What not to eat when you have NASH?: A Comprehensive Nutrition Guide

October 13, 2025 •

4 min read

Medical experts state that dietary changes are a cornerstone of managing nonalcoholic steatohepatitis (NASH). For those diagnosed with this condition, understanding what not to eat when you have NASH is arguably the most impactful lifestyle change for reversing liver damage and improving overall health.

Quick Summary

Managing a NASH diagnosis involves strict dietary discipline by eliminating key inflammation-causing and fat-promoting foods. Focus on cutting out added sugars, unhealthy fats, and refined carbohydrates.

Key Points

Cut the sugar: Added sugars, especially fructose, overwhelm the liver and promote fat storage, so eliminate sugar-sweetened beverages and sweets.
Avoid unhealthy fats: Saturated and trans fats from fatty meats, fried foods, and processed snacks drive liver inflammation and fat accumulation.
Minimize refined carbs: White bread, pasta, and other refined grains cause blood sugar spikes that worsen insulin resistance and NASH.
Eliminate alcohol: Alcohol should be completely avoided as it is toxic to the liver and accelerates damage in individuals with NASH.
Choose whole foods: A diet rich in whole grains, fruits, vegetables, and lean protein, similar to the Mediterranean diet, is the best approach for NASH.
Focus on weight management: A gradual weight loss of 5-10% of body weight can significantly improve NASH symptoms and liver health.

Nonalcoholic steatohepatitis, or NASH, is a progressive form of nonalcoholic fatty liver disease (NAFLD), which can lead to severe liver scarring (fibrosis) and, if left unchecked, cirrhosis and liver failure. While there is no approved drug treatment for NASH, dietary and lifestyle modifications are the first and most crucial line of defense. The core principle of a NASH diet is to reduce the burden on your liver by eliminating foods that promote fat accumulation and inflammation.

The Primary Culinary Culprits: What to Eliminate

Sugary Beverages and Added Sugars

Added sugars, especially fructose, are a major driver of liver fat. Your liver is responsible for processing fructose, and an excess amount overloads the organ, converting the sugar into fat. This process, known as de novo lipogenesis, is a direct cause of liver fat buildup. A diet high in added sugar also contributes to obesity and insulin resistance, both significant risk factors for NASH. To mitigate this damage, you must eliminate or severely limit:

Sugar-sweetened beverages: Sodas, fruit juices, sports drinks, and sweet teas are packed with fructose.
Candy and sweets: These are concentrated sources of added sugars with little nutritional value.
Baked goods: Many commercial cookies, cakes, and pastries use high-fructose corn syrup and other added sugars.
Sweetened condiments: Sauces, jams, and jellies often contain high levels of sugar.

Unhealthy Fats

Just as important as cutting sugar is reducing your intake of unhealthy fats. Saturated and trans fats contribute directly to fat deposition in the liver and heighten the risk of heart disease, a common co-morbidity for those with NASH.

Red and processed meats: Fatty cuts of beef, lamb, and pork, as well as deli meats like sausage, bacon, and cold cuts, are high in saturated fat.
Full-fat dairy: Whole milk, full-fat cheeses, and high-fat yogurt should be replaced with low-fat alternatives.
Fried foods: French fries, onion rings, doughnuts, and other fried items are high in trans fats and calories.
Hydrogenated oils: Check labels for “partially hydrogenated oils” in packaged snacks and baked goods.

Refined Carbohydrates

Refined carbohydrates, which are stripped of their fiber and nutrients, cause rapid spikes in blood sugar. This can worsen insulin resistance, which is closely linked to NASH development. Swapping these for whole-grain, fiber-rich alternatives is a critical step for liver health. Avoid:

White bread, rice, and pasta
Refined snack foods: Pretzels, crackers, and many packaged breakfast bars are made with refined grains.

Processed and Packaged Foods

Ultra-processed foods are often a combination of the worst elements for NASH: high in unhealthy fats, added sugars, and sodium. These are designed to be hyper-palatable and easy to overeat. Common examples include packaged snacks, instant foods, and ready-made meals. Excess sodium, often found in these products, can also increase the risk of NAFLD.

Alcohol

For any form of liver disease, including NASH, alcohol should be avoided entirely. Even low levels of alcohol consumption can further damage an already inflamed and damaged liver, increasing the risk of severe complications.

Side-by-Side: The Best vs. The Worst for NASH Liver Health


Food Category	To Avoid (Worst)	To Embrace (Best)
Carbohydrates	White bread, white rice, sugary cereals, pastries	Whole-grain bread, brown rice, oats, quinoa
Proteins	Fatty red meats, processed deli meats, sausages	Lean poultry (skinless), fish (especially fatty fish like salmon), beans, legumes, tofu
Fats	Fried foods, trans fats (hydrogenated oils), butter, palm oil, coconut oil	Extra virgin olive oil, avocado, walnuts, seeds, fatty fish
Beverages	Regular soda, fruit juice, sports drinks, alcohol	Water, green tea, black coffee (plain), unsweetened beverages
Dairy	Full-fat cheese, whole milk, sweetened yogurt	Low-fat or skim milk, low-fat cottage cheese, plain low-fat yogurt
Sweets & Snacks	Candy, cookies, ice cream, chips, sugary snacks	Fresh fruit (in moderation), nuts, sunflower seeds, plain popcorn

Beyond the Plate: Additional Lifestyle Factors

While diet is paramount, other lifestyle choices can significantly influence NASH progression.

Weight Loss: Gradual weight loss (5-10% of total body weight) is one of the most effective treatments for NASH, as it can reduce liver fat and inflammation. Rapid weight loss is not recommended as it can worsen the condition.
Exercise: Aim for at least 150 minutes of moderate-intensity exercise per week. Regular physical activity, both aerobic and resistance training, can reduce liver fat and improve cardiovascular health, independent of weight loss.
Manage Associated Conditions: Effectively controlling diabetes, high cholesterol, and high blood pressure is vital, as these conditions are often linked to NASH and accelerate liver damage.

Conclusion

For individuals with NASH, a disciplined approach to diet is not merely about weight management but about actively preventing further liver damage. By eliminating or severely restricting added sugars, unhealthy fats, refined carbs, processed foods, and alcohol, you can significantly reduce the liver's fat burden and inflammation. Adopting a Mediterranean-style eating pattern rich in fruits, vegetables, whole grains, and lean proteins, combined with regular exercise, offers the best path to improving liver health and overall well-being. Always consult with a healthcare provider or registered dietitian before making drastic dietary changes to ensure they are appropriate for your specific health needs.

American Liver Foundation

A NASH-Friendly Kitchen Shopping Guide

Vegetables: Leafy greens (spinach, kale), broccoli, cauliflower, carrots, bell peppers, onions, garlic.
Fruits: Berries, apples, pears, oranges, melons.
Whole Grains: Oats, brown rice, quinoa, whole-wheat bread.
Legumes and Nuts: Beans, lentils, chickpeas, walnuts, almonds.
Lean Proteins: Fish (salmon, sardines, tuna), skinless poultry, eggs, tofu.
Healthy Fats: Extra virgin olive oil, avocado, seeds.
Beverages: Water, black coffee, green tea, herbal tea.

Creating a NASH-Friendly Kitchen

Adopting a new way of eating is easier with some preparation. Start by clearing your pantry of tempting, pro-inflammatory foods. Restock your kitchen with whole, unprocessed items. This might include buying more fresh produce, stocking up on whole grains, and choosing leaner protein sources. Utilizing simple cooking methods like grilling, baking, and steaming instead of frying also helps reduce fat intake. Focus on flavor from herbs and spices rather than added salt, sugar, and fat. This shift from packaged to whole foods not only supports liver health but also improves overall nutrient intake.

Frequently Asked Questions

Without significant dietary changes, NASH can progress, leading to increased liver inflammation and scarring (fibrosis). Over time, this can result in cirrhosis, liver failure, and an increased risk of liver cancer.

Yes, fruit juice is generally bad for NASH because it is a concentrated source of fructose, a type of sugar that can contribute to liver fat buildup. Opt for whole fruits in moderation, which contain fiber that slows sugar absorption.

You should limit or avoid fatty red meats like beef and pork, as they are high in saturated fats that can worsen liver fat accumulation. Choose lean protein sources like fish, skinless poultry, and legumes instead.

Not necessarily. Many 'fat-free' or 'low-fat' products replace fat with large amounts of added sugars, which are detrimental to liver health. Always check the nutrition label for added sugars and opt for whole, unprocessed foods.

Alcohol puts an extra burden on the liver, disrupting its function and increasing damage. For someone with NASH, who already has a compromised liver, any alcohol consumption can accelerate liver disease progression.

Extra virgin olive oil is often recommended because it is a source of monounsaturated fats that have been shown to be beneficial for liver health. Other healthy fats include those found in avocados, nuts, and seeds.

Eggs are a good source of lean protein and can be included in a NASH diet in moderation. However, it is always best to consult with a healthcare provider about specific dietary recommendations.

Research suggests that regular consumption of plain, black coffee may actually be beneficial for the liver by lowering abnormal liver enzymes and potentially reducing the risk of liver fibrosis. However, excessive amounts should be avoided.