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Special diet for hepatic steatosis

Hepatic steatosis, also called "fatty liver", is a disorder related to the accumulation of lipids in the liver, forming deposits. It is a reversible stage of the disease, which can however evolve towards fibrosis or even cirrhosis if no measures are taken. The special hepatic steatosis diet aims to improve liver health by reducing insulin resistance and regulating blood lipid levels.

The main points of the special hepatic steatosis diet:
  • Favour foods with a low glycemic index
  • Consume omega-3
  • Avoid saturated and trans fats
  • Reduce consumption of sugary products
  • Moderate alcohol consumption

 Benefits of the special hepatic steatosis diet

The special hepatic steatosis diet aims to :
  • Reduce or prevent insulin resistance
  • Reduce cardiovascular risk and blood lipid levels
  • Regain a healthy weight to improve hepatic steatosis
Hepatic steatosis affects 7 to 35% of adults in the United States and Europe. It is the most common cause of chronic liver disease and appears to be closely linked to insulin resistance and metabolic syndrome. To date, there is no official consensus on how to treat fatty liver. However, experts recommend that the first priority is to intervene at the dietary level. The goal is to adopt a diet that reduces insulin resistance and cardiovascular risk while promoting a return to a healthy weight.

Diet and liver: the importance of reducing or preventing insulin resistance

A diet high in carbohydrates has been shown to worsen liver damage. The special steatosis diet makes it possible to reduce the total amount of carbohydrates in the diet and to favor foods with a low glycemic index. Indeed, foods with a high glycemic index cause a significant increase in blood sugar levels and induce a strong secretion of insulin that is harmful to the liver.

A diet to reduce cardiovascular risk

In case of hepatic steatosis, it is essential to have a diet that includes good fats to the detriment of saturated and trans fats. Indeed, bad fats are associated with an increase in blood triglyceride levels and contribute to metabolic syndrome. The special diet for hepatic steatosis is therefore inspired by the Mediterranean diet and proposes a diet rich in mono unsaturated fatty acids and Omega-3.

The special diet for hepatic steatosis should allow weight loss

A weight loss of about 5 to 10% would be sufficient to improve the comfort of people suffering from hepatic steatosis. A specific diet combined with regular physical activity would be the best way to achieve a desirable weight loss. Changes in ALT (enzyme produced by the liver) would be visible after only one month of dieting.

Be careful though, losing weight too quickly, i.e. more than 2kg per week, can lead to inflammation. Inflammation is linked to hepatic steatosis and accelerates the progression of the disease. It is therefore necessary to remain cautious and not to lose more than 1kg per week.

Diet and liver: dietary recommendations

In case of hepatic steatosis, it is necessary to adopt an adapted diet without too much delay. Indeed, the situation being reversible, the diet will aim at reducing the blood sugar and lipid levels. By following the dietary recommendations, you will have a better chance of resting the liver and promoting its recovery.

Hepatic steatosis: what diet to adopt?

The special diet for hepatic steatosis includes foods with low energy density and low glycemic index. In addition, by promoting good fats and a good supply of antioxidants, it helps to improve liver health.

Low energy density foods for weight loss
To lose weight, it is recommended to eat foods with low energy density because they provide few calories while being satiating. The foods to be favored in the special steatosis diet are :
  • Fresh fruits
  • Seasonal vegetables
  • Skim milk
  • Low-fat milk
  • Whole grain cereals
  • Tofu
  • Pulses
  • Seafood
  • Broths and soups
Low glycemic index foods
A low glycemic index diet can be very beneficial in cases of hepatic steatosis. Indeed, it would allow to decrease the blood sugar level and not to stimulate the secretion of insulin in a too important way.

Good fats
In the context of a special diet for fatty liver, we should stick to a Mediterranean diet, rich in monounsaturated fatty acids and Omega-3.

Monounsaturated fats are mostly found in olive oil, nuts and avocados. You should choose virgin olive oil from the first cold pressing to take advantage of all its health benefits. Omega-3s reduce inflammation and oxidative stress, so they are particularly recommended for patients with hepatic steatosis. In addition, Omega-3 supplementation may decrease the amount of lipids stored in the liver. However, the optimal dose is not yet known. In any case, it is recommended to increase the consumption of food sources of Omega-3.

Foods rich in Omega-3 are
  • Salmon
  • Trout
  • Mackerel
  • Herring
  • Sardines
  • Tuna
  • Nuts
  • Flaxseed oil
  • Hemp
  • Chia seeds
  • Rapeseed oil
Antioxidants such as selenium, vitamin C or vitamin E could have benefits on liver health. Indeed, antioxidants decrease oxidative stress and inflammation. Although there is not yet enough evidence to link antioxidants and liver health, a diet rich in fruits and vegetables containing antioxidants can only have health benefits. For this reason, it is recommended to consume at least 5 servings of fruits and vegetables per day.

The fruits and vegetables rich in antioxidants that are good for the liver are
  • Red fruits
  • Prunes
  • Beets
  • Asparagus
  • Broccoli
  • Bell pepper
  • Red cabbage
  • Legumes
Probiotics have been proposed as an interesting treatment option for hepatic steatosis. They have a beneficial effect on the intestinal flora and could potentially have an influence on the liver by reducing oxidative stress. For the moment, there is still a lack of scientific data to frankly encourage the use of probiotics in patients with hepatic steatosis.

Other recommended foods :
  • Legumes
  • Good hydration
  • Lemon
  • Foods rich in fiber
  • Low-fat dairy products

Food not recommended in case of hepatic steatosis

Because of their harmful nature for the liver, certain foods should be avoided in the context of a special diet for hepatic steatosis. These include foods with a high glycemic index, trans fats, saturated fats and alcohol.

Foods with a high glycemic index
Foods with a high glycemic index raise blood sugar levels and cause high insulin secretion, which is harmful to fatty liver.

Foods with a high glycemic index to be avoided in the special diet for fatty liver are :
  • Breads and cereal products made with white flour: burger buns, baguettes, pastries, etc.
  • White pasta
  • Couscous
  • Instant and risotto rice, rice vermicelli
  • Breakfast cereals
  • Dry cookies
  • Sugar, honey, glucose-fructose syrup, brown sugar, dextrose
  • Sodas
  • Cakes, muffins, cereal bars
  • Jams, jellies
Trans and saturated fats
In addition to being associated with obesity, cardiovascular risks and insulin resistance, trans and saturated fats aggravate hepatic steatosis by promoting its development. Trans fats are obtained by hydrogenation of vegetable oils and contribute to increase the total cholesterol and the "bad" cholesterol (LDL). Worse, they decrease the good cholesterol (HDL). They are mostly found in industrial dishes made with margarines and hydrogenated vegetable oils. The terms indicating the presence of trans fats are: hydrogenated vegetable oil, partially hydrogenated vegetable oil, hydrogenated vegetable fats, hydrogenated margarine. Saturated fats also contribute to the increase of cholesterol, a risk factor for cardiovascular disease.

Excessive alcohol consumption is a risk factor for chronic liver disease. Thus, it should be avoided by patients with fatty liver. It is recommended not to exceed two glasses of alcohol per day for women and three glasses per day for men.

One serving of alcohol is equivalent to :
  • 25cl of beer
  • 12.5cl of wine
  • 2.5cl of strong alcohol
Glucose-fructose syrup
Also called corn syrup, glucose-fructose syrup is a liquid sweetener that has gradually replaced sugar in many industrial preparations. It has been shown that a diet rich in fructose promotes the deposit of lipids in the liver. It is therefore preferable, in case of hepatic steatosis, to avoid foods containing this sweetener. Instead, make sure to choose foods that contain little added sugar.

Foods that are sources of glucose-fructose:
  • Sodas
  • Sweetened fruit drinks (cocktails, nectars, etc.)
  • Flavored yogurt
  • Breakfast cereals
  • Canned fruit
  • Industrial pastries and cakes
  • Frozen meals
  • Ketchup
  • Fruit jams and jellies
Industrial and processed products
Because they often contain a lot of sugar and bad fats, industrial and processed foods should be avoided in the special diet for hapatic steatosis. It is recommended to cook as much as possible and to avoid prepared meals and other industrial foods. Foods with sugar as one of the first ingredients on the list should be avoided. The same goes for saturated and trans fats. It is very important to read labels carefully to make the right choices.

Other foods that should not be eaten :
  • White sugar
  • Fried and breaded foods
  • Dishes with sauce
  • Refined grain products

Practical daily tips for incorporating liver-healthy foods

  • Add legumes to your menu and reduce your consumption of starchy foods
  • Cook as much as possible and prefer homemade pastries with little sugar
  • Eat fish 2 to 3 times a week
  • Replace pasta with vegetable tagliatelle
  • Replace traditional starches with quinoa and whole grain starches
  • Prefer yogurt, nuts and fruit as snacks
  • Avoid industrial and processed products as much as possible
  • Add a dash of vegetable oil to your dishes after cooking: walnut oil, rapeseed oil, linseed oil.

To go further: should we encourage the intake of betaine?

Betaine is a nitrogenous compound found in several plant and animal species. Its consumption could help treat certain liver diseases such as hepatic steatosis. For the moment, scientific studies have not been able to demonstrate any additional benefits. Betaine is found in whole grains, oatmeal, barley, quinoa, beets and spinach.

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