If you have high liver enzymes, you likely have too much fat in the liver. The fatty liver disease diet is like the Mediterranean diet, an eating plan that includes fruits, vegetables, nuts, whole grains, fatty fish and olive oil. It also limits meat, sugar and refined grains.
Causes of High Liver Enzymes
When the liver is injured, it releases several substances, two of which are enzymes called aspartate transaminase and alanine transaminase, explains the American Academy of Family Physicians. The most common causes of high liver enzymes are alcoholic liver disease and nonalcoholic fatty liver disease (NAFLD). Less common causes include certain medications, hepatitis B, hepatitis C and a hereditary condition called hemochromatosis.
Read more: Causes of High Liver Enzyme Levels
If the enzymes are only mildly elevated, usually no symptoms of NAFLD are present, says the American Academy of Family Physicians. However, sufferers sometimes manifest weakness, nausea, fatigue, loss of appetite, abdominal pain and weight loss, notes Harvard Health Publishing.
The disease has no drug treatment, so doctors focus on preventing further fat accumulation in the liver by addressing the underlying causes, which are diabetes, high blood lipids and obesity, states Harvard Health Publishing.
While remediation goals include controlling blood sugar and lipids, a key treatment goal is to promote weight loss, an objective accomplished through exercise and diet, notes the Mayo Clinic. A 10 percent weight loss is desirable, but smaller reductions can also improve risk factors.
Fatty Liver Disease Diet Don'ts
According to the Fatty Liver Foundation, one of the main dietary strategies for fatty liver disease involves abstaining from beverages and foods that stress the liver. Avoid eating red meat, trans fat, high-fructose corn syrup, nonskim dairy products and hydrogenated oils. Also eliminate most sodium and saturated fat from the diet. In addition, don't consume processed grains, such as white rice and white bread, and foods with added sugar. It's important to refrain from drinking alcohol.
A January 2019 study published in JAMA demonstrates how restricting sugar in the diet can affect liver health. In the clinical trial involving 40 adolescents with NAFLD, researchers compared the effects of a low-sugar diet with those of a diet containing the usual amount of sugar. After eight weeks, the low-sugar diet led to a greater reduction in liver fat.
Other foods to avoid with elevated liver enzymes are raw and under-cooked shellfish, notes the American Liver Foundation. To further prevent taxing the liver, abstain from most dietary supplements, advises the Fatty Liver Foundation.
Fatty Liver Disease Diet Do's
The other main dietary approach is to eat plentiful amounts of foods that protect the liver, states the Fatty Liver Foundation. This includes eating healthy-fat fish varieties, such as salmon, several times per week, as well as fruits, vegetables, beans and whole grains like brown rice and quinoa. Also, take 1 tablespoon per day of refined salmon oil and 4 tablespoons per day of extra virgin olive oil.
Harvard Health Publishing says the diet for elevated liver enzymes or fatty liver disease equates with following a plant-based eating plan like the Mediterranean diet or DASH diet. University of Chicago Medicine states that the Mediterranean diet involves everything dietitians would recommend eating and avoiding. Research also shows the diet is beneficial for heart disease and diabetes, which contribute to fatty liver disease.
The above recommendations provide a general guide. Nonetheless, it's a good idea to consult a dietitian, who can devise a fatty liver disease diet that is individually tailored to your nutritional needs, notes UCM.
Aside from eating the right foods, don't forget to drink plenty of water. A 2015 review article published in Evidence-Based Complementary and Alternative Medicine says that good hydration is vital for liver functions. An adequate water intake can detoxify and cleanse the organ.
Read more: How to Repair a Fatty Liver
Coffee for Fatty Liver Disease
Repeated liver damage can lead to scarring, which is called fibrosis. When scarring is widespread, it leads to cirrhosis, where healthy liver tissue is gradually replaced by scar tissue. This blocks the flow of blood through the organ and hinders its ability to process nutrients, drugs and natural toxins. The condition also lowers the liver's production of proteins. It leads to more than a million deaths per year. One cause of the destructive process is fatty liver disease, states the Cleveland Clinic.
Harvard Health Publishing notes that some studies indicate people with NAFLD who drink two cups of coffee per day have a lower risk of cirrhosis of the liver. Authors of a January 2016 review featured in Alimentary Pharmacology & Therapeutics said that earlier studies show an inverse relationship between drinking coffee and the disease. After examining the scientific literature on the topic they concluded that coffee consumption may decrease the risk of liver cirrhosis substantially.
A November 2013 study appearing in the Journal of Gastroenterology and Hepatology attributed coffee's benefits for NAFLD to components other than caffeine. The authors said the protective properties could stem from anti-inflammatory and antioxidant compounds in the beverage. Their results showed that coffee may also protect against liver cancer.
The Fatty Liver Foundation advocates using a paper filter when brewing coffee to remove substances that may harm the liver. A November 2013 study published in Clinical Gastroenterology and Hepatology said two such compounds in coffee are removed by paper filters.
Tea for Fatty Liver Disease
Studies associate green tea with diverse health advantages, one of which is improving liver function in NAFLD. A November 2013 clinical trial featured in the International Journal of Molecular Medicine tested the effects of catechins, one of the major compounds in green tea, on 17 patients with NAFLD. It discovered that drinking three cups of a high-catechin version of green tea per day for 12 weeks improved liver fat and inflammation.
Other investigations also link green tea to liver health, but the benefit doesn't include taking green tea supplements. In contrast, the supplements have a toxic effect on the liver. An August 2015 study published in Archives of Toxicology concludes that liver patients should be discouraged from taking dietary supplements containing complex mixtures of botanicals, even if they include green tea extract.
Is This an Emergency?
- American Academy of Family Physicians: "Elevated Liver Enzymes"
- Harvard Health Publishing: "The Skinny on Fatty Liver Disease"
- Mayo Clinic: "Nonalcoholic Fatty Liver Disease"
- Fatty Liver Foundation: "When Your Liver Is Compromised by NASH, Make It Work Less"
- JAMA: "Effect of a Low Free Sugar Diet vs. Usual Diet on Nonalcoholic Fatty Liver Disease in Adolescent Boys"
- American Liver Foundation: "A Healthy Diet, a Healthier Liver, a Healthier You"
- University of Chicago Medicine: "Why Some Foods Can Help Treat the Nation's Most Common Chronic Liver Disease"
- Evidence-Based Complementary and Alternative Medicine: "Plants Consumption and Liver Health"
- Cleveland Clinic: "Can More Coffee Lead to Less Liver Damage? Study Finds Link"
- Alimentary Pharmacology & Therapeutics: "Systematic Review With Meta‐Analysis: Coffee Consumption and the Risk of Cirrhosis"
- Journal of Gastroenterology and Hepatology: "Coffee and Non‐Alcoholic Fatty Liver Disease: Brewing Evidence for Hepatoprotection?"
- Fatty Liver Foundation: "Coffee - Is It Good or Bad for My Liver?"
- Clinical Gastroenterology and Hepatology: "Can Daily Coffee Consumption Reduce Liver Disease–Related Mortality?"
- International Journal of Molecular Medicine: "Green Tea With High-Density Catechins Improves Liver Function and Fat Infiltration in Non-Alcoholic Fatty Liver Disease (NAFLD) Patients: A Double-Blind Placebo-Controlled Study"
- Archives of Toxicology: "Hepatotoxicity of Green Tea: An Update"