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.
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
- Learn about liver transplant at Mayo Clinic.
- Explore Mayo’s Transplant Center.
- Request an appointment.
I've known about having a fatty liver for years due to high triglycerides. My PCP referred me to a Gastrologist due to a diagnosis of a fatty liver by high liver enzymes & ultrasound. This was around 2015 and basically said there was nothing he could do as there were no medications and to watch my diet & exercise. He eventually discharged me 2 yrs later. In 2022, my new PCP sent me for FibroScan & put me on Ozempic since it treated diabetes & was good for the liver. The FibroScan placed me in a Cat 2 fibrosis, and he referred me to a Gastroenterologist, and she placed me on 800 IU vitamin E, & my liver enzymes were normal. Last August I went for a FibroScan and my fibrosis increased significantly to a Cat 3 with lots of scarring. She placed me on the new drug Rezdiffra 80mg, which is very expensive, and sees me every 3 months. She will have me submit to another FibroScan in August.
@rebel56, I think that you are fortunate to have an observant PCP who knew to refer you to a specialist (GI) for further care. I also had a PCP who observed my liver numbers during routine labs and then referred me to a very capable GI. As a patient, I realize that the liver can develop all sorts of complications, but it is equally capable of improving under certain circumstances. I hope that this treatment will be a benefit to you in spite of the cost.
Rebel56, Have you had positive results from the Ozympic or from any dietary changes? How are you feeling?