Your liver is one of the hardest-working organs in your body. In a world filled with toxins, the liver’s main job is to break down the contaminants that come your way and get them ready to be escorted out of the body. But your liver also digests fats, regulates energy, and stores nutrients. It’s such a multi-tasking organ that you might say it’s your body’s superhero.
But, unlike Superman, your liver’s not invincible. Thanks largely to a modern lifestyle filled with ultra-processed foods, sugary drinks, and a lack of exercise, about 25 percent of Americans are living with nonalcoholic fatty liver disease (NAFLD). And, over time, that can lead to serious liver damage.
Let’s take a closer look at this increasingly common liver condition, as well as the many ways you can avoid becoming one of the statistics.
Nonalcoholic fatty liver disease is marked by the accumulation of fat inside your liver cells. While tiny amounts of fat are naturally found in the liver, the condition occurs when fat makes up more than five percent of the liver. There are two forms of NAFLD: simple nonalcoholic fatty liver disease and nonalcoholic steatohepatitis (NASH). Simple nonalcoholic fatty liver means you have some fat buildup in your liver but there is little or no inflammation or damage to your liver cells. NASH, on the other hand, is NAFLD’s more serious cousin because it signifies that inflammation, excess fat, and cell damage have now developed in the liver. Over time, NASH can increase the risk of fibrosis (the formation of large amounts of scar tissue in the liver), cirrhosis (excessive scarring that permanently damages the liver), and liver cancer.
While alcohol abuse is typically fingered as the cause of alcoholic fatty liver disease, NAFLD is caused by an array of factors. These include:
Excess belly fat. According to one study review, people with a higher waist circumference and waist-to-hip ratio had a greater risk of NAFLD than those who were generally obese.
Type 2 diabetes. People with type 2 diabetes have a five-times higher incidence of NAFLD compared to people without the disease.
A diet high in refined carbohydrates. A diet filled with bread, pasta, and other highly processed carbohydrates can increase your risk of developing NAFLD. Even if you don’t indulge in carb-heavy ultra-processed foods on a regular basis, binging on carbs for just three weeks can increase liver fat 10-fold.
Sugary drinks. Sugar-sweetened drinks like soda or sports drinks can increase the risk of NAFLD by as much as 40 percent. When you consume a sugar-sweetened drink, the high-fructose corn syrup it contains causes fat to accumulate in the liver.
Exposure to pesticides. Research has linked exposure to hormone-disrupting pesticides and herbicides like glyphosate to an increased risk of NAFLD.
Certain drugs. Findings in the Journal of Clinical and Translational Hepatology report that common drugs, including antidepressants, glucocorticoids, and even ibuprofen, can increase your odds of developing NAFLD.
Recent studies suggest that an imbalance in your microbiota (a condition known as dysbiosis) can contribute to NAFLD. Research has also found that a compromised intestinal barrier, a condition commonly known as leaky gut syndrome, can up your chances of developing a fatty liver.
High triglycerides. High triglyceride levels and low high-density lipoproteins (HDL) can be a clue that you have NAFLD. In fact, some studies have concluded that elevated triglycerides are an independent indicator for fatty liver, even if you’re not overweight.
The Signs of Non-Alcoholic Fatty Liver Disease
Nonalcoholic fatty liver disease is considered a “silent” condition since there are often few, if any, symptoms. But when symptoms do occur, they can be subtle or mistaken for other health problems. These include fatigue, muscle weakness, muscle loss, and pain in the upper right abdomen. Because NAFLD can often fly under the radar, it’s smart to get regular checkups. A routine blood test called a liver function test can help uncover liver problems in the early stages when NAFLD can be readily reversed. This test looks for elevated liver enzymes, especially alanine transaminase (ALT) and aspartate transaminase (AST). Even a slightly elevated ratio of AST/ALT can point to NAFLD.
Unfortunately, there are currently no approved medical treatments for NAFLD. But the good news is that the following tried-and-true supplements are clinically shown to help prevent and improve the condition.
Andrographis is an herb that’s popular in Ayurvedic and Traditional Chinese Medicine because of its ability to strengthen the immune system. But that’s not andrographis’s only claim to fame. Studies show that the herb’s star compound, andrographolide, can also support liver health thanks to its anti-inflammatory properties. It’s so effective that andrographis has been shown to reduce not only inflammation but also fibrosis in cases of NASH. But to get the most from this botanical, check supplement labels to ensure the andrographis is standardized to 20 percent andrographolides.
Grape Seed Extract, which is made from the seeds of wine grapes, contains powerful antioxidants known as proanthocyanidins. In one small study, people with NAFLD were divided into two groups. One group took a daily dose of grape seed extract; the other took vitamin C. While the vitamin C didn’t provide any liver benefits, supplementing with the grape seed extract led to a significant drop in the liver enzyme ALT, indicating less liver inflammation. The herb also improved the amount of fat in the liver.
Another randomized, double-blind trial found that supplementing with grape seed extract for two months resulted in a substantial reduction in both AST and ALT enzymes, plus lower levels of fasting blood sugar, triglycerides, and LDL cholesterol. But be aware that not all grape seed extracts are equally effective. Look for a product that delivers tannin-free, readily absorbed oligomeric proanthocyanidins that protect liver cells from oxidative stress and damage.
Milk Thistle Extract is perhaps the most well-known herb for liver support. Milk thistle’s active compound is silymarin, a polyphenol with powerful antioxidant activity that reduces oxidative damage by scavenging free radicals. What’s more, milk thistle boosts the activity of the body’s own antioxidants such as glutathione. Studies suggest that milk thistle also inhibits inflammation, stimulates new liver-cell production, and prevents glutathione depletion. Research in the journal Advances in Therapy has also noted that the silymarin in milk thistle modulates AST and ALT enzymes, which helps prevent cellular damage, fibrosis, and cirrhosis. These findings were confirmed during a recent meta-analysis that found silymarin reduced liver enzyme levels better than a placebo in people with NAFLD. Better yet, according to a randomized, double-blind, placebo-controlled study reported in the Caspian Journal of Internal Medicine, silymarin is so effective that it was shown to reduce ALT and AST in a group of patients whose NAFLD had progressed to NASH.
But when choosing a milk thistle product, make sure it’s standardized to contain more than 29.7 percent silymarin (also called silybin). Because milk thistle is such an overall liver–loving herb, it can even benefit those at risk of NASH or other serious liver problems.
Lifestyle Tips for Preventing and Reversing NAFLD
The liver has the remarkable ability to regenerate itself, which is why the following strategies can be so effective in preventing, and potentially even reversing, NAFLD.
Minimize or avoid alcohol. Even though alcohol consumption doesn’t cause NAFLD, people who have been diagnosed with the condition are typically advised to avoid drinking since research suggests that even small amounts of alcohol can accelerate the progression of the disease. However, for those who are at a higher-than-normal risk for developing NAFLD, some studies have concluded that light to moderate drinking may actually have a protective effect.
Get some regular exercise. Studies show that participating in regular aerobic and resistance training reduces the amount of fat stored in your liver cells. High-intensity interval training (HIIT) workouts are among the most effective for preventing and improving NAFLD. One small clinical trial found that people with type 2 diabetes who participated in HIIT three times per week for 12 weeks experienced a significant 39 percent reduction in liver fat. Whatever type of exercise you choose, make sure it’s something you enjoy. This can help you stick with it long-term.
Up your antioxidants. According to recent research, a diet high in antioxidants can help inhibit cellular damage, which in turn prevents the accumulation of fat in the liver. One six-month clinical trial involving 76 people with NAFLD found that a diet high in antioxidants reduced liver fat by as much as 40 percent. Good sources include colorful fruits and vegetables, coffee, green tea, extra-virgin olive oil, pecans, and dark chocolate.
Lose weight. Weight loss can also decrease the amount of fat and inflammation in your liver. Studies show that losing just five percent of your body weight can help improve NAFLD. One study published in the journal African Health Sciences reported that a 15 percent reduction in body mass index (BMI) can also improve both liver function and insulin resistance in type 2 diabetics with the disease.