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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.
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I am a 57-year old male. At the age of 57 I was diagnosed with fatty liver disease after an abnormal lipid panel. I immediately stopped drinking alcohol and I began eliminating "bad carbs" from my diet. My lipids are still elevated but now I have more energy and my mind is clearer. It is very difficult to eat well when I am not at home, but I think that fast food and regular restaurants will start offering more healthful options as keto, paleo and other low-carb diets become more popular.
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3 Reactions@leehearn, Congratulations on your new healthy lifestyle! I am a liver/kidney transplant recipient, and I also make it my goal to practice healthy eating habits. In today's growing market of tempting foods, it is not always easy. Your immediate dietary changes are fantastic! And it must be a real boost to continue the effort when you are already experiencing results!
You raise a good question about the choices at restaurants. Already salt and fat are monumental concern with much of the fast food industry. But I do hope that as people continue to be more health conscious that they will respond.
I like to eat at local restaurants rather that chains because they often will make substitutes more readily.
Keep up[ the good effort! I'm cheering for you.
Rosemary
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2 Reactions@leehearn It sounds as if you are doing all the right things. Is the fatty liver then still at a point of being reversible? If so how was it caught so early? I wonder because my cirrhosis was caused by fatty liver but I apparently had cirrhosis for about 10 years before it was diagnosed so if that took so long I wonder how fatty liver would be diagnosed -- just the lipid panel? When I look at my test results what is the lipid panel referred to as? I am curious to go back and check that out.
Eating out can be very difficult, particularly in less expensive restaurants. The higher priced restaurants prepare to order so they can customize their food better than the family style restaurants. I have now come to realize that when we go away having the ability to do some cooking so I don't have to eat out all the time, is really the best way for me.
JK
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3 Reactions@rosemarya I was just diagnosed with fatty liver disease this week. I eat pretty healthy so was surprised by this diagnosis. I am 61 yo and am a kidney donor for my daughter in November. I have a few tests to get completed next week, Abdomen Ultrasound and Spleen/Liver Scan. There are a few issues that the hepatologist wants to rule out, degree of inflammation. My WOE is primarily Mediterranean. I exercise 5x per week. I do suffer from a bit of nausea and fatigue since June 2018 so we’re trying to eliminate and diagnose. Have you heard of a donor having these issues and might I still be able to move forward with the donation? Just asking as it seems you may have some background knowledge since you are a recipient. Look forward to your response.
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1 Reaction@jonilee, I want to welcome you to Mayo Connect. I am sorry to hear about the untimely diagnosis of fatty liver disease that you have just received. I assume that this was discovered during your living donor evaluation. (?)
My background experience tells me nothing that I have to share in answer to your question about your kidney donation. Your tests next week will give your hepatologist more information about what is happening inside of you, and whether or not this could interfere with organ donation. I sincerely hope that everything points to the positive.
What is WOE? If you mean that your diet is primarily Mediterranean, then I congratulate you on the healthy eating and exercising that are important.
I wish that I could offer more information. Please know that I will keep you in my thoughts and prayers. Will you tell me what you find out?
jonilee, Where are you and your daughter going thru this process?
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1 Reaction@rosemarya, actually it was not discovered during the transplant eval process. I’ve had some nausea since June 2018 and had been debilitating so my internist said to visit a hepatologist. I had a thorough exam, this dr indicated a lump in the liver. So, now onward through the tests I have to get done this week. I had a CT scan of my lungs back in May that indicated fatty liver. The report was given to the transplant team but they never said anything about it. My biggest issue right now is the nausea and fatigue which this dr indicates the liver disease. The hospital we are using for the transplant is Cedars Sinai in Los Angeles. I will definitely keep you posted on my results. Oh, by the way, WOE is way of eating. It’s Facebook lingo in the low carb forums.
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3 ReactionsI was diagnosed with NASH 18 months ago. I have had NAFLD for a long time. I have been asked to be part of a liver study to try a new med starting in a few weeks. It will last 2 years. I have gone through a slew of tests including a liver biopsy a month ago. I hope this med has good results so that others can benefit from it.
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4 Reactions@andys I hope that works us great. Please keep us up to date on it. Where is this liver study? It would be great if they came up with something to reverse this. I am not sure, if NASH has not progressed to cirrhosis is it considered reversible?
JK
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2 ReactionsHi JK. I have cirrhosis and understand it is not reversible. The study is in Canada, the USA and Britain I believe. I am in Central Ontario, Canada. I'll have more information on Nov. 29 when I start the medication. I will keep you apprised of everything as it becomes known to me. All the best.
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3 ReactionsHi, andys. Welcome to Connect. I join JK in my hopes that the liver study that you will participate in will prove to be beneficial for you as well as your fellow participants and the future generation of liver patients. I will be thinking of you when begin your medication in 2 weeks.
I would like to ask you how you are feeling (any symptoms due to the cirrhosis)? I was very sick prior to my transplant as my cirrhosis progressed. But we are all different in how our bodies react to liver disease.
Here is some information about Nonalcoholic fatty liver disease which includes NASH {Nonalcoholic steatohepatitis). I don't think we can ever have too much information from reliable sources.
https://www.mayoclinic.org/diseases-conditions/nonalcoholic-fatty-liver-disease/symptoms-causes/syc-20354567
I look forward to your updates - when and if - you have permission to post them.
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