alone is good for you.  While generally true, if we consider the liver the kind of calories you consume is important. You can feed it almost anything and it will try to make something out of it.  It is filled with about 500 robots that each know how to do one thing.  As long as a robot knows what to do with what you send it and the supply isn't overwhelming all is well.  However, if you supply more than it can process bad things happen.  With too much raw material things in the factory can pile up.  When a robot is broken or over supplied, the wrong product might be made or the robot might fail.  Break too many of your liver robots and the entire factory fails.  These are the reasons why what you eat really does matter to your long term health.

When you hear the term fatty liver you instinctively assume that eating fat is what caused it and the siren song of low fat diets that get so much attention have appeal.  The problem is that the important thing is not what you eat but what does your liver do with what you eat.  As you think about the rest of this material remember this one fact as you learn about fatty liver disease and lifestyle.  The first step in carbohydrate metabolism is to turn the carbs to fat in the form of palmitic acid. Excess carbohydrates in the body are converted to palmitic acid which is the first fatty acid produced during fatty acid synthesis and is the precursor to longer chain fatty acids. The critical idea here is the presence of excess carbohydrates. 

Palmitic acid is a major body component of the body and is made primarily in the liver.

Sugar is also half fructose.  Unlike glucose, which is a direct fuel for all organs, fructose can only be processed by the liver and it is turned into fat inside the liver cells.  That process is unlimited so unlike glucose it just keeps building fatty acids in the liver and if you exceed what the liver can manage bad things happen. You can learn about that here.

When you eat too much sugar some of it is converted to fat in your liver cells and if the amount exceeds what the liver can dispose of you get accumulation.  There are many other chemical pathways in the liver but you can probably see how this might apply to you.

What is a good diet for a healthy person

What is a diet for fatty liver or NAFLD

What is a diet for a damaged liver NASH or cirrhosis

Much of this advice will be familiar to you, however, there is one critical food item which under official US food advice is different.  That is the extensive use of extra virgin olive oil. It is important to be aware that the Official American Dietary Guidelines  advise  calorie reduction and exercise with limited dietary fat. It limits saturated fats but ignores the differences between various oils.  If you want to study the official recommendation you can do it here.  You might wonder whether the official federal policy has anything to do with the vast amount of disease afflicting our society.

USDA Dietary Guidelines

The nutritional approach to fatty liver disease has a broad base of support among providers, including MDs. The optimal approach is still a matter of investigation and debate. However, the Mediterranean diet is one of the most studied diets in science and medicine. As the most common cause of mortality among patients with NAFLD is cardiovascular events, the impact on mortality alone make it worthwhile to adopt. The anti inflammatory and anti-fibrotic literature for the diet are also compelling and since we are focused on liver disease that is the focus of this information.

Much of our advice is built around extra virgin olive oil. If you would like
more information see this link on olive oil
but if your interest is about
fatty liver disease and its complication click here.

If you have a liver problem, you should be aware that liver disease is ignored by almost all diet plans.  The reason is that it is mostly symptom free and there are no treatments so most of the research has been on heart and diabetes issues.  If you are concerned about your liver you are part of an ignored patient group.  If you would like to test that theory,

US News has an excellent summary of popular diets which you can look at here for an overview.

Just be aware that they ignore the questions that brought you here. Diet plans mostly ignore the liver even though its health is the foundation upon which most of the bio-chemistry that is you depends.  So look around but come back here when you find out that the diet plan advocates ignore you.


Please note that extreme low carb plans are probably bad for you.  Your body must have fuel and when we eliminate sugar that comes significantly in the form of fats and carbs.  The kind of carbs is what you need to pay attention to.  Ideally you want to eat a good supply of resistant starch, that is starch that is digested in the colon and not the small intestine.  This is very important for the health of the colon as much of its energy is in the form of short chain molecules called butyrate which are produced by the healthy bacteria.  Take those away and the cells lining the colon suffer.

Resistant starch is considered both a dietary fiber and a functional fiber, depending on whether it is naturally in foods or added. Although the U.S. Institute of Medicine has defined total fiber as equal to functional fiber plus dietary fiber, U.S. food labeling does not distinguish between them.

Examples of naturally occurring resistant starch[35]
Food Serving size Resistant starch
Banana flour,[36] from green bananas 1/4 cup, uncooked 10.5-13.2
Banana, raw, slightly green 1 medium, peeled 4.7
High amylose RS2 corn resistant starch 1 tablespoon (9.5 g) 4.5
Oats, rolled 1/4 cup, uncooked 4.4
Green peas, frozen 1 cup, cooked 4.0
White beans 1/2 cup, cooked 3.7
Lentils 1/2 cup cooked 2.5
Cold pasta 1 cup 1.9
Pearl barley 1/2 cup cooked 1.6
Cold potato 1/2" diameter 0.6 - 0.8
Oatmeal 1 cup cooked 0.5


Processing may affect the natural resistant starch content of foods. In general, processes that break down structural barriers to digestion reduce resistant starch content, with greater reductions resulting from processing. Whole grain wheat may contain as high as 14% resistant starch, while milled wheat flour may contain only 2%.

Other types of processing increase resistant starch content. If cooking includes excess water, the starch is gelatinized and becomes more digestible. However, if these starch gels are then cooled, they can form starch crystals resistant to digestive enzymes such as those occurring in cooked and cooled cereals or potatoes (e.g., potato salad). Cooling a boiled potato overnight increases the amount of resistant starch for example.

Resistant starch does not release glucose within the small intestine, but rather reaches the large intestine where it is consumed or fermented by colonic bacteria (gut microbiota).[10] On a daily basis, human intestinal microbiota encounter more carbohydrates than any other dietary component. This includes resistant starch, non-starch polysaccharide fibers, oligosaccharides, and simple sugars which have significance to colon health.[10][12]

The fermentation of resistant starch produces short-chain fatty acids, including acetate, propionate, and butyrate and increased bacterial cell mass. The short-chain fatty acids are produced in the large intestine where they are rapidly absorbed from the colon, then are metabolized in colonic epithelial cells, liver or other tissues.[13][14] The fermentation of resistant starch produces more butyrate than other types of dietary fibers.[15]

Modest amounts of gases such as carbon dioxide, methane, and hydrogen are also produced in intestinal fermentation. One review estimated that the acceptable daily intake of resistant starch may be as high as 45 grams in adults,[16] an amount exceeding the total recommended intake for dietary fiber of 25–38 grams per day.[17] When isolated resistant starch is used to substitute for flour in foods, the glycemic response of that food is reduced.[18][19]

Here is a link to a discussion of Resistant Starch


If Fatty Liver disease or its cousins concern you join the Foundation, its free