NASH-friendly diet: what you need to know

Non-alcoholic steatohepatitis (NASH) is a progressive form of non-alcoholic fatty liver disease (NAFLD). Dietary changes can slow the progression of NASH and prevent lasting liver damage.

There is no approved drug treatment for NASH. Methods of managing the condition include lifestyle and diet changes, including a nutritious diet rich in a variety of plant foods.

A NASH-friendly diet will also limit or eliminate certain types of foods, such as animal products and processed foods.

Have NASH indicated a person has excess fat and inflammation of the liver which can cause liver scarring or fibrosis. As scar tissue builds up in the liver, it can affect how it works, and if left untreated, this scarring can lead to cirrhosis and liver failure. A NASH-friendly liver diet can prevent or reduce further damage in someone with the disease.

Keep reading to learn more about the NASH diet, including foods to eat, foods to avoid, and other lifestyle changes that may benefit people with the disease.

A healthy NASH diet focuses on modifying the diet by including various nutritious food.

The program may seem restrictive at first and require significant changes in the daily eating habits of some people. However, a nutritious NASH diet still allows for a range of foods.

Vegetables

Vegetables are essential for overall health. Eating a wide range of vegetables regularly helps to ensure that the body receives plenty of nutrients and vitamins. Adults should consume about 2 to 4 cups of vegetables per day, depending on their gender and age.

Here are some examples of vegetable groups:

  • dark leafy greens, such as kale, mustard greens, and spinach
  • root vegetables, such as yams, turnips, and beets
  • legumes, including beans, peas, and lentils
  • cruciferous vegetables, such as Brussels sprouts, cabbage, and broccoli
  • alliums, such as onion, garlic, and leeks
  • stem vegetables, such as celery, asparagus, and fennel

There are many vegetables to include in the diet. It may be more important to find a wide variety and to eat enough vegetables each day.

Fruits

Fruit can be part of a NASH diet in moderation. Whole fruits can provide many nutrients and vitamins to the body and make a suitable snack or dessert.

Fruit can include:

  • citrus fruits, such as lemon, orange, and grapefruit
  • stone fruits, such as apricots, peaches, and plums
  • berries, including raspberries, blueberries, and blackberries
  • melons, such as watermelon and canteloupe
  • tropical fruits, such as pineapple, banana, and papaya

Whole grains

Whole grain options can offer an alternative to processed and refined grains that are high in fiber and nutrients.

Whole grains or substitutes include:

  • wheat
  • Brown rice
  • barley
  • groats
  • But
  • buckwheat
  • quinoa

Good sources of protein

A NASH diet will also include appropriate protein sources. Some protein options that can fit into a liver-healthy diet include:

  • fatty fish, such as cod, sardines, and salmon
  • cooked shellfish, such as shrimp, crab, and lobster
  • lean poultry, such as chicken or turkey
  • lean, trimmed red meat options, such as trimmed loin, round or sirloin
  • eggs
  • legumes and beans, such as soy products, lentils, or chickpeas
  • nuts, such as almonds, cashews, or peanuts

healthy fats

A healthy diet will still have room for fat, but will focus on replacing saturated and trans fats with more nutritious unsaturated fats.

Examples of nutritious fat sources include:

  • nuts
  • seeds, such as chia and flax
  • extra virgin olive oil
  • olives
  • lawyers
  • fatty fish, such as sardines, herring, and salmon

Diet programs

Few diets follow many of the tenants of healthy eating. However, with little modification, some eating plans may be easier to adapt than trying to create a new plan.

Some types of diets that can follow a nutritious eating pattern similar to a NASH diet include low-carb diets that limit added sugars and refined carbohydrates. Additionally, low-fat diets that limit trans and saturated fats might also work.

A NASH diet will also focus on modifying the diet by excluding or limiting certain foods, including the following.

sweet foods

Foods high in sugar can be a high calorie source with little nutritional value for many people.

Many sweet foods also contain fructose, a fruit sugar that the liver breaks down during digestion.

The body also breaks down other sugars, such as sucrose or table sugar, into glucose and fructose during digestion, which means sugar is another source of fructose.

Research from 2021 that fructose in the diet stimulates the body to produce more fat and contributes to insulin resistance. It also indicates that fructose consumption is a major possible dietary risk factor for NAFLD.

Here are some examples of sugary foods to limit or avoid:

  • sugary drinks, such as sodas, juices, and fruit cocktails
  • jams and jellies sweetened with sugars
  • baked goods or packaged foods with added sugars
  • sweets and other sweets
  • ice cream
  • sauces and condiments containing added sugars

Refined or processed carbohydrates

Processed carbohydrates can cause similar increases in sugars in the body after digestion. An appropriate diet for NASH may limit or avoid refined or processed carbohydrates, such as:

  • White bread
  • White rice
  • starches and starches
  • commonly fried foods, such as fries, potato chips, and onion rings

Fat food

Doctors may also recommend eliminating foods high in saturated fats, trans fats, or hydrogenated oils.

the National Institute of Diabetes and Digestive and Kidney Diseases states that these fats are a source of high calories that increase the risk of obesity. Non-nutritive fats can also increase the risk of diseases such as heart disease. Both of these conditions are risk factors for NAFLD and NASH.

There are several dietary sources of these fats to avoid, and doctors may recommend eliminating or greatly reducing sources, including:

  • fatty red meats, such as beef, lamb, and pork
  • deli meats, such as potted meats, deli meats, and packaged sausages
  • pastries, cookies and cakes
  • packaged foods containing saturated fats and hydrogenated oils
  • whole dairy products, ice cream and yogurt

Doctors may also recommend limiting or adding other foods depending on the person’s risk factors. This may include:

  • limit sodium intake
  • eliminate alcohol consumption
  • eliminate dietary supplements that can affect the liver
  • add coffee to diet
  • add green tea to food
  • add a variety of spices to the diet

A proper NASH diet is one of many beneficial changes to help protect and reduce liver damage. Doctors will also recommend other lifestyle changes for a healthy body, including:

Regular aerobic exercise

Active exercise that increases heart rate benefits overall health and can help burn calories and maintain a moderate weight.

Move 150 minutes of activity that increases heart rate each week may be enough for most. This consists of approximately 30 minutes each day of activities such as:

  • fast walk
  • gardening
  • bodybuilding
  • jogging
  • ride a bike
  • to swim
  • Martial Arts

Maintain a moderate weight

Maintaining a moderate weight is a key step in the treatment of NAFLD and NASH.

Research from 2018 indicates that losing at least 3–5% of a person’s body weight can reduce the fat in their liver. Larger increases, around 7-10% of an individual’s total body weight, can also help reduce inflammation and scarring from NASH.

Other factors

Controlling other factors is an important part of treating or preventing NASH. This may include:

  • control diabetes
  • keep cholesterol within healthy ranges
  • avoid alcohol
  • avoid smoking
  • only use over-the-counter medications that may affect the liver under the direction of a doctor
  • speak with a healthcare professional before taking supplements
  • consider vaccinations for diseases that can affect the liver, such as hepatitis

Anyone concerned about their metabolic health should seek medical attention. In some cases, NAFLD and NASH will show no symptoms, making regular checkups and screenings an important part of prevention.

Anyone with NAFLD or NASH should see their doctor to discuss treatment options. They may refer the person to a dietitian to design a meal plan or decide which foods they can eliminate from their diet and recommend alternatives.

Dietary changes can prevent lasting liver damage and slow the progression of nonalcoholic steatohepatitis (NASH), a progressive form of nonalcoholic fatty liver disease (NAFLD).

People with NASH tend to have fatty accumulation and inflammation in the liver, which can damage the organ, in the form of scarring or fibrosis.

Eating more fruits, vegetables and grains is a vital dietary change for people with NASH. Avoiding or limiting sugary foods, fatty foods, and refined carbohydrates is also beneficial in slowing disease progression.

Exercising regularly and maintaining a moderate weight are also recommended for people with NASH.

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