NASH Patients: Add These Foods to Your Diet

Nov 3, 2016 | Mayo Clinic Transplant Dietitian | @mayoclinictransplantdietitian | Comments (48)

The second most common reason for liver transplant is a condition called nonalcoholic fatty liver disease, also known as nonalcoholic steatohepatitis (NASH).  NASH takes place when fat accumulates in the liver of people who drink little or no alcohol. At its most severe, NASH can progress to cirrhosis and liver failure.

2016-11-04-almond crusted chicken

If you have NASH, losing weight and becoming more active are currently the primary treatments for a fatty liver. If your condition has progressed to liver failure and you need a transplant, your physician may recommend weight loss prior to receiving a transplant so you’re healthy enough for surgery.

What you can do

With weight loss, making healthy, long-term changes is key to success. We recommend a modified Mediterranean diet because studies have shown it can help reduce the amount of fat stored in the liver for people with NASH. Even modest reductions in weight (5-10% of total body weight) can help decrease the amount of fat deposited in the liver. Set reasonable goals for yourself as you begin your weight loss journey; a weight loss of 1-2 pounds per week is ideal.

The Mediterranean diet focuses on delicious fruits, vegetables, whole grains, and heart-healthy protein each day. Set yourself up for success by adding these foods to your diet each day:

  • Vegetables: Eat at least three servings of vegetables daily. Try eating vegetables that are in season for extra flavor and nourishment. Sneak vegetables into foods you love, like with this recipe for garlic cauliflower potato mash.
  • Fruit: Eat at least two servings of fruit each day. Serve it on a skewer with a low fat yogurt-based dip for a delicious snack.
  • Protein: Choose a good source of protein, like fish, shellfish, legumes or beans, white meat, lean red meat or eggs, with every meal. Try this almond crusted chicken for a filling and flavorful entrée.
  • Grains: Choose whole grains such as 100% whole-grain or whole wheat bread, 100% whole grain cereals, brown or wild rice. Experiment with grains such as quinoa, barley, bulgar, farro and whole-grain pastas. Give these protein-packed quinoa cakes as an appetizer or side dish.
  • Dairy and Dairy Alternatives: Choose up to 3 servings of dairy or dairy alternatives daily. Choose low fat or fat free milk, yogurt and cheese. Pass on sugar-sweetened dairy products such as yogurt or flavored milks or sweetened milk alternatives. This strawberry banana milkshake uses soy milk and fresh fruit to satisfy your sweet tooth.
  • Healthy fats: Eat healthy fats daily, like walnuts, hazelnuts and almonds. Be sure to count your calories for added fats and nuts into your daily allotment. Use “extra-virgin” or virgin olive oil in place of other fats such as vegetable oil or butter in low temperature cooking.  Here’s a savory and superfood-packed recipe using walnuts to add healthy fat and a tasty crunch.

If you have NASH, how have you changed your diet? What are your go-to healthy recipes?

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I too have NASH, recently diagnosed. I am now under the care of an actual liver specialist who has done so many tests and one genetic test specifically showed a genetic influence in my diagnosis. This is such a complex disease please, please make sure you are monitored closely by an aggressive physician that gets all the tests you really need to treat you successfully. For years all I was told is “your numbers are high, just watch what you eat”!
If correct info had been given to me years ago, this would not have progressed to NASH!

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Also wanted to mention there are decent sugar substitutes, such as Stevia liquid (my go-to) as well as salt substitutes that I find acceptable as well.

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@kathywebb52

I too have NASH, recently diagnosed. I am now under the care of an actual liver specialist who has done so many tests and one genetic test specifically showed a genetic influence in my diagnosis. This is such a complex disease please, please make sure you are monitored closely by an aggressive physician that gets all the tests you really need to treat you successfully. For years all I was told is “your numbers are high, just watch what you eat”!
If correct info had been given to me years ago, this would not have progressed to NASH!

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Hi Kathy, Are you managing NASH through lifestyle (diet and activity)? What changes have you made? Which ones were a challenge?

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@colleenyoung

Hi Kathy, Are you managing NASH through lifestyle (diet and activity)? What changes have you made? Which ones were a challenge?

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Yes! I watch labels very closely avoiding sugar and unhealthy fats. Eating lots of healthy fresh vegetables and fresh fruits. Main protein comes from chicken. My breakfast this morning was a cup of coffee with egg fried in olive oil spray and a small avacado toast. Disappointed how majority of “healthy” protein bars/easy go-to choices are full of well hidden bad foods for one’s liver. Choices are almost zero if you are truly committed. Most hide unhealthy ingredients in the fine print which is so shady to me….
I have my standard go-to’s that sustain my home meal cooking…simply don’t eat out unless its a healthy salad & even then I take my salt substitute and my own homemade healthy dressing. 😬
My go-to supplement that I take twice daily is by 1MD LiverMD which friends of mine are also on. I honestly can tell a big difference in the way I feel daily.
Good luck….this isn’t easy and it’s not cheap eating healthy!

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I have changed my diet, 4 months ago and have lost 33 pound and my bmi is now 25 or 24. my colesterol was lower 233 than it had been and triglycerides were now normal but a fibroscan said i have f0 and a cap of 317. How can i lower this fat and why is the fatty part so high. I believe i have familial nafld and does that make it harder?

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@jbesh00g

I have changed my diet, 4 months ago and have lost 33 pound and my bmi is now 25 or 24. my colesterol was lower 233 than it had been and triglycerides were now normal but a fibroscan said i have f0 and a cap of 317. How can i lower this fat and why is the fatty part so high. I believe i have familial nafld and does that make it harder?

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@jbesh00g, welcome. You must be proud of the results of your diet change.

You ask a good question about the measurement of fatty change in your liver and results of your FibroScan. I'm bringing @riflemanz64, @troyhenn22, @marjou, @deloresthanasse, @rashida and others who have experience with Non Alcoholic Fatty Liver Disease (NAFLD) and who may be able to shed some light on what can be done.

Have you discussed your CAP score and strategies to lower it with your health team?

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@kathywebb52

Yes! I watch labels very closely avoiding sugar and unhealthy fats. Eating lots of healthy fresh vegetables and fresh fruits. Main protein comes from chicken. My breakfast this morning was a cup of coffee with egg fried in olive oil spray and a small avacado toast. Disappointed how majority of “healthy” protein bars/easy go-to choices are full of well hidden bad foods for one’s liver. Choices are almost zero if you are truly committed. Most hide unhealthy ingredients in the fine print which is so shady to me….
I have my standard go-to’s that sustain my home meal cooking…simply don’t eat out unless its a healthy salad & even then I take my salt substitute and my own homemade healthy dressing. 😬
My go-to supplement that I take twice daily is by 1MD LiverMD which friends of mine are also on. I honestly can tell a big difference in the way I feel daily.
Good luck….this isn’t easy and it’s not cheap eating healthy!

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How did you find out about LiverMD? Was this recommended by physician?
Not FDA approved because it is a supplement.

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@jbesh00g

I have changed my diet, 4 months ago and have lost 33 pound and my bmi is now 25 or 24. my colesterol was lower 233 than it had been and triglycerides were now normal but a fibroscan said i have f0 and a cap of 317. How can i lower this fat and why is the fatty part so high. I believe i have familial nafld and does that make it harder?

Jump to this post

That’s great!! Congratulations!
I was just diagnosed with high triglycerides and cholesterol, and I’m now obese for my height.
If you don’t mind sharing, what is your diet plan like?

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@tulips

That’s great!! Congratulations!
I was just diagnosed with high triglycerides and cholesterol, and I’m now obese for my height.
If you don’t mind sharing, what is your diet plan like?

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LOTS OF CLEAN WATER
dark chocolate powder in coffee
lots of black coffee
green tea or black tea..no sugar
HOT clean water in am with fresh lemon...a couple of times a week - do not brush your teeth for two hours after consuming; I was told to use a straw if possible. Not easy to do so I don't .
no sugar
use avocado oil to cook and olive oil to flavor
nothing made with any white flour
no white rice
no fast food
no fried food
Many vegetables
Much fresh or frozen fruit
nuts for snacks (pecans walnuts brazil nuts)
substitute chickpea pasta (it has much protein and fiber) for regular pasta ( with fresh garlic, olive oil, fresh lemon, and sometimes aged parmesan and Italian seasoning. You can vary this recipe with leeks, sweet onions, the thing is - create your own recipes to your tastes and you can also make spaghetti with it.
Use turmeric with black pepper on some foods
Dr told me to cut back on salt...another doctor told me to take a pinch of iodized salt every day. other than than I eat no salt. The iodized is good for thyroid which mine is beginning to act up a bit.
no red meat
NO DELI MEATS
I don't eat pork at all
very little chicken
no ice cream, candy, sodas or fruit juices
no alcohol
Little dairy
Get the app called YUKA. It has a carrot on the app and if you have an iphone you can scan foods and even cosmetics to see if they are bad for you or good. This app will actually show you why it's bad. I scanned almost everything in my kitchen when I first got it - you will be surprised at how many "healthy" high dollar foods are unhealthy. I do hope you are able to do this. I have so much energy again - I was sleeping almost all day just a year ago, or not able to sleep at all. BTW if your spleen is bothering you try to not eat food or drink liquids that are cold.
Use as much non gmo and organic food as you can find
Off hand this is what I eat. The strange thing is...I do not crave food now.
I am not perfect at all this one thing I do that may not be a perfect thing is I make enchiladas out of spinach.
Just put fresh spinach (no water) in a pot and as it heats stir it and when when it is cooked down take off heat and cover while you pan fry tortilla in avocado oil. Put spinach inside cooked shell and pour about a teaspoon of enchilada sauce on spinach...roll spinach with tortilla and put enchilada sauce on the shell. put a small amount of grated jack cheese on top and stick this into hot broiler on bottom shelf until cheese on top is melted. I serve it with either pico de Gallo or fresh pineapple or whatever your tastebud feel complement it. You have to get creative because you will get bored with food.
Smoothies are good - you can use fresh or frozen fruit for the smoothies. I eat as much fruit as I want.
Pumpernickel bread and Daves bread are good to eat. NO butter!!! No margarine!!! Also there are some crackers that are a goto for a snack. Wasa whole grain wheat crackers.
I know it sounds impossible but your cravings for whatever just stop. Another tip...do not have anything in your house that you tend to compulsively eat...actually keep out any bad things that you might eat. You will not do all of this perfectly at all times but follow as closely as possible and strive for your health.
As far as exercise, start slowly but begin working in your yard or cleaning your house deeply or walking. You have to set your head for all of this. If you can, join a gym. I get better at exercise each day. The food begins to be not hard to reject at all and I used to be a big eater. Now the weight just seems to fall off. I sometimes think I was just swollen!
I also take Vitamin E, D3, and probiotic and fish oil (not on an empty stomach).
If all this sounds expensive, it is at first but then you begin to eat so much less and you begin to cook less because so much is eaten raw and/or fresh..it's also good for the whole family to follow a little. Bless you and take care!

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I'm 81 with non alcoholic cirrhosis of the liver. Do they do transplants on people my age?

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