Now that you know the basics of nonalcoholic fatty liver disease (NAFLD), let's talk about prevention and treatment.Lifestyle changes include losing weight and regular exercise can control or even reverse the fat build up in the liver. These 11 tips will help prevent developing NAFLD as well as treat it once diagnosed:

• Lose 5-7% of your body weight. For a 200-pound person, that means losing 10-15 pounds. For even better health, lose 10% or more of your body weight. Losing weight and maintaining healthy changes to maintain at a lower weight is one of the most important strategies to control or reverse NAFLD.
• Research shows that low-fat, high-carbohydrate plans such as a Mediterranean-style of eating promote weight loss and decrease liver fat compared to low-carbohydrate, high-fat diets which may actually increase fat in the liver.
• Replace sweetened beverages like soda, juice drinks, sweet tea, and sports/energy drinks with plain water or flavored water without added sugar.Read food labels for added sugars and keep the levels to no more than 6% of your total daily calories.
  • For most men that means no more than 150 calories or 36 grams of added sugars.
  • For most women 100 calories or 25 grams of added sugars is the limit.
  • 20 ounces of sports drink contains about 122 calories from added sugars and a 16-ounce mocha Frappuccino has about 51 grams of sugar.
• If you need a quick meal, avoid fast food burgers and fries. Instead opt for a turkey sandwich with loads of veggies on whole grain bread and a bottle of water.
• When your usual morning routine involves grabbing coffee and a breakfast sandwich or donuts in the drive-through, switch gears and either make breakfast at home or opt for a brewed coffee or flat white with an egg-white breakfast sandwich to reduce saturated fat, added sugar, and processed foods.
• Enjoy a variety of fresh, frozen or canned fruits without added sugar for dessert instead of cookies, cakes, pies or ice cream that are high in both added sugar and saturated fat. Layer plain yogurt with fruit for a healthy parfait, stir fruit into plain oatmeal for a satisfying breakfast, or pass around a plate of cut-up fresh fruit for a delicious snack.
• Fill half your lunch and dinner plate with vegetables, either raw or cooked. Vegetables are high in important vitamins and minerals that promote liver health and low in fat and calories.
• Replace animal protein (that is often high in saturated fat) with plant-based protein. Instead of a beef burrito, choose a bean burrito; opt for lentil soup instead of a creamy chowder.
• Avoid all types of alcohol and instead enjoy sparkling water with a twist of lime.
• Aim for 60 minutes of physical activity every day. Follow each meal with a 5–10-minute brisk walk, take the stairs whenever possible, organize a family game of catch or tag, or put on music and dance to fit physical activity into your daily routine.

By Lynn Grieger, RDN, CDCES, CPT, CHWCReferences:

1. Ando, Y. and Jou, J.H. (2021), Nonalcoholic Fatty Liver Disease and Recent Guideline Updates. Clinical Liver Disease, 17: 23-28. https://doi.org/10.1002/cld.1045
2. PCRM's Nutrition Guide for Clinicians. Fatty Liver Disease. https://nutritionguide.pcrm.org/nutritionguide/view/Nutrition_Guide_for_Clinicians/1342048/all/Nonalcoholic_Fatty_Liver_Disease   last updated 12-1-2020. Accessed 12-18-21
3. Bataller R, Brenner DA. Liver fibrosis [published correction appears in J Clin Invest. 2005 Apr;115(4):1100]. J Clin Invest. 2005;115(2):209-218. doi:10.1172/JCI24282
4. National Institute of Diabetes and Digestive and Kidney Diseases. Cirrhosis.  https://www.niddk.nih.gov/health-information/liver-disease/cirrhosis   last reviewed March 2018. Accessed 12-18-21
5. University of Michigan Health. High Triglycerides. https://www.uofmhealth.org/health-library/zp3387  current as of 8-31-2020; accessed 12-18-21
6. American Heart Association. Added Sugars. https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/sugar/added-sugars  accessed 12-18-21. Last reviewed 11-2-21.