Transcription
If you've been told that you have fatty liver disease or NAFLD, the good news is is that it is reversible. And in this video, I'm going to break down the seven key steps that you can take to reverse your fatty liver disease ASAP without medications.
Now, I'm going to cover a variety of dietary adjustments here to basically help you lean out your liver, get the fat out of the liver, but I do have a calculator and food guide set up that covers of the majority of these dietary adjustments. So, I'd recommend you check that out. I'll put the link in the description.
Now one of the most important things at least that comes out of the research in terms of leaning out the liver getting the fat off the liver is actually losing body fat in general and basically what they show in the research is that there is a dose dependent association between weight reduction or fat reduction and a reduction of fat in the liver. So if you have a higher body fat percentage for men this is going to be greater than 20% for ladies going to be greater than 30%. I would look to take off that body fat percentage. So for men we want to be between 10 to 15% body fat and ladies around 20 to 30 or 20 to 25% body fat.
In the research the way that they have or set up the diets to lead to an adequate amount of body fat loss is through caloric reductions. Now, some of the the studies, some of the diets they set up are really extreme, but some of the more balanced ones kind of align with things that I've seen with clients where about a 20 to 25% caloric deficit actually leads to a significant loss of body fat. And you also see a loss in liver fat. And I've actually seen this with clients. I've had quite a few clients who they had initial ultrasound of their liver um and then the follow-up ultrasound after they lost significant amounts of weight saw a drop in the percentage of fat in liver the fatty liver score or they didn't have fatty liver at all anymore and that was something that we actually directly targeted. So weight loss by itself is a very potent stimulus to actually lose fat in the liver and reverse fatty liver altogether.
The next one with weight loss is we don't want to lose muscle tissue. You don't want to lose weight. You want to lose fat. If you're losing your lean muscle tissue in the long run, it'll actually be worse off. And this actually ties in pretty well with some of the strategies. The second strategy here to reverse fatty liver is making sure that you have adequate protein intake in your diet. So, there are studies in humans where they show that having a uh protein intake, I think it's about 30% of the total energy intake led to a 36 to 48% reduction in liver fat by 6 weeks. and they tested both uh plant proteins and animal proteins and they they still see the loss in liver fat. So an adequate protein intake, a higher protein intake can be quite helpful to actually lean out the liver. I typically shoot for 082 grams per pound per day if you are on the leaner side. So this for men if your body fat percent is less than 26% for ladies if you're less than 38%. But when you go over 26% as a man or over 38% as a woman, then I would shoot more for one gram per pound of lean body mass or else the protein target is going to be exceptionally high or excessively high for what you need to eat in a day.
Now the third component and this this kind of ties in with protein as well is there are certain protein sources that are very high in certain types of amino acids like the branch chain amino acids that have a beneficial effect on leaning out the liver. So, one of those is whey protein. And there was a study done in women for four weeks where they were given 60 grams of whey protein per day. And what they found was that the fat content of the liver had decreased by about 20%. So, if you use a a large portion of the protein that you're going to take to lean out the liver, if you make that whey protein, it can actually help to increase the loss of fat from the liver altogether. And also the way is quite easy to incorporate logistically and it's a great thing to aid in resistance training which we'll talk about in just a few minutes here.
The next one is fats. There's quite a bit to go through when you're looking at fatty acids because you have the three different types of fats and in the research are trying to delineate between saturated fats, monounsaturated fats and polyunsaturated fats. Now the saturated fats because of their structure they are processed a bit differently in the body and in particular at the liver. So if you overfeed in saturated fats in most of these studies there's like a very famous study um where basically they overfed people muffins like an extra thousand calories and they did it with saturated fat so it was like palm oil versus sunflower oil and they had more liver fat in the palm oil group and obviously in the bioenergetics doesn't line up well saturated fat is supposed to be better but essentially unsaturated fats so the more double bonds that are present it's a little bit easier to process they're processed a bit differently than the saturated fats and they take the pressure off the liver.
Now the problem is we have two unsaturated fat groups. We have polyunsaturated and we have monounsaturated. Inside the fatty liver studies, you basically get this perspective of the double hit or the dual hit hypothesis. So first you have fat accumulation and then you get oxidative stress uh buildup inside the liver or something that induces oxidative stress in the liver where it's not just fat buildup in the liver. Now the liver becomes inflamed and now you get hepatitis, sttoepatitis instead of just fatty liver, non-alcoholic fatty liver disease. Usually oxidative stress is the driver. So incorporating large amounts of polyunsaturated fatty acids in this circumstance isn't really ideal because they are very liable to oxidative stress. And in some of the animal studies when they feed the polyunsaturated fatty acids while they see changes in some of the liver fat composition what they wind up seeing is an increase in reactive lipid peroxides and markers of oxidative stress increase. So in this circumstance, we want to go for a middle- of the road option, which are going to be the monounsaturated fats. And the monounsaturated fats, they they are much more stable than polyunsaturated fats, but because they have that singular double bond in their structure, they don't create the same pressure on the liver that these saturated fats do. And there's actually a couple studies, there's actually human trials where they have incorporated monounsaturated fats. I think they they were basically like Mediterranean style studies where they used things like olive oil. And what they basically found is improvements in liver fat. So the liver fat actually decreased and there's an improvement in insulin sensitivity as well. So all in all, and this this was after a 12-week time frame, when you're dealing with fatty liver, I would shift away from some of the saturated fat sources. These are going to be your things like your butter, um the dairy fats in general, too much coconut fats, and some of the the palm kernel fats and shift more towards your macadamia nut, your olive oil, and components such as such as these so that you can take the pressure off the liver. And I would shy away from high amounts of polyunsaturated fats like you would see in your corn oil, your safflower oil, your sunflower oil, etc. because you have a high amount of the polyunsaturated fats which are more likely to create a lipid oxidation stress at the liver when it's already metabolically deranged.
Now the next component is how much is the total fat in your diet on a regular basis. And in some of the studies they do a lower fat diet. The way they defined it in these papers is less than 30% of calories. And I would actually run a higher monounsaturated fat diet that is less than 30% of calories. But I wouldn't go less than 20% of your caloric intake. If you go less than 20% of your caloric intake, you can run into issues with your libido. You can run into issues with your satiety, with your blood glucose regulation, potentially with your sleep at night and with your overall hormonal function. So, you don't want to dip your fat too low, but being between that 20 to 30% of caloric intake sweet spot, it can be quite helpful to take the pressure off the liver while also switching to the monounsaturated fats.
The next one is going to be your carbohydrates. And this one's actually quite important because in most of the studies when you're trying to create a fatty liver scenario, they tend to do a highfat, high sugar diet. So, it's a combination of the fat sources and the sugars together. Obviously, they're not using like, you know, oranges and bananas. They're using things like refined granulated sugar and added sugar products and components such as this on top of a normal rat chow which is some type of starchy component um maybe corn starch or or some other basic labbased starch like this. And typically when you feed high amounts of refined sugar in this very rapidly digestible form, it actually puts pressure on the liver. So what we don't want to do when we're setting up our diet is incorporate tons of highly refined sugar sources. And even in clients that I work with, I tend to issue fruit juice if I know fatty liver is present. And I go towards whole fruits. I go towards tubers. I incorporate things like rice, very easily digested carb sources, but that tend to have a higher glucose content than fructose content to take some of the pressure off the liver and at the same time don't have it in such a rapidly digestible form like granulated sugar, like honey, like maple syrup and definitely not uh sodas and and components like this. And essentially what they show there's even in papers just switching to people towards whole fruit you see a decrease in fat and liver fat percentage uh across the board and there's an Italian study where they show that 30% of people just switch to having whole oranges or incorporating whole oranges in their diet saw a decrease in um their stosis the the amount of fat in the liver. So we want to switch towards whole fruit sources. We want to switch towards tubers, rice, components like this. We want to avoid any rapidly digesting sugars and and sugars that we can get in a very refined form in very high amounts.
The next component, and this is extremely important, is going to be resistance training. And you'd be surprised how much resistance training actually is needed to make a difference. They actually define it in this study. And what they did was they took people and they put them in two different groups. One group did resistance training, one group just did stretching. And the resistance training that they had them do is basically if you go to your gym and they have those circuits where you have like a leg press, leg extension, leg curl, you basically just go through do the circuit and you cover the major muscle groups. And they did that for three sets for 8 to 12 repetitions. It basically wound up being about 40 minutes in the gym total. Now most people, they were prescribed to do this three times a week, but most people really only made it about two times per week. So just two times per week of training for about 40 minutes resistance training led to a significant decrease in liver fat percentage as well as visceral fat total fat and then the lean body mass also statistically significantly increased in this paper as well. So the resistance training plus the dietary adjustments can be a huge combination a synergistic combination to see a change in your overall liver fat percentage. And when I'm working with clients this is what I'm doing. I'll take a look at what they're eating in chronometer. I will go through and I'll start adjusting how much protein they have. I'll look at their total caloric intake. I'll set up that 20% deficit. I'll increase the protein sources. I'll incorporate things like whey protein if they tolerate that. I'll usually uh incorporate collagen with the whey protein. And then what I'll do is I'll shift their carb sources around and I'll shift their fat sources around to be mostly monounsaturated. I'll shift their carb source be whole food carb sources. And if they have fatty liver, I'll do more starches than sugars or kind of a mix of starch and sugars. So it's not all towards sugars. But the resistance training even twice a week plus the diet can make a huge difference and your the lab tests that you see your ALT, your AS or GGT, your alkaline phosphotase, as well as the body composition. And then the if you're diagnosing via ultrasound, the ultrasound scoring of the liver. And I've seen this with clients on a consistent basis, just putting these very basic lifestyle modifications in without even getting to supplements.
Now, the last piece that I want to talk about here is supplements. So, there are certain supplements that I tend to stack together. I don't really rely on one. Many of the papers rely on just one supplement in different animal models or in human models to see the benefit, but I typically combined a variety of supplements together. So some of the first ones I incorporate are the fats soluble vitamins. And the two major ones I incorporate here are going to be vitamin K and vitamin E. And there's direct studies in animal models using vitamin K to protect against fatty liver disease. So the dosage that they use when you convert it into a human equivalent dose about 016 milligrams per kilogram per day. So for somebody my size, a 90 kilogram man, that's about 1.4 milligrams of vitamin K2 MK4. And in the different animal models, they basically feed the animals highfat, high sugar diets. And the vitamin K almost completely protects them against the formation of fatty liver disease. This is an animal study. So is this going to do the exact same thing as in a human? No. But there's a lot more research coming out in vitamin K for even things like hpaticellular carcinoma or liver cancer. We're actually showing uh benefit uh and protection against uh recurrence of liver cancers and they're looking at to use this in fatty liver disease and other liver disease as well.
Now, for vitamin E, there's actually human studies with this. And they actually compared vitamin E to different diabetes medications and placebo, and they found that 800 IUs of vitamin E or have a 43% improvement in the liver fat content compared to placebo. And in the diabetes medication, it's poglutazzone. That that one went that only had a 34% um improvement. So the vitamin E had a more significant improvement or a higher level of improvement even than the medication. So the one thing to keep in mind with vitamin E and you'll see this talked about in a lot of the alternative spheres or even the doctors will talk about it is that there's some studies showing an association with vitamin E with total mortality. Now the thing to keep in mind with this is in the studies where they see it saw an increased risk of mortality. I think there's like prostate cancer or something like this as well. They usually use synthetic vitamin E um just in the alpha to go forall form and the dosage if you go higher than 400 IU per day is where you see the effect. Obviously the fatty liver dosage here is about 800 IU per day at least in this study. The thing is when you're looking to use vitamin E or at least at least when I'm looking to use vitamin E, I typically shoot for a vitamin E combination that has both alpha and gamma topherol at least in a 1:1 ratio if not in favor of gamma topherol because too much alpha topherol can actually deplete gamma topherol and then that can open you up to reactive nitrogen species stress. And I think part of this is why we see the effects in some of these studies, some of these more negative outcomes um because of the form that was used and because the balance was off. I also tend to incorporate tootryenols with that vitamin E. But essentially, you can incorporate the vitamin E to help minimize oxidative stress and decrease the liver fat content to reverse the fatty liver in conjunction with the vitamin K. The one thing I'll mention here though, vitamin E can have some blood thinning effects. So, it's important to watch out for that and be careful when using vitamin E at higher dosages.
Now some other components that are extremely helpful and I tend to use these all together to help reverse fatty liver is betane. So trimethly, choline and then a B complex vitamin. The reason I use them together is because they all work together. There's multiple different metabolic pathways where they all intersect. But essentially there's multiple animal studies where they incorporate betane. Um and they're even trying this in different human trials now. It's about two grams twice per day. So four grams total per day or eight grams total per day. I typically do about one to two grams twice a day. So usually two to four grams per day. And it basically helps the the liver process fats effectively. So you can incorporate betine very easy to get over the counter. There's not really much risk for it. The biggest thing is digestive side effects and components like this. And it will help the liver process the fatty acids quite a bit better and it's directly involved in the methylation cycle as well.
The next one is choline. Same deal. Choline is involved in helping the liver process fatty acids, package the fatty acids, and move them around the body. And so there are studies using choline. They were using phosphatidylcholine. Um they're using about 2 grams per day or 2400 milligrams per day. And they basically saw that using that for 12 weeks decreased liver fat and also improved the uh liver enzymes ALT and A. So I typically will dose choline, phosphotidylcholine, uh one gram with breakfast, one gram with dinner on top of the one to two grams with betane. We're doing that twice a day so that you're able to give your liver the resources it needs to actually process the fatty acids, export them effectively, and minimize the burden of having too much fats in in the liver. The other one is the B complex vitamins. Individually, there are some studies showing improvements with certain B complex vitamins like vitamin B6 and vitamin B1 and as well as vitamin B3. Now some of them are just in like pilot studies in humans. So we need some more data there. And other ones are in animal models, but generally the B complex vitamins are directly involved in the metabolism of both fats and carbohydrates. And in a lot of the fatty liver studies, you wind up seeing that people are low in a variety of different vitamins and minerals across the board. So repleting the B vitamins and backfilling those pathways can help take some of the pressure off the liver so it's able to take the fatty acids and convert them into energy effectively or to export them out of the liver to other tissues to be used effectively in conjunction with the betane and the choline. So I typically use a B complex usually just like a pure encapsulation. There's no affiliation but that's the one that I typically use the B complex plus. I incorporate that with the betane and choline. Usually just one capsule in the morning or half a capsule in the morning, half a capsule at night, so that the liver has all the resources it needs to process the fats effectively.
In that same vein, there's two other components that I typically incorporate to help the liver in processing fats. And those are glycine and torine. And there's multiple animal studies with torine where torine is actually added to the diet in a highfat, high sugar feeding. and it allows the animals to um avoid the development of fatty liver if the torine is present. I typically shoot for about three grams of torine per day. Um that's the dose that I find people tolerate. The biggest thing to keep in mind is if the torine dose gets too high, it can change bile acid composition and lead to some digestive issues. So keep an eye out for that. And when we're looking at something like glycine, the glycine target is actually pretty high. So there's a Spanish study where they basically found that for about a 70 kg human, you need about 10 grams of glycine per day. So it's about 0.15 to 0.2 grams per kilogram per day of glycine. So I usually shoot for that in the diet between food and between supplements to make sure that you have enough glycine for collagen synthesis, but also glycine can help take the pressure off the liver. And the other thing that's very interesting about glycine is that glycine can protect the liver from endotoxin. And in fatty liver disease, what we tend to see is microbiome dispiosis with a high amount of toxins produced from the bacteria in the gut in the gut called endotoxin. And that endotoxin impairs liver metabolism and drives the fatty deposition in the liver through the inflammatory signaling. And glycine can help to dampen that and lower that down. On top of the fact that glycine is able to effectively improve the metabolism uh of fats because it's involved in bile acid conjugation with torine. So it can help to export excess fats out of the liver and help to aid the detoxification pathways in the liver.
The next one is an acetylcysteine which is a co-actor for glutathione synthesis. Now glutathione is the major antioxidant in the body and it's made of glutamate, glycine and cyine. You're taking glycine. If you add cyine with the glycine and even in older adults adult adults there's studies looking at this and what you find is that between glycine and cysteine together you can boost glutathione status in children they've tested this was a randomized double blind placebo control trial. They tested NAC it was about 600 milligrams twice a day or 1,200 milligrams twice a day and they saw an improvement in glutathione. They saw decreases in liver enzymes, improvement in glucose metabolism as well as improvement in insulin sensitivity. So overall, you can incorporate the NAC plus the glycine together with the torine and other components to improve the antioxidant function of the liver and help the liver to process those fats effectively and decrease its overall oxidative stress.
Now the last one, psyllium goes with this because the psyllium induces some of the enzymes in the liver that are involved with the production of glutathione and the upregulating or upregulation of antioxidant defense. So you're basically providing the NAC and the glycine to produce the glutathione and then you have the psyllium coming in to stimulate that glutathione production and stimulate antioxidant defense. So they synergize together on top of having adequate vitamin E which directly lowers the oxidative stress and then improving metabolic function with the choline with the betane and with the B complex vitamins. So you're trying to hit it from multiple angles on top of taking the pressure off the liver with the diet and with the resistance training. I wouldn't think of these things as doing one thing by itself. I think of doing all of these things together helps to protect the liver from multiple different angles and take the pressure off in multiple different angles while supplying appropriate nutrients so that the liver can clear out the fat effectively, minimize the oxidative stress and decrease the damage to itself over the long term.
So, these are the strategies that I typically recommend to reverse fatty liver. I've seen multiple clients incorporate these. Usually, it takes a couple weeks to a couple months depending on how much weight the person has to lose and how much liver fat they have. But if this is done on a consistent basis, you can expect the liver enzymes ALT, A and GGTT to come back to normal. And you can also see a change if you do follow-up ultrasound where the liver fat has decreased significantly. So these would be the strategies I incorporate. I recommend you try them out. Let me know how it goes in the com in the comment section. And if you want to learn more about how I set up the diet in terms of the the caloric restriction piece so that you don't damage your hormones or you don't impact your lean muscle tissue, I recommend that you check out this video here.