What should you eat if you have a fatty liver and fibrosis?

October 11, 2025 •

5 min read

Research has shown that lifestyle changes, including diet, are a primary and effective treatment for fatty liver disease and can slow the progression of fibrosis. For those with a fatty liver and fibrosis, adopting a specialized diet is a powerful step toward managing the condition and supporting liver health.

Quick Summary

A diet for fatty liver and fibrosis emphasizes whole, unprocessed foods like fruits, vegetables, whole grains, and healthy fats, while restricting alcohol, added sugars, processed foods, and saturated fats. Significant weight loss through dietary changes and exercise is key to reducing liver fat and scarring. Following a Mediterranean-style eating pattern is highly recommended.

Key Points

Embrace a Mediterranean-style diet: Focus on plant-based foods, whole grains, and healthy fats from sources like olive oil, nuts, and fish to reduce liver fat.
Eliminate added sugars and processed foods: Avoid sugary drinks, sweets, and high-fructose corn syrup, as they contribute significantly to liver fat accumulation.
Restrict saturated and trans fats: Cut out fried foods, fatty red meats, and processed meats to minimize harmful fat deposits in the liver.
Avoid alcohol completely: Alcohol directly damages the liver and is a major factor in accelerating fibrosis, so abstinence is critical.
Manage weight with steady loss: Gradual weight loss (1-2 pounds per week) is one of the most effective ways to reduce liver fat and is especially important for reversing fibrosis.
Incorporate liver-friendly foods: Include coffee, green tea, cruciferous vegetables (broccoli), garlic, and walnuts in your diet for their protective and antioxidant effects.
Control sodium intake: Limit salt to prevent or manage fluid retention, which can be a complication of advanced liver disease.

Understanding the role of diet in liver health

Fatty liver disease, or hepatic steatosis, is a condition marked by excess fat accumulation in the liver. When this condition is accompanied by inflammation and damage, it can progress to fibrosis, which is the scarring of liver tissue. A healthy diet is not only foundational for overall health but is also the first line of treatment for managing and potentially reversing fatty liver disease in its earlier stages. By focusing on nutrient-dense foods and avoiding inflammatory, processed items, you can help reduce liver fat, minimize inflammation, and support the liver's function.

The liver-friendly Mediterranean diet

Many experts recommend a Mediterranean-style diet for individuals with fatty liver disease and fibrosis, as this eating pattern is associated with reduced liver fat and improved metabolic health. This diet emphasizes whole foods and healthy fats while limiting red meat and sweets.

Foods to emphasize:

Vegetables and fruits: Aim for a wide variety of colorful fruits and non-starchy vegetables. Leafy greens like spinach, kale, and broccoli are particularly beneficial due to their antioxidant properties. Berries, grapes, and grapefruit also offer protective compounds.
Whole grains: Choose high-fiber options like oatmeal, brown rice, whole-wheat bread, and quinoa instead of refined grains. The fiber helps regulate blood sugar and supports a healthy weight.
Healthy fats: Incorporate monounsaturated and omega-3 fatty acids. Excellent sources include extra virgin olive oil, avocados, nuts (especially walnuts), and seeds (like flaxseed and sunflower seeds). Fatty fish such as salmon, tuna, and sardines are also rich in omega-3s.
Lean protein: Opt for plant-based proteins like legumes (beans, lentils, chickpeas) and tofu, as well as lean poultry and fish. A high-protein diet is important for preventing muscle loss, a common issue in advanced liver disease.
Coffee and green tea: Moderate consumption of coffee (2-3 cups a day) has been linked to a reduced risk of fibrosis and cirrhosis. Green tea also contains antioxidants that may reduce liver fat.

Foods and drinks to avoid or limit

Restricting or eliminating certain foods is as important as including beneficial ones. These foods can cause inflammation, contribute to insulin resistance, and accelerate liver damage.

Added sugars: Sugary beverages like sodas, juices, and sports drinks should be avoided, as should sweets like candy, cookies, and cakes. Excess sugar is converted to fat and stored in the liver.
Refined carbohydrates: Products made from white flour, such as white bread, white rice, and white pasta, can cause rapid blood sugar spikes and should be limited.
Saturated and trans fats: Avoid fried foods, baked goods made with partially hydrogenated oils, fatty cuts of red meat (beef, pork), processed meats (bacon, sausage), and full-fat dairy products.
Alcohol: For those with fatty liver, especially if fibrosis is present, it is critical to avoid alcohol entirely, as it causes direct liver damage and exacerbates scarring.
Excess salt: A high-salt diet can worsen fluid retention (ascites), which is a complication of liver disease. Limit processed foods, high-sodium condiments, and avoid adding extra salt during cooking.

Comparison of diet approaches for fatty liver


Feature	Mediterranean Diet	Typical Western Diet
Carbohydrates	Focuses on high-fiber, complex carbs from whole grains, legumes, fruits, and vegetables.	High in refined carbs from white flour products, sugary foods, and snack foods.
Fats	Rich in healthy fats like omega-3s and monounsaturated fats from olive oil, nuts, seeds, and fatty fish.	High in saturated fats and trans fats from fried foods, processed meats, and baked goods.
Protein	Emphasizes lean and plant-based protein sources like fish, poultry, legumes, and nuts.	Frequent consumption of red and processed meats high in saturated fat.
Fruits & Vegetables	Abundant intake of various fruits and vegetables provides antioxidants and fiber.	Generally low intake of fresh produce.
Sugar	Very low in added sugars and sweetened beverages.	High consumption of added sugars, high-fructose corn syrup, and sugary drinks.
Salt	Naturally low in sodium, with flavor from herbs and spices.	High in sodium from processed and fast foods.

Lifestyle and dietary modifications for fibrosis

While diet is crucial for fatty liver management, special attention is needed if fibrosis is present. Adherence to a strict eating plan, combined with other lifestyle changes, is key.

Targeted weight loss: For individuals who are overweight or obese, losing weight is one of the most effective strategies for reducing liver fat and fibrosis. A gradual and steady loss of 1 to 2 pounds per week is recommended to avoid stressing the liver. Losing at least 10% of body weight is often required to see a reduction in fibrosis.
Regular physical activity: Exercise complements a healthy diet by aiding weight loss, improving insulin sensitivity, and reducing liver fat. Aim for at least 150 minutes of moderate exercise per week, such as brisk walking, swimming, or cycling.
Small, frequent meals: If liver function is significantly compromised, eating smaller, more frequent meals can help prevent muscle breakdown and maintain energy levels. A protein-rich, carbohydrate-containing snack before bed can also help prevent muscle loss overnight.
Sodium and fluid management: With advanced liver disease and ascites (fluid buildup), limiting sodium intake is critical. A doctor or dietitian may also recommend a fluid restriction.
Protein monitoring: While sufficient protein is needed, people with severe liver disease and hepatic encephalopathy may need to adjust protein intake under medical supervision. Non-meat protein sources like tofu and legumes may be better tolerated.

Cooking techniques and meal planning

Choosing the right foods is only part of the equation; how you prepare them is also important. Opt for cooking methods that use little to no added fat, such as grilling, baking, boiling, steaming, and poaching. Flavor your meals with herbs, spices, and fresh citrus instead of high-sodium sauces and condiments. Planning meals in advance can help you stick to your diet by ensuring you have liver-friendly options on hand and reducing reliance on convenience foods.

Conclusion

Managing a fatty liver with fibrosis through diet is a long-term commitment to improving liver health. By embracing a diet rich in plant-based foods, healthy fats, and whole grains, while diligently avoiding sugars, processed foods, and unhealthy fats, you can help reduce liver fat, minimize inflammation, and slow the progression of scarring. Remember that working with a healthcare professional, such as a doctor or registered dietitian, is essential for creating a personalized eating plan that addresses your specific needs and medical condition.

A note on supplements

While some supplements are studied for their potential liver benefits (like vitamin E or turmeric), they should not replace a healthy diet and should always be discussed with a doctor, especially if liver disease is present.

Disclaimer

This information is for educational purposes only and is not medical advice. Consult with a healthcare professional before making any significant changes to your diet or lifestyle.

Helpful resource

For more information on diet and liver disease, consider consulting the American Liver Foundation.

Frequently Asked Questions

Weight loss is extremely important. Losing at least 10% of your body weight is often necessary to reduce liver scarring (fibrosis). Gradual and steady weight loss (1-2 pounds per week) through a calorie-controlled diet and regular exercise is recommended.

Protein is essential for repairing tissues and maintaining muscle mass, which is often depleted in liver disease. In cases of severe liver damage and hepatic encephalopathy, protein intake may need careful adjustment under a doctor's supervision. Sources like legumes, tofu, and lean poultry or fish are recommended.

Yes, research suggests that moderate coffee consumption (2-3 cups daily) can help reduce liver damage, fibrosis, and cirrhosis. Green tea, rich in antioxidants, has also been shown to help reduce liver fat accumulation.

No, you should not avoid all fat. Instead, focus on incorporating healthy fats like omega-3 and monounsaturated fats from sources such as extra virgin olive oil, nuts, seeds, and fatty fish. These are beneficial for liver health, unlike saturated and trans fats, which should be limited.

The best beverages are water, coffee, and unsweetened tea. It is critical to avoid sugary drinks like soda, juice, and energy drinks, as they contribute to liver fat accumulation.

Excess sodium can cause your body to retain fluid, leading to or worsening ascites (fluid buildup in the abdomen) in advanced liver disease. Limiting salt is crucial for managing this symptom, so avoid processed foods and high-sodium condiments.

While highly recommended due to its focus on whole, plant-based foods and healthy fats, the Mediterranean diet is a guiding pattern, not the only option. The core principles—reducing processed foods, sugars, and unhealthy fats while increasing fiber and healthy fats—are adaptable to many dietary approaches.