Prioritizing fiber, plant-based protein, and healthy fats can help you manage your liver condition.
Metabolic dysfunction–associated steatohepatitis (MASH) is a disease in which excess fat accumulates in the liver and contributes to inflammation that can lead to scarring and cirrhosis. Until recently, the condition was known as nonalcoholic steatohepatitis (NASH).
Because the liver processes what you eat, a healthy diet can be key to managing MASH and its symptoms. It may be wise to move toward unprocessed or whole foods, says Joe Galati, MD, the founder of Liver Specialists of Texas in Houston and the author of Eating Yourself Sick.
“A whole-food, plant-based diet is really the preferred diet. In the same breath, you could also recommend following a Mediterranean diet,” Dr. Galati says. “These are anti-inflammatory diets that will typically promote weight loss, control hypertension, and lower cholesterol.”
While diet is important and can support your overall health, it's not a replacement for the treatment plan your doctor recommends. But the following seven foods could help your liver and keep MASH in check.
Nuts such as walnuts are rich in heart-healthy unsaturated fatty acids, plus fiber and plant protein. They may help regulate weight gain by controlling appetite, improving gut health, and bettering metabolic health. As whole foods, they also may help your gut microbiome, the colony of microbes that live in your intestines and help you digest food and maintain a strong immune system.
“These foods will provide a balanced amount of carbohydrates, fats, and protein, and they are also rich in fiber, which is important for keeping your gut microbiome healthy,” says Zhaoping Li, MD, PhD, a professor of medicine and the chief of the division of clinical nutrition at the University of California in Los Angeles.
Conversely, research shows that foods high in fat or calories can cause imbalance in the gut microbiome, which can expose liver cells to damaging toxins and promote liver disease.
Although all nuts may fit into a MASH diet, research has shown that consuming walnuts and their oil may reduce inflammation.
Olive oil is a core ingredient in a Mediterranean diet, and research suggests that it may be healthy for your liver, too.
Olive oil is a rich source of monounsaturated fatty acids that may help decrease the accumulation of triglycerides (a type of fat) in the liver. It also contains plant compounds called phenols that help neutralize free radicals. Free radicals are compounds that damage cells in the body. Olive oil also may help reduce levels of liver enzymes, which are markers of liver disease.
Keep in mind that olive oil also is calorie-dense. One tablespoon contains 126 calories, so moderate your portions.
Flavonoids are plant chemicals that can provide antioxidant and anti-inflammatory benefits. A diet rich in flavonoids may help delay the progression of liver disease, according to research on middle-age adults.
According to the research, apples are a good source of flavonoids, alongside pears, peaches, and other options. Consuming flavonoid-rich foods also can reduce fat accumulation and inflammation and improve insulin resistance.
Green tea contains polyphenols, plant compounds that quash free radicals. One of those is a catechin called epigallocatechin gallate, or EGCG. Research has shown that EGCG can help manage and prevent MASH.
Green tea's EGCG aids liver function by reducing oxidative stress, an imbalance between the damaging free radicals in your body and neutralizing antioxidants. By doing so, it can improve lipid metabolism, reduce inflammation, and stop the progression of cirrhosis and fibrosis.
Another plus about green tea: It's a nearly calorie-free beverage, so it can help support a healthy weight. Bottled iced green tea or matcha teas (a form of powdered green tea), however, can contain added sugar. Scan the nutrition label and be sure to choose sugar-free or low-sugar versions.
Oranges and other citrus fruits contain a compound called hesperidin that may decrease blood sugar, help break down fatty acids, and reduce liver fat.
People who consumed nearly three whole oranges per day for four weeks saw a reduction in liver fat compared with a control group who consumed the same amount of non-citrus fruits daily.
One caveat: The orange intake in this small study of adults with liver disease was high, and experts generally recommend keeping fruit intake moderate when you have MASH.
"Eating fruit in place of starch is a good choice," Dr. Li says. "If you have a sedentary office job, I recommend consuming no more than two fruits daily. Sugar in a natural food like fruit does not have as many negative effects as cereal or bread, but you don't want to overdo it."
Leafy greens may be especially good choices for fatty liver. Research suggests that swapping one portion of carbohydrate-rich food bread, pasta, or potatoes for one portion of green leafy vegetables like kale (about 1.5 cups cooked) for three months helps reduce fatty liver, including MASH in mild or advanced stages.
These greens provide fiber that aids with digestion, as well as vitamins and nutrients.
In general, vegetables are an important part of your regular meal plan if you have MASH, Li says. She recommends focusing on nonstarchy vegetables, including:
Asparagus
Green beans
Broccoli
Cabbage
Cauliflower
Whole soy foods also may help your liver. In addition to tofu, these include edamame, soy nuts, and unsweetened soy milk.
Soy, which is a source of plant-based protein, may reduce fasting blood sugar, insulin, inflammatory markers, and blood pressure, all metabolic health components that are often “off” in those who have MASH.
Soy protein contains isoflavones that reduce lipids (fats) in the blood and stalls the accumulation of liver fat to improve MASH. This ingredient also protects the liver against cell damage and inflammation.
A healthy diet of whole foods, such as those found in the Mediterranean diet, can help you manage symptoms of MASH, formerly known as nonalcoholic steatohepatitis (NASH).
Foods such as walnuts, oranges, and leafy green vegetables may help you find the right balance of fat, protein, fiber, and carbohydrates.
Dietary changes should supplement your prescribed MASH treatment plan, not replace it. Ask your doctor what is right for you.
