6 Natural Ways To Prevent Fatty Liver Disease: Part 3 of Liver Health

How you choose to move and fuel your body has a great impact on your health and wellbeing. More and more research is coming out about the many links to chronic illness and a diet high in processed foods. According to the FDA, more than one million people in America die each year from diseases related to the foods we eat.¹

A recently published paper from the British Medical Journal shows exactly how harmful processed foods are. Processed foods include packaged snacks, soda, and frozen/microwave meals. Eating a diet high in processed foods is linked to 32 different health conditions like heart disease, diabetes, obesity, metabolic syndrome, and (you guessed it) fatty liver disease

Fatty liver disease is a condition that happens when too much fat is stored in the liver. Over time, these fat stores build up in the liver and replace healthy liver cells. This can cause liver damage and even lead to cirrhosis. 

When it comes to the treatment of fatty liver disease, there's currently no FDA-approved medications that specifically treat it.³ But there are many different vitamins, supplements, and other medications that have been found to improve and even prevent fatty liver disease. 

And like any other disease, prevention is key.

I've lost track of how many patients have come to me and have said that other doctors have told them that there was nothing they could do about their fatty liver disease. 

But this couldn't be further from the truth. 

It's better to treat and prevent liver disease from getting worse than to do nothing at all. 

I recently did a talk on liver health where I went into depth about the different ways to prevent and treat fatty liver disease, and I want to share some of them with you today.

While several treatments for fatty liver disease have been studied, I want to talk about several ways you can start taking better care of your liver today with lifestyle changes and supplements. And if you already have a form of liver disease, there are things you can do to keep it from getting worse.  

What is Fatty Liver Disease?

Before we dive into the different ways to keep your liver healthy, we need to go over exactly what fatty liver disease is. 

Fatty liver disease is a condition that happens when too much fat is stored in the liver. The liver has many functions, and one of the big ones is flushing harmful toxins out of the body. Most of the time, your liver can keep up with the workload. But if you're consuming or exposing yourself to too many toxins, your liver will struggle to keep up. 

In fact, your liver will run out of ways to get rid of the toxins they've processed. As a result, these processed and filtered toxins get stored as fat in the liver. 

Because we have fat in other places in our bodies, this may not seem like a problem. But it is. 

Over time, these fat stores build up in the liver and replace healthy liver cells. This can cause liver damage and even lead to cirrhosis, which is permanent scarring of the liver.

What Causes Fatty Liver Disease?

When the different types of liver diseases were discovered, the initial thought was that alcohol was the main cause. Because of this, the types of fatty liver disease were originally divided up into two categories: non-alcoholic and alcoholic.

We now know that liver problems are caused by so many things - some big ones being the foods we eat, the environments we live in, and whether or not we have something called metabolic syndrome

Metabolic syndrome is a group of conditions that occur together and increase the risk of having diabetes, heart attack, and stroke. The five conditions that make up metabolic syndrome include:⁴

  • Obesity

  • High blood sugar levels

  • High blood pressure

  • High triglyceride levels

  • Low HDL levels

Because of these discoveries, the official name of fatty liver disease not caused by alcohol has changed from nonalcoholic fatty liver disease (NAFLD) to metabolic dysfunction associated steatotic liver disease (MASLD).

The focus of preventing MASLD is to:

  1. Limit the amount of toxins we expose ourselves to

  2. Make sure we have enough of the nutrients our livers need to be healthy

Prevention is important for people with and without fatty liver disease. Because by doing these things to take care of your liver, you can not only prevent fatty liver disease from happening but also keep liver disease from getting worse. 

From lifestyle changes to supplements, here are six natural ways you can prevent liver disease. 

6 Natural Ways To Help Prevent Fatty Liver Disease

The ways to prevent liver disease that I want to discuss today are some of the ones that have been the most studied and have shown to work the best. The prevention of liver disease comes down to living a healthy lifestyle and making sure you're getting enough of certain vitamins, especially vitamin D

1. Maintain A Healthy Weight

Since obesity is one of the conditions that can cause metabolic syndrome, it's important to maintain a healthy weight. And when it comes specifically to MASLD, the power of weight loss has been proven. In fact, weight loss may be one of the most important things you can do to help your body and your liver.

Weight loss of 3-5% of your total body weight has been shown to decrease the fat stores in your liver and improve liver health in those with MASLD.⁵

While weight loss isn't always easy to do, getting more exercise and making changes to your diet is a good start. If after six months of effort you're still not able to lose weight, bariatric surgery is one of the most common treatments recommended by western medicine for the treatment of MASLD. As a Naturopathic Physician, however, I like to recommend everything we can prior to recommending any surgery. 

I like to work with patients on optimizing nutrition, working on infections that contribute to obesity including candida overgrowth as well as microbiome imbalance in the GI tract. There are a lot of different things we can do to help with this, and I will discuss a few of them below. 

2. Increase Exercise

As I mentioned before, increasing the amount of exercise you do can help you both lose weight and maintain a healthy weight. The impact that exercise has on MASLD is significant. Research has shown that doing 150 minutes of aerobic and resistance exercise per week can reverse MASLD.⁶

Some examples of aerobic exercise are running, biking, and swimming. Resistance exercises most often include lifting weights and doing body-weight exercises like sit-ups, pull-ups, crunches, or squats.

It’s also important that we move our bodies regularly so our lymphatic systems can drain. I really like to recommend exercise that you like so that it’s something that also brings you happiness in your life. 

When we do workouts that we don’t enjoy, we tend to not continue them. Maybe for you it might look a little different than joining a gym. Maybe it's taking a dance class, learning how to rock climb, or heading out with your kids to a trampoline place!

3. Cut Toxins Out Of Your Diet

As we now know, the foods we eat can really impact our liver health. And it's not so much the food itself that's causing the problem. Instead, it's how it’s grown, how it’s processed, and how it’s prepared that’s causing the issues. 

What Are We Putting in Our Food That Is Making Us Fat? Food Additives, Contaminants, and Other Putative Contributors to Obesity⁷

There are over 4,000 additives and preservatives that are used in the US food supply alone.⁷ The problem with additives is that they’re not thoroughly tested for the chronic and cumulative effects they have on the body. 

Fortunately, there are ways to avoid many of these toxins and additives. For the foundation of your diet, I recommend eating:

  • Whole foods

  • Non-genetically modified organisms (non-GMO)

  • Organic foods

  • Food that comes with the least amount of packaging possible - since many of the toxins may leach from the packaging material, such as the plastic liners they use for canned goods

By making your food choices around these few tips, you'll avoid many of the toxins linked to fatty liver disease that are used in the farming and processing steps. 

Here are some other tips to keep your liver healthy:

  • Increase dietary fiber to 50g daily, which you should meet just by eating a whole foods diet alone

  • Remove artificial sweeteners, such as splenda, aspartame, sucrose, sucralose, and malitiol

  • Stay away from high fructose corn syrup⁸

  • Avoid artificial food colors⁹

  • Steer clear of food additives, such as proprionic acid¹⁰

4. Change Your Diet To Keep Your Liver Healthy

When it comes to a specific diet for liver health, there are many that have been well-studied and proven to work. Here are a few diets that I recommend for keeping your liver in good health.

For liver health, I typically recommend diets that fall into a category called very low carbohydrate diets (VLCDs). These types of diet have been found to lower triglycerides and help regulate blood sugar levels. Doing both of these things help to decrease the risk of metabolic syndrome and ultimately MASLD. Some examples of these diets include:

  • Paleo diet

  • Carnivore diet

  • Ketogenic diet

By limiting how many carbohydrates you eat, a ketogenic diet causes something called ketosis. This process increases levels of something called beta hydroxybutyrate which helps to regulate your blood sugar levels. A ketogenic diet also lowers inflammation of the liver which can help prevent MASLD.¹¹

While a ketogenic diet can be difficult to maintain, the benefits of it are well worth it. In addition to helping the liver, a ketogenic diet also improves brain functioning and reduces "brain fog." I've seen many patients with traumatic brain injuries (TBIs) have improvements in their brain health on a ketogenic diet.

Intermittent fasting is another healthy diet I recommend, as it's been shown to keep MASLD from getting worse and help with weight loss in adults with MASLD.¹² Intermittent fasting has also been shown to normalize levels of something called leptin.¹³ Leptin is a hormone that helps keep your weight stable on a long-term basis. It does this by regulating feelings of hunger and fullness when you eat.

5. Get Good Quality Sleep

When it comes to sleep, you've probably heard of something called the circadian rhythm. This is basically the process that happens throughout our entire body that helps to tell us when it's time to sleep and wake up. Sleep, or lack of it, affects many different parts of the body - including the liver. 

Just like our brains and other organs in the body, our liver cells contain circadian rhythm clocks that work as timing systems to help the liver function appropriately. This helps the liver automatically increase its function during daytime hours and decrease it during nighttime hours.¹⁴

So prioritizing your sleep is a must for liver health. Here are some of my tips:

  • Sleep eight to nine hours a night

  • No food three hours before bed¹⁵

  • Don't use electronic devices two hours before bed¹⁶ ¹⁷ 

If you must use electronic devices before bedtime, use apps like Flux or wear blue-light-blocking glasses. It's important to avoid blue light exposure close to bedtime because it lowers levels of melatonin, which we need to get healthy sleep. For more information on the science of sleep and more tips on how to get good, quality sleep, check out my blogs on sleep.

6. Get Enough Vitamin D

The last, but probably one of the most important, ways to prevent and even treat certain types of liver disease is to take a vitamin D supplement. I'm sure you know that vitamin D is needed for bone health. But did you know that it's also needed for liver and metabolic health?

It can be difficult to get enough vitamin D because it's not naturally found in a lot of foods. The main way that we naturally get vitamin D is when we're in the sun. When our skin is exposed to sunlight, a certain chemical in the skin is converted into vitamin D for our bodies to use. So for people that live in an area that doesn't get a lot of sunlight, this can be a problem. 

Low levels of vitamin D have been linked to MASLD.¹⁸ For this reason, as well as many others, every patient in my office is tested for vitamin D deficiency. I've found that about 98% of my patients have levels below 30 ng/ml, which can cause countless problems in the body. Adequate levels of vitamin D are above 50 ng/ml, but I recommend levels at a 70-90 ng/ml level.¹⁹

What I typically hear from patients is that they've been advised by other physicians to take 1,000-2,000iu of vitamin D daily. But this isn't even enough to maintain what vitamin D your body has. At a minimum, you need to take 5,000iu daily just to maintain your current vitamin D levels. If your levels of vitamin D are low, then you'll need additional supplementation. Sometimes this includes doing weekly vitamin D injections for four to six weeks. 

Keeping your vitamin D levels high enough comes with many benefits for liver and metabolic health. Some of these benefits include:²⁰ ²¹ 

  • Decreased inflammation in the liver and throughout the body

  • Better blood sugar

  • Weight loss

  • Improved cholesterol

  • Decrease in metabolic syndrome

Having healthy levels of vitamin D will help keep MASLD from progressing to permanent diseases of the liver like cirrhosis. Taking vitamin D has also been shown to prevent liver cancer in those with liver disease²² and also prevent cardiovascular disease.²³

Unfortunately, I've run into many issues and barriers when it comes to treating vitamin D deficiency. This is largely due to the fact that many insurance companies are no longer paying for vitamin D levels to be checked. This can make it extremely difficult to monitor vitamin D levels to make sure they're going up appropriately with supplements. 

Are There Other Treatments For Liver Disease?

As you now know, there are many natural ways to keep MASLD from getting worse and also prevent it from happening in the first place. But if you have a more advanced type of chronic liver disease or damage to the liver, you may need additional treatment. Treatments for liver disease that I routinely use in my practice include:

  • Antioxidants

  • Vitamins and minerals

  • Prebiotics

  • Probiotics

  • Herbs

  • Medications

  • Toxin binders

I recently discussed all of these different treatments for liver disease when I spoke at The Gut Rescue Summit. While the live event has come and gone, you can still access all of the valuable information. Not only did the summit include my talk on liver health, but it also featured other experts who spoke about the latest research and breakthroughs on topics like:

  • How to improve your gut health

  • GI motility disorders

  • Inflammatory bowel disease (IBD)

  • Irritable bowel syndrome (IBS)

  • Small intestine bacterial overgrowth (SIBO)

  • Other chronic gut conditions

You can access all of these expert-led presentations by clicking the link below.

And like other organs in your body, your liver function should be monitored closely, especially if you have a condition like MASLD. If you haven't already, talk to your functional medicine doctor about getting your liver enzymes and vitamin D levels checked today. And in the meantime, try to make some positive changes in your diet, sleep, and exercise habits. 

Your liver will thank you.


References:

1. Improving Nutrition to Turn the Tide on Diet-Related Chronic Disease – (fda.gov)

2. Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses – (bmj.com)

3. Nonalcoholic Fatty Liver Disease in Patients with Type 2 Diabetes: Screening, Diagnosis, and Treatment – (nih.gov)

4. What Is Metabolic Syndrome? – (nih.gov)

5. Treatment options for alcoholic and non-alcoholic fatty liver disease: A review – (nih.gov)

6. The Effects of Physical Exercise on Fatty Liver Disease – (nih.gov)

7. What Are We Putting in Our Food That Is Making Us Fat? Food Additives, Contaminants, and Other Putative Contributors to Obesity – (nih.gov)

8. High fructose corn syrup induces metabolic dysregulation and altered dopamine signaling in the absence of obesity – (nih.gov)

9. Chronic exposure to synthetic food colorant Allura Red AC promotes susceptibility to experimental colitis via intestinal serotonin in mice – (nih.gov)

10. The short-chain fatty acid propionate increases glucagon and FABP4 production, impairing insulin action in mice and humans – (nih.gov)

11. Beneficial effects of the ketogenic diet on nonalcoholic fatty liver disease: A comprehensive review of the literature – (nih.gov)

12. Intermittent fasting improves hepatic end points in nonalcoholic fatty liver disease: A systematic review and meta-analysis – (nih.gov)

13. Timed high-fat diet resets circadian metabolism and prevents obesity – (nih.gov)

14. The Importance of Keeping Time in the Liver – (nih.gov)

15. Eating Dinner Early Improves 24-h Blood Glucose Levels and Boosts Lipid Metabolism after Breakfast the Next Day: A Randomized Cross-Over Trial – (nih.gov)

16. Screen time is associated with adiposity and insulin resistance in children – (nih.gov)

17. An emerging connection between circadian rhythm disruption and type 2 diabetes mellitus – (mayoclinic.org)

18. Relationship Between Vitamin D Deficiency and Non-alcoholic Fatty Liver Disease: A Cross-Sectional Study From a Tertiary Care Center in Northern India – (nih.gov)

19. Vitamin D Dosing: Basic Principles and a Brief Algorithm (2021 Update) – (nih.gov)

20. Strong association between non alcoholic fatty liver disease (NAFLD) and low 25(OH) vitamin D levels in an adult population with normal serum liver enzymes – (nih.gov)

21. The Effects of Vitamin D Supplementation on Anthropometric and Biochemical Indices in Patients With Non-alcoholic Fatty Liver Disease: A Systematic Review and Meta-analysis – (frontiersin.org)

22. Vitamin D in liver cancer: novel insights and future perspectives – (nih.gov)

23. Vitamin D supplementation and major cardiovascular events: D-Health randomised controlled trial – (nih.gov)