NASH Patients: Add These Foods to Your Diet

Nov 3, 2016 | Mayo Clinic Transplant Dietitian | @mayoclinictransplantdietitian | Comments (30)

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?

HELPFUL LINKS

Yes ma'am! We all are doing this together(except older brother sneaks a hotdog or two in lol)! My 14yr old(Larry) has been a trooper in all this! He has only been negative about it one time…and that was after being in the store for an hour and a half trying to figure out what he can and can't have. We are learning as we go with help from my cousin. We have started walking a mile a day or more(except the last two days as he is sick). I will gladly share this information with him and know he will be grateful for any added information!

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@gsgirl72007

Yes ma'am! We all are doing this together(except older brother sneaks a hotdog or two in lol)! My 14yr old(Larry) has been a trooper in all this! He has only been negative about it one time…and that was after being in the store for an hour and a half trying to figure out what he can and can't have. We are learning as we go with help from my cousin. We have started walking a mile a day or more(except the last two days as he is sick). I will gladly share this information with him and know he will be grateful for any added information!

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@gsgirl72007 I am joining this late, but I just wanted to comment. I have restrictions, I had a liver transplant due to NASH which progressed to cirrhosis. Even as an adult it can be difficult to sit by while others have various foods and beverages that we cannot have. I sympathize with your son, I am sure it is even more difficult when you are young. It sounds as if you are doing all of the right things. The more he knows about the risks the more he will realize that he does have to abide by the restrictions, even when he is out with friends.
That's really great too that you are getting exercise together. It is so much easier for a person, particularly a young person, when they don't feel alone in these things.
JK

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@jeanne5009

The keto diet is not so good..for me at least. MAYO DOCS recommend the Medditeran Diet. Ai cut all salt and sugar…lost weight a d feel better. Im not very strict about it..its just simple logic.

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Do you get overwhelmed by reading labels cause I’ve reading how much sodium and sugar is in almost everything you buy at the market it’s so confusing I feel like I’m starving I just wanna eat I’ve been leaning more towards vegetarian/vegan but feel like I don’t know what I’m doing any advice

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@frog

Do you get overwhelmed by reading labels cause I’ve reading how much sodium and sugar is in almost everything you buy at the market it’s so confusing I feel like I’m starving I just wanna eat I’ve been leaning more towards vegetarian/vegan but feel like I don’t know what I’m doing any advice

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Hi @frog and welcome to Mayo Clinic Connect. Reading labels can be very overwhelming – not to mention the darn small print and I never seem to remember to bring my reading glasses with me to the grocery store! I find that I'm using prepared sauces, dressings, condiments less and less all the time. With COVID keeping me at home, I have more time to make stuff myself and I'm hoping to stay in the habit now that I've found it not to be so hard.

You might be interested in this related blog post:
– Key Points when Reading Nutrition Labels https://connect.mayoclinic.org/page/weight-management-1/newsfeed-post/key-points-when-reading-nutrition-labels/

@frog do you have NASH?

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Diagnosed last Fall with Nash after too long of a period of time of caregivers monitoring blood tests, but didn't mention anything about consequences of bad test levels, just said they were monitoring me. I assume then, that I was in NAFLD state prior to NASH, but nothing mentioned until NASH was diagnosed….that's how it works right, first comes Fatty Liver Disease, and if not corrected, turns into NASH? …..not too happy about it all, especially if that's the case. Seems some things online about diet are contradicting. Is there a place I can find correct information of things I can no longer eat? ….can't seem to find a definitive answer about meat…is pork allowed…. chicken, but only white…. I know there are a lot of reputable sites, but looking for ones that might be more helpful overall. …..and yes, I have looked at the Mayo Clinic site info….any other places?

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@lrr

Diagnosed last Fall with Nash after too long of a period of time of caregivers monitoring blood tests, but didn't mention anything about consequences of bad test levels, just said they were monitoring me. I assume then, that I was in NAFLD state prior to NASH, but nothing mentioned until NASH was diagnosed….that's how it works right, first comes Fatty Liver Disease, and if not corrected, turns into NASH? …..not too happy about it all, especially if that's the case. Seems some things online about diet are contradicting. Is there a place I can find correct information of things I can no longer eat? ….can't seem to find a definitive answer about meat…is pork allowed…. chicken, but only white…. I know there are a lot of reputable sites, but looking for ones that might be more helpful overall. …..and yes, I have looked at the Mayo Clinic site info….any other places?

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@lrr, Welcome to Mayo Connect.
I was not diagnosed with NASH, but I also went thru a long period of tests, monitoring, and observation until my liver disease was diagnosed.
Here is some information that I have located.

From the NIH National Institute of Diabetes and Digestive and Kidney –Diseases: Definition & Facts:
Nonalcoholic fatty liver disease (NAFLD) is a condition in which fat builds up in your liver. Nonalcoholic steatohepatitis (NASH) is a type of NAFLD. If you have NASH, you have inflammation and liver cell damage, along with fat in your liver.
-Eating, Diet & Nutrition
https://www.niddk.nih.gov/health-information/liver-disease/nafld-nash/eating-diet-nutrition
From Fatty Liver Foundation
Diet – https://www.fattyliverfoundation.org/diet_nash

Here are a couple of discussions that I recommend. As Mayo Connect Member, you can post a question and participate with a question or comment anywhere, anytime.
-Liver transplant support group
https://connect.mayoclinic.org/discussion/liver-support-group/
I'd like to direct you to this discussion with other members talking specifically about cirrhosis of the liver:
– NASH and cirrhosis of the liver https://connect.mayoclinic.org/discussion/nash-and-cirrhosis-of-the-liver/

@irr – Have you been making any dietary changes that seem to work for you? What is your doctor telling you about when/if you will see positive results?

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