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What diet makes my liver work less with NASH?



We start with the fact that the fundamental problem is the bio-chemical flow between the liver and fat cells. When diet is poorly balanced, over time fat accumulates in the liver and by itself is rather benign but when other chemistries like insulin management begin to degrade you get inflammation which leads to fibrosis and if not stopped progresses to cirrhosis. Since there is no treatment your tool is diet and the question is to avoid anything that stresses the liver and load up on anything that is protective. Easy peasy right. Well let's take a look

  • eliminate all alcohol
  • eliminate most saturated fat and no red meat
  • eliminate all non skim dairy products
  • eliminate trans-fat and all hydrogenated oils
  • eliminate all high fructose corn syrup
  • eliminate most sodium -- the goal 1,500 mg of salt.
  • eliminate all added dietary sugar
  • eliminate processed grains, no white flour or white rice
  • Avoid most products hustled by the supplement industry
  • Make sure that any medications you take are not harming your liver

Oh my god. That is a terrible list. Not possible to live that way. OK, take a breath. The goal is to take as much pressure off the liver as possible, provide molecules from your diet that are protective and don't stimulate the stellate cells to initiate scaring, but still provide proper nutrition. So what do you do?

  • For oil get 60 ml, that's 1/4 cup, a day of extra virgin olive oil
  • Take one tablespoon per day of refined fish or salmon oil
  • Don't buy prepared foods without reading the label, there isn't actually much that you can buy
  • Eat lots of fruits and vegetables but remember the salt limit
  • Learn to like kale, lima beans, brussel sprouts, etc.
  • Look for fiber like whole wheat bread no white breads and use brown rice
  • Eat fatty fish like salmon at least a few times a week
  • Eat skinless chicken or turkey and lean pork, fresh pork not processed like ham
  • Explore new foods like quinoa as a grain
  • Eat plenty of vegetable protein like beans.
  • Take 400 mg to 800 mg of vitamin E
  • Drink 3 to 4 cups of paper filtered coffee daily
  • Eating on the road is tough as very little fast food is good for you
  • Take 4 gm of BCAA in a vegetable smoothie or water at bedtime

You get the idea. you might call this a type of Mediterranean diet but the excess olive oil is specifically a source of unsaturated fat. The rest is mostly nutrition. The fish oil is to get a significant source of omega 3 oil to balance the omega 6 you routinely get in food. The salt limitation is good for you and lowers your blood pressure. The BCAA is a branched chain amino acid mix which is basically predigested protein and helps prevent muscle wasting if your digestion is damaged.

So why should you think this might work for you? Without getting too technical your energy systems are built around triglycerides. Any oil can be used by the body to make them but if made with unsaturated oil they are better for the body. More importantly olive oil is mostly an omega 9 fatty acid. Good olive oil is a complex mixture of around 30 oils and phyto chemicals which support liver function and soothe activated stellate cells which cools inflammation. Good olive oil causes a burning feeling at the back of your throat. Those are the phyto chemicals and more is better if you ever go to an oil tasting bar.  The omega 3 reduces the amount of inflammation caused by omega 6 and is required for good health even if you don't have liver disease.

Click here for a more general discussion about diets.

If you are interested in the science of liver disease here is a link to our educational videos.

DISCLAIMER: Be aware that I am not a doctor.  I cannot give medical advice.  I am a cirrhosis patient and I have apparently halted the progression of my disease following this strategy. You must not assume that this advice will necessarily apply to your situation and you must work closely with your physicians as your situation is unique to you.

Please note that everyone has different a different culture and diet preferences.  We cannot provide a diet plan that suits everyone so we offer you the general guidelines but each person has to look at their personal food choices and modify them to be as kind as they can to their liver.  There is no one size fits all plan.